The eruption of a baby’s first teeth is an exciting milestone for parents. These tiny pearly whites not only contribute to a child’s adorable smile but also play a crucial role in their ability to chew, speak, and develop proper oral habits.
However, when baby teeth fail to emerge on time, parents often find themselves wondering if something is wrong. While some variations in the timing of teething are normal, significant delays may require medical attention.
This article explores when to worry about baby teeth not coming in and what parents can do about it.
Typical Timeline for Baby Teeth Eruption
On average, a baby’s first tooth appears between 4 and 12 months of age. The two lower central incisors (bottom front teeth) usually emerge first, followed by the upper central incisors.
By the age of three, most children will have a full set of 20 primary teeth.
Below is a general timeline:
4 to 7 months: First teeth (lower central incisors) begin to emerge.
8 to 12 months: Upper central incisors come in.
9 to 16 months: Lateral incisors (beside the central ones) appear.
13 to 19 months: First molars emerge.
16 to 23 months: Canines (pointed teeth) start coming in.
23 to 33 months: Second molars complete the set.
While this timeline provides a general guideline, some children may experience delays.
In many cases, a slight delay is normal and not a cause for concern.
However, prolonged delays may indicate underlying issues.
When to Be Concerned About Delayed Teething
Teething delays can sometimes be a normal variation, but parents should be attentive to significant delays.
Consider consulting a pediatrician or pediatric dentist if:
1. No Teeth by 12-15 Months
If a baby has not cut their first tooth by 12 to 15 months, it is worth discussing with a healthcare provider.
While some late bloomers catch up, it’s essential to rule out any underlying issues.
2. No Teeth by 18 Months
At 18 months, if there are still no signs of teeth emerging, a dentist may recommend an evaluation to check for possible developmental concerns.
3. Family History of Late Teething
If parents or siblings had significantly delayed teething, there might be a genetic component at play. While this may not be an issue on its own, discussing it with a pediatric dentist can provide reassurance.
4. Signs of an Underlying Health Issue
Delayed teething can sometimes be linked to medical conditions such as:
Hypothyroidism: An underactive thyroid gland can slow down many developmental processes, including tooth eruption.
Nutritional Deficiencies: Lack of vitamin D, calcium, or phosphorus may affect bone and tooth development.
Genetic Disorders: Conditions such as Down syndrome or ectodermal dysplasia can affect tooth formation.
Celiac Disease: Poor nutrient absorption due to gluten intolerance can impact tooth development.
Rickets: A condition caused by severe vitamin D deficiency leading to soft and weak bones, which can affect teething.
Anemia: Low iron levels can impact overall development, including tooth eruption.
5. Concerns About Jaw Development
If delayed teething is accompanied by issues with jaw growth or abnormal gum structure, an evaluation is necessary to ensure normal development.
What Causes Delayed Teething?
Several factors can contribute to delayed teething, including:
1. Genetics
A family history of late teething can mean a baby will also experience a delay. If parents or older siblings got their teeth late, it’s likely the baby will too.
2. Premature Birth or Low Birth Weight
Babies born prematurely or with low birth weight may experience delayed teething due to underdeveloped systems at birth.
3. Poor Nutrition
A lack of essential nutrients, particularly calcium, vitamin D, and phosphorus, can delay tooth eruption. Proper nutrition during infancy supports healthy bone and dental development.
4. Hormonal Imbalances
Conditions like hypothyroidism can affect growth, metabolism, and teething patterns. If other developmental delays are present, a doctor may recommend testing for hormonal imbalances.
5. Medical Conditions
Certain congenital conditions, such as Down syndrome or ectodermal dysplasia, can affect the formation and eruption of teeth. Children with these conditions should be monitored by a specialist.
6. Oral Obstructions or Gum Overgrowth
In rare cases, there may be physical barriers preventing teeth from erupting, such as gum overgrowth or cysts within the gums.
7. Excessive Fluoride Exposure
While fluoride is beneficial for dental health, excessive exposure can cause dental fluorosis, which may contribute to delayed eruption in some cases.
What Parents Can Do
While it’s natural to worry when a baby’s teeth do not appear on schedule, there are steps parents can take:
1. Be Patient
Every child develops at their own pace. If there are no other health concerns, waiting a little longer may be the best approach.
2. Maintain a Nutrient-Rich Diet
Ensure the baby is getting adequate calcium and vitamin D, either through breast milk, formula, or solid foods once introduced. Sunlight exposure also helps with vitamin D production.
3. Regular Dental Checkups
The American Academy of Pediatric Dentistry recommends a child’s first dental visit by their first birthday or within six months of their first tooth appearing. If a baby has no teeth by 12-15 months, an early checkup can help assess potential concerns.
4. Look for Other Developmental Delays
If delayed teething is accompanied by other developmental delays, consult a pediatrician to rule out underlying health issues.
5. Encourage Gum Stimulation
Letting babies chew on safe teething toys or gently massaging their gums may encourage tooth eruption.
6. Avoid Unverified Remedies
Some parents try home remedies or over-the-counter products to “speed up” teething. However, these can be unsafe or ineffective. Always consult a healthcare professional before using any treatments.
7. Monitor for Other Symptoms
If teething delays are accompanied by symptoms like chronic fatigue, slow weight gain, brittle bones, or digestive issues, further medical evaluation may be necessary.
When to See a Dentist or Doctor
While mild delays are often not a concern, it’s important to see a dentist or doctor if:
No teeth have erupted by 12-15 months.
No signs of teething are present by 18 months.
The child shows difficulty chewing or signs of pain.
There are abnormalities in the gums or jaw.
The baby has other developmental delays.
The child experiences frequent illness or poor growth.
Final Thoughts
Delayed teething can cause anxiety for parents, but in most cases, it is not a major health concern.
Genetics, birth factors, nutrition, and medical conditions all play a role in determining when baby teeth emerge.
Monitoring a child’s development, ensuring they receive proper nutrition, and scheduling regular dental visits can help address concerns early.
If a child has not developed any teeth by 18 months, seeking professional evaluation is recommended to rule out underlying issues.
Remember, every child is different, and patience, along with expert guidance, can ensure the best outcome for your little one’s oral health.
