Do baby teeth always come in pairs?

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You wait, you peek, you might even poke. You get through some fitful nights with your unusually fussy baby ... and ta-da! That first teeny-tiny baby tooth appears. But once those little pearly whites start popping up, then what? 

Baby teeth, also called primary or deciduous teeth, are temporary placeholders for the permanent set, but they play an important role in your child's development. Here’s what you should know about your baby’s first tooth and baby teeth eruption.

What age do babies get teeth?

When it comes to baby teeth eruption, there’s a wide range of normal. The average first baby tooth erupts at 6 or 7 months, but first teeth may emerge at around 12 months old (or even later). And some babies cut their first teeth very early, at around 3 or 4 months old.

It’s hard to predict exactly when your baby’s teeth will arrive. Your baby might experience teething symptoms for months before the first tooth erupts, or he may have virtually no noticeable symptoms at all. 

Baby teeth chart and order of tooth appearance

For many babies, the bottom front teeth (also known as lower central incisors) appear first, at around 6 to 10 months. It’s also normal for the top front teeth (or upper central incisors) to come in on the same schedule, at around 8 to 12 months.

A baby’s first teeth tend to hurt the most, as do molars (simply because they’re bigger). But most babies get used to the pain of baby teeth eruption and aren’t too bothered later on.

Here’s a typical baby teeth timeline, so you know when to be on the lookout for baby teeth eruption:

• Lower central incisor: Erupts 6-10 months
• Upper central incisor: Erupts 8-12 months
• Upper lateral incisor: Erupts 9-13 months
• Lower lateral incisor: Erupts 10-16 months
• Upper first molar: Erupts 13-19 months
• Lower first molar: Erupts 14-18 months
• Upper canine or cuspid: Erupts 16-22 months
• Lower canine or cuspid: Erupts 17-23 months
• Lower second molar: Erupts 23-31 months
• Upper second molar: Erupts 25-33 months

How many teeth should babies and kids have?

By the time they're 1 year old, most kids have between two and four teeth. Baby teeth eruption continues until about age 2 1/2, at which point most children have their full set of 20 primary teeth. 

Despite being called “baby teeth,” these tiny chompers stay put well past the baby years. The first baby tooth will typically fall out to make room for your child’s permanent choppers when he’s about 6 or 7 years old. The last of his primary teeth won’t be replaced by permanent teeth until around age 12, although some kids don’t get all of their 32 permanent teeth until they’re 21. 

It’s actually even relatively common to keep baby teeth for longer and possibly for life. These “retained primary teeth” usually occur when there isn’t a permanent successor, although sometimes it’s simply because a permanent tooth doesn’t grow in.

If your child has a retained primary tooth, his dentist may recommend removal of the baby tooth or other orthodontic procedures.

Do babies need their teeth to chew?

Baby’s first teeth are used for biting on food (and crib rails, and crib guards, and toys, and fingers) instead of chewing, which starts when molars come in during year 2.

Until then, babies primarily use their gums to mash food.

How do I care for my baby’s first teeth?

Just because they’re not permanent doesn’t mean they’re not important. To prevent cavities and keep baby's teeth healthy, abide by the following baby teeth care tips:

• Brush baby's teeth regularly. Make sure to brush your baby’s teeth twice a day as soon as the first tooth pokes through. A playful baby toothbrush makes the job more fun. Both manual toothbrushes and electric toothbrushes for kids do the job well, so choose whatever option your little one seems to prefer. Make sure the toothbrush has real bristles rather than rubber bristles, which work well for massaging gums but not for brushing teeth.
• Serve up low-sugar foods and drinks. Sugary foods, especially potentially sneaky ones like processed foods and fruit juice, are thought to be the reason nearly a quarter of toddlers have cavities. Babies under 1 should have no juice whatsoever and if you must give your toddler the sweet drink, limit it to 4 ounces of 100 percent fruit juice per day. Also skip the sugar-sweetened beverages and always read food labels.
• Be cautious with bottles. To help prevent tooth decay, avoid serving juice in a bottle. You also shouldn’t put your baby to bed with a bottle of breast milk or formula, as sugars can still eat away at teeth. After nursing or bottle-feeding, you should either brush your baby's teeth or wipe them with a wet gauze or washcloth.
• Use a plain pacifier. Never dip it in honey (which can cause infant botulism) or sugar.
• Avoid sharing spoons or other utensils. That way any bad bacteria that’s in your mouth (or a sibling’s mouth) can't spread in your baby’s mouth and cause decay. 
• Visit the dentist. Schedule your baby’s first dentist appointment by the time he gets his first tooth or turns 1 year old, whichever comes first. 
• Use fluoride toothpaste. Pediatricians and dentists once recommended that you not start your baby on fluoride toothpaste until he could spit it out, around age 3 or 4. But the American Academy of Pediatrics (AAP) now recommends starting babies on a tiny smear of fluoride toothpaste (about the size of a grain of rice) once they cut their first teeth, and gradually working them up to a pea-sized amount when they can spit it out well, around age 2 to 3.

Does your baby need fluoride supplements?

There may be no need to give your child a fluoride supplement, but check with your pediatrician to be sure.

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