Medical Conditions

Baby Teeth Coming in Wrong Order

Content reviewed against published AAPD, AAP, NIH guidelines

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If your baby has been diagnosed with or you suspect baby teeth coming in wrong order, here is what the evidence says.

The short answer

While there is a typical order for baby teeth eruption, with lower central incisors usually appearing first, it is completely normal for teeth to come in a different order. Variations in teething sequence are common and almost never indicate a developmental problem. What matters is that all 20 primary teeth eventually come in by about age 3.

Key takeaways

  • While there is a typical order for baby teeth eruption, with lower central incisors usually appearing first, it is completely normal for teeth to come in a different order. Variations in teething sequence are common and almost never indicate a developmental problem. What matters is that all 20 primary teeth eventually come in by about age 3.
  • Usually normal when: Your baby gets an upper tooth before a lower tooth, or lateral incisors before central incisors
  • Call your doctor if: Your child has no teeth by 18 months, which may warrant evaluation for conditions like hypodontia or ectodermal dysplasia
  • Varies by age — see the age-by-age breakdown below
“Fever itself is not an illness — rather, it is a sign or symptom that the body is fighting an infection. Fever stimulates certain defenses, such as the white blood cells, which attack and destroy invading bacteria.”
— Fever and Your Child, American Academy of Pediatrics (AAP)

Parents everywhere have the same worry. You are doing the right thing by looking into it.

By Age

What to expect by age

0-3 months

Most babies do not have teeth yet at this age. Rare cases of natal teeth (born with teeth) or neonatal teeth (erupting within the first month) do occur and should be evaluated by a dentist, but these are not related to eruption order concerns.

3-6 months

Some babies begin teething during this period. The typical first teeth are the lower central incisors, but some babies may get an upper tooth first or a lateral incisor before a central incisor. This is a normal variation and does not require intervention.

6-12 months

This is the most active teething period for many babies. The standard sequence is lower central incisors, upper central incisors, then upper and lower lateral incisors. However, variations are common. Some babies may get their upper teeth first or even get their first molars before completing their incisors.

12 months+

Between 12 and 33 months, the remaining baby teeth typically come in, including canines and molars. As long as teeth are erupting and your child has regular dental visits, an atypical order is rarely a concern. If teeth are significantly delayed overall (no teeth by 18 months), discuss this with your pediatric dentist.

What Should You Do?

When to take action

Probably normal when...
  • Your baby gets an upper tooth before a lower tooth, or lateral incisors before central incisors
  • Teeth come in one at a time rather than in pairs
  • One side erupts before the matching tooth on the other side
  • Your baby is teething later than friends' babies but teeth are still appearing
Mention at your next visit when...
  • Your baby has no teeth by 12 months of age
  • Teeth appear significantly misshapen, discolored, or unusually small
  • Your baby seems to have gaps where teeth should have appeared long ago based on the expected timeline
Act now when...
  • Your child has no teeth by 18 months, which may warrant evaluation for conditions like hypodontia or ectodermal dysplasia
  • A tooth erupts and appears severely malformed, dark, or the gum around it is very swollen and red, which could indicate an underlying issue

Doctor Visit Checklist

Bring this checklist to your next pediatrician visit to discuss Baby Teeth Coming in Wrong Order.

Things to mention

  • Your baby has no teeth by 12 months of age
  • Teeth appear significantly misshapen, discolored, or unusually small
  • Your baby seems to have gaps where teeth should have appeared long ago based on the expected timeline

Observations to share

  • Your baby has no teeth by 12 months of age
  • Teeth appear significantly misshapen, discolored, or unusually small
  • Your baby seems to have gaps where teeth should have appeared long ago based on the expected timeline

Urgent signs to report immediately

  • Your child has no teeth by 18 months, which may warrant evaluation for conditions like hypodontia or ectodermal dysplasia
  • A tooth erupts and appears severely malformed, dark, or the gum around it is very swollen and red, which could indicate an underlying issue

My notes

From ismybabyalright.com — free, evidence-based baby health guides

Milestone

Month-by-Month Development

Detailed monthly development guides from birth through 24 months.

