Baby Teeth Not Coming In or Coming In Out of Order
Medically reviewed by Dr. Sarah Chen, MD, FAAP · Board-Certified Pediatrician
Content reviewed against published AAP, AAP, AAPD guidelines
Last reviewed:
Your baby's physical development is unique, and concerns about baby teeth not coming in or coming in out of order, here is what you need to know.
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.
Key takeaways
- 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.
- Usually normal when: Teeth arriving in any order, not just the "textbook" pattern
- Call your doctor if: A baby tooth is very loose or falls out in a child under 4 (this is premature and could indicate underlying issues)
- Varies by age — see the age-by-age breakdown below
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What Parents Should Know
According to AAP, AAPD guidelines, 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. At 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. It is generally considered normal when teeth arriving in any order, not just the "textbook" pattern. However, you should contact your pediatrician promptly if a baby tooth is very loose or falls out in a child under 4 (this is premature and could indicate underlying issues).
Normal vs. Concerning
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 to Tell Your Pediatrician
- Describe when you first noticed baby teeth not coming in or coming in out of order and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if no teeth at all by 15-18 months.
- Mention if your child has fewer than 4 teeth by 18 months.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
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
What You Can Do at Home
- Keep track of when you notice baby teeth not coming in or coming in out of order — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that teeth arriving in any order, not just the "textbook" pattern — this is generally within the range of normal.
- At 0-6 months, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Provide plenty of supervised floor time and tummy time to support your baby's physical development.
- While monitoring at home, seek immediate care if a baby tooth is very loose or falls out in a child under 4 (this is premature and could indicate underlying issues).
Related Conditions
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.
Related Resources
Milestone Checklists by Age
Track your baby's developmental milestones from birth to 5 years with age-specific checklists.
Month-by-Month Development
Detailed monthly development guides from birth through 24 months.
When to Call the Doctor
General guide on when to call the pediatrician, visit urgent care, or go to the ER.
Frequently asked questions
Is baby teeth not coming in or coming in out of order normal?
When should I call the doctor about baby teeth not coming in or coming in out of order?
When is baby teeth not coming in or coming in out of order normal?
What causes baby teeth not coming in or coming in out of order?
What should I mention to my pediatrician about baby teeth not coming in or coming in out of order?
Is baby teeth not coming in or coming in out of order normal at 0-6 months?
Is baby teeth not coming in or coming in out of order normal at 6-12 months?
Should I go to the ER for baby teeth not coming in or coming in out of order?
Does baby teeth not coming in or coming in out of order go away on its own?
References
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Baby Teeth Not Coming In or Coming In Out of Order.
Things to mention
- Describe when you first noticed baby teeth not coming in or coming in out of order and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if no teeth at all by 15-18 months.
- Mention if your child has fewer than 4 teeth by 18 months.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- 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
Urgent signs to report immediately
- 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
My notes
From ismybabyalright.com — free, evidence-based baby health guides
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members
Related Resources
Bottom line
Most cases of baby teeth not coming in or coming in out of order are normal. Talk to your pediatrician if a baby tooth is very loose or falls out in a child under 4 (this is premature and could indicate underlying issues).
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
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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.
Should I Use Adjusted Age for My Preemie's Milestones?
Yes — for premature babies, developmental milestones should be assessed using adjusted (corrected) age, not chronological age, until at least 2 years of age. Adjusted age is calculated by subtracting the number of weeks your baby was born early from their actual age. For example, a 6-month-old born 2 months early would have an adjusted age of 4 months, and should be assessed against 4-month milestones. Most pediatricians use adjusted age for developmental assessment through age 2-3, and for growth charts through age 2.
Baby-Proofing a Small Apartment
Baby-proofing a small apartment is absolutely possible and focuses on the same key safety principles as any home: securing furniture to walls, covering outlets, locking cabinets with hazardous materials, and ensuring safe sleep spaces. Small spaces actually have an advantage - there is less area to monitor. Focus on eliminating the most dangerous hazards first: falls, poisoning, choking, and burns.
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.