Early Vs. Late Teething: When Should Parents Be Concerned?

Call me strange, but I found it adorable during my son's baby years when I'd see him with a stream of drool running down the front of his shirt. Each time I witnessed it, I knew he had a tooth growing in. Slightly less adorable was the crying that came with the teething phase, but even then, I enjoyed the moments of connection that came with soothing. However, if I had to relive teething as a mom, there is one thing I'd do differently — I'd resist the urge to collect data from other parents and compare his journey with other babies. Experts advise parents not to stress about early or late teething, and note that the number of teeth (and pace of growth) varies greatly in children through the first year.

"I have seen babies born with a tooth, and I have also seen healthy and happy 10-month-olds without any teeth at all," said Dr. Lucienne Pino, pediatric dentist and clinical director at Philadelphia-based Kid Smiles. "Both cases are quite common and completely normal." If a baby still has no teeth by 18 months of age, Pino recommends that parents contact their family dentist. Teething that begins past 18 months is known as delayed tooth eruption, which can be caused by premature birth, low birth weight, nutritional deficiencies, or genetics. "Rare hormonal conditions such as hypothyroidism can be a cause of a delay as well," Pino said. "Early teething is most likely due to genetic factors." In most cases, early and late teething don't pose a detriment to the child's overall health, she said.

According to Dr. Lucienne Pino, the bottom front teeth are usually the first to erupt, and most children have their full set of baby teeth (20 total) by the time they turn 3. As teeth erupt, parents should look out for discoloration – which can be a sign of enamel issues — and teeth that come in out of order (especially if paired with large spaces between teeth or if your toddler has trouble eating). If there is pain or swelling without teeth emerging, parents should contact their child's dentist for further evaluation.

"Generally, there is nothing parents can or should do to try to speed up or slow down their child's teething," Pino said. Rather than seeking to impact growth pace, Pino said parents should focus on proper dental health and hygiene at home by wiping their baby's gums after each feeding with a damp cloth and brushing gently with an infant toothbrush as soon as the first tooth arrives. Parents should also follow guidance from their healthcare provider to ensure proper nutrition to support their baby's overall growth — including their teeth. Some studies have linked malnutrition in a child's first year to a greater risk for dental issues later. "Visiting your child's dentist regularly is the best step for parents to ensure healthy and happy smiles," Pino notes.