Baby Teeth Not Coming In or Coming In Out of Order
The short answer
The "typical" tooth eruption order (bottom front teeth first around 6 months, then top front teeth) is just an average - many babies get their teeth in a different order, and this is completely normal. Some babies get top teeth first, molars before incisors, or teeth in a seemingly random pattern. The order of tooth eruption does not affect dental health or the eventual position of permanent teeth. Spacing between baby teeth is actually a good sign, as it leaves room for larger permanent teeth.
Parents everywhere have the same worry. You are doing the right thing by looking into it.
By Age
What to expect by age
0-6 months
Most babies have no teeth at birth, though some are born with one or two natal teeth. The first tooth typically appears around 6 months, but there is wide normal variation from 4-15 months. Some babies show teething signs (drooling, chewing, fussiness) weeks before a tooth appears. The absence of teeth at 6 months is completely normal and does not indicate any problem.
6-12 months
The typical pattern is bottom central incisors first, then top central incisors, but your baby may get teeth in any order. Getting teeth on one side before the other, or getting lateral incisors before central incisors, are all normal variations. Teeth sometimes appear with spaces between them, which is healthy and expected in baby teeth. By 12 months, most babies have 2-4 teeth, but having more or fewer is not concerning.
1-3 years
By age 3, most children have all 20 baby teeth. If your child has significantly fewer teeth than expected by age 2-2.5, your pediatrician or dentist may want to evaluate. Teeth coming in crooked or overlapping in toddlers does not predict how permanent teeth will come in. The first dental visit is recommended by age 1 or within 6 months of the first tooth.
What Should You Do?
When to take action
- Teeth arriving in any order, not just the "textbook" pattern
- No teeth at all until 10-12 months or even later
- Gaps and spacing between baby teeth (actually desirable)
- Teeth arriving one at a time or several at once
- Teeth that appear slightly crooked or rotated initially
- No teeth at all by 15-18 months
- Your child has fewer than 4 teeth by 18 months
- Teeth appear discolored, pitted, or malformed when they come in
- A tooth comes in and then seems to disappear or dissolve
- A baby tooth is very loose or falls out in a child under 4 (this is premature and could indicate underlying issues)
- An erupting tooth is causing significant bleeding or a large cyst on the gum
- Your baby was born with teeth and they are very loose and at risk of being swallowed
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
Worrying about your baby means you care. That is a good thing.
Related Physical Concerns
My Baby's Teeth Aren't Coming In
The first tooth typically appears around 6 months, but the normal range is enormous - some babies are born with teeth, and others don't get their first tooth until 12-14 months. Late teething is almost always a normal variation and very rarely indicates a problem. If your baby has no teeth by 18 months, your pediatrician or dentist can take a look.
Baby Born with Teeth - Natal Teeth
Natal teeth (teeth present at birth) occur in about 1 in 2,000-3,000 births. In most cases, these are actual primary (baby) teeth that erupted early, not extra teeth. Most natal teeth are the lower front incisors. While natal teeth can sometimes cause breastfeeding difficulties or have a risk of becoming loose and being a choking hazard, many can be left in place and monitored. The decision to keep or remove a natal tooth depends on how firmly it is attached and whether it is causing problems.
My Baby Grinds Their Teeth
Teeth grinding (bruxism) is surprisingly common in babies and toddlers, affecting up to 30% of young children. Most children grind their teeth as they explore their new teeth or self-soothe, and the vast majority outgrow it completely by age 6 with no lasting damage to their teeth.
My Baby Seems to Use One Side More Than the Other
Babies should use both sides of their body fairly equally during the first 18 months of life. While slight preferences can be normal, a consistent pattern of favoring one side - using one arm much more than the other, crawling with one leg dragging, or turning the head predominantly one way - should always be discussed with your pediatrician. Early identification of asymmetry leads to the best outcomes.
My Baby Only Army Crawls
Army crawling (also called commando crawling) is a completely valid and normal way for babies to move. Many babies army crawl for weeks or even months before transitioning to hands-and-knees crawling, and some skip hands-and-knees crawling entirely. What matters is that your baby is independently mobile and exploring their environment.
One Side of My Baby's Body Moves Differently
Babies should generally use both sides of their body equally. If one side consistently moves differently, is weaker, stiffer, or less coordinated, this warrants evaluation. Asymmetric movement can indicate hemiplegia (cerebral palsy affecting one side), brachial plexus injury, or other neurological conditions that benefit from early therapy.