Guide

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 coming in wrong order normal?
While there is a typical order for baby teeth eruption, with lower central incisors usually appearing first, it is completely normal for teeth to come in a different order. Variations in teething sequence are common and almost never indicate a developmental problem. What matters is that all 20 primary teeth eventually come in by about age 3.
When should I call the doctor about baby teeth coming in wrong order?
Your child has no teeth by 18 months, which may warrant evaluation for conditions like hypodontia or ectodermal dysplasia A tooth erupts and appears severely malformed, dark, or the gum around it is very swollen and red, which could indicate an underlying issue
When is baby teeth coming in wrong order normal?
Your baby gets an upper tooth before a lower tooth, or lateral incisors before central incisors Teeth come in one at a time rather than in pairs One side erupts before the matching tooth on the other side
What causes baby teeth coming in wrong order?
While there is a typical order for baby teeth eruption, with lower central incisors usually appearing first, it is completely normal for teeth to come in a different order. Variations in teething sequence are common and almost never indicate a developmental problem. What matters is that all 20 primary teeth eventually come in by about age 3. Common explanations include: Your baby gets an upper tooth before a lower tooth, or lateral incisors before central incisors. Teeth come in one at a time rather than in pairs.
What should I mention to my pediatrician about baby teeth coming in wrong order?
You should mention baby teeth coming in wrong order at your next visit if: Your baby has no teeth by 12 months of age. Teeth appear significantly misshapen, discolored, or unusually small. Your baby seems to have gaps where teeth should have appeared long ago based on the expected timeline.
Is baby teeth coming in wrong order normal at 0-3 months?
Most babies do not have teeth yet at this age. Rare cases of natal teeth (born with teeth) or neonatal teeth (erupting within the first month) do occur and should be evaluated by a dentist, but these are not related to eruption order concerns.
Is baby teeth coming in wrong order normal at 3-6 months?
Some babies begin teething during this period. The typical first teeth are the lower central incisors, but some babies may get an upper tooth first or a lateral incisor before a central incisor. This is a normal variation and does not require intervention.
Should I go to the ER for baby teeth coming in wrong order?
Seek emergency care if your child has no teeth by 18 months, which may warrant evaluation for conditions like hypodontia or ectodermal dysplasia, or if a tooth erupts and appears severely malformed, dark, or the gum around it is very swollen and red, which could indicate an underlying issue. When in doubt, call your pediatrician's after-hours line for guidance.
Does baby teeth coming in wrong order go away on its own?
In many cases, baby teeth coming in wrong order resolves on its own, especially when your baby gets an upper tooth before a lower tooth, or lateral incisors before central incisors. By 12 months+, between 12 and 33 months, the remaining baby teeth typically come in, including canines and molars. As long as teeth are erupting and your child has regular dental visits, an atypical order is rarely a concern. If teeth are significantly delayed overall (no teeth by 18 months), discuss this with your pediatric dentist.
AAPDAAPNIH

References

  1. [1]American Academy of Pediatric Dentistry. Guideline on Management of the Developing Dentition and Occlusion in Pediatric Dentistry. AAPD
  2. [2]American Academy of Pediatrics. Baby's First Teeth. HealthyChildren.org. AAP
  3. [3]National Library of Medicine. Chronology of primary tooth eruption in children: a review. Journal of Clinical and Experimental Dentistry. NIH

All content follows our editorial policy and is reviewed against published clinical guidelines.

2,705 evidence-based guides6 authoritative medical sources

Related Resources

Teething GuideWell-Baby Visit PrepBaby Tracker

Bottom line

Most cases of baby teeth coming in wrong order are normal. Talk to your pediatrician if your child has no teeth by 18 months, which may warrant evaluation for conditions like hypodontia or ectodermal dysplasia.

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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