The initial development of primary (baby) teeth begins during the second trimester of pregnancy, typically between weeks 16 and 20. During this vital period, pregnant mothers should prioritize a healthy, nutritious diet to support the proper development of their baby's bones and soft tissues.

While the exact timing of tooth eruption can vary from child to child, primary teeth usually start to appear around six to eight months of age. By the time a child is three years old, they will typically have a full set of twenty primary teeth.

The American Academy of Pediatric Dentistry (AAPD) recommends scheduling a child's first "well-baby" dental visit around the age of twelve months (or six months after the first tooth emerges). This early visit helps the child become comfortable with the dental environment, allows the pediatric dentist to track their oral development, and provides a valuable opportunity for parents to ask questions.

Which teeth emerge first?

Generally, teeth emerge in pairs, starting at the front of the mouth.

Around 6-10 months: The two lower central incisors are usually the first to erupt. Once these adjacent teeth appear, it's time to start flossing to prevent cavities from forming between them.
Around 8-12 months: The two upper central incisors typically emerge next (sometimes at the same time as the lower ones). Teething can be a source of discomfort for babies, and clean, chilled teething rings or a cool, damp cloth can provide relief.
Around 9-16 months: The upper lateral incisors (next to the central incisors) usually emerge around this time, followed closely by the lower lateral incisors. This means the baby will have four front teeth on both the top and bottom. Pediatric dentists advise that sippy cup use should ideally be discontinued by 14 months to minimize the risk of "baby bottle tooth decay."
Around 13-23 months: Eight more teeth will emerge during this period. On each arch, a cuspid (canine) tooth will appear next to each lateral incisor. Immediately behind these (towards the back of the mouth), the first molars will emerge on both sides of the canine teeth in both jaws.
By around 33 months: Finally, the second set of molars will emerge on each arch, usually starting on the lower arch. Most children will have their full set of twenty primary teeth by this age. Pediatric dentists often apply dental sealants to the chewing surfaces of molars to protect them from food, bacteria, and enamel-eroding acids.

How can I reduce the risk of early caries (cavities)?

Primary teeth are essential for maintaining space for permanent teeth and guiding their proper alignment. They also play a vital role in speech development, prevent improper tongue positioning, and are necessary for chewing food. Therefore, proper care of your child's emerging teeth is crucial.

Here are some helpful tips:

Brush twice a day: The AAPD recommends using a smear-sized amount of ADA-approved non-fluoridated toothpaste for children under two years old, and a pea-sized amount of ADA-approved fluoridated toothpaste for children over this age. Use a soft-bristled toothbrush designed for infants.
Begin flossing when teeth touch: Even though it can be tricky, flossing should start as soon as two adjacent teeth emerge. Your pediatric dentist can show you the best flossing techniques for infants.
Encourage a balanced diet: Sugars and starches provide food for oral bacteria, which produce harmful acids that attack tooth enamel. Make sure your child eats a balanced diet and limit sugary and starchy snacks.
Lead by example: Children who see their parents brushing and flossing regularly are more likely to adopt these habits themselves. Explain the importance of oral hygiene in a way your child can understand (age-appropriate books can be helpful).
Schedule regular dental checkups: Your pediatric dentist will monitor your child's oral development, provide professional cleanings, apply topical fluoride to strengthen teeth, and seal molars for protection. Regular visits can help prevent many painful dental problems later.

If you have any questions or concerns about your child’s teething or early dental care, please contact your pediatric dentist.