GPAtlas🧭 When to suspect
Teething is the normal eruption of the primary (milk) teeth through the gums, and it is fundamentally a clinical diagnosis of exclusion.
• Most infants are affected between 6 and 24 months, with symptoms clustering in the few days around each tooth breaking through.
• The genuine features are mild and localised: drooling, gum-rubbing, a desire to bite and chew, irritability, disturbed sleep, a flushed cheek, and a drool rash on the chin.
Teething does not cause significant illness.
• A high fever (≥38°C), diarrhoea, vomiting or a productive cough must never be attributed to teething until other causes – otitis media, UTI, lower respiratory infection and meningitis – have been considered and excluded.
• In practice: recognise the benign pattern, and never miss the unwell child hiding behind a teething label.
| Tooth | Typical age of eruption |
|---|---|
| Central incisors (front teeth) | Around 6 months – usually the first to appear |
| Lateral incisors | Around 8 months |
| First molars (back teeth) | Around 12 months |
| Canines | Around 18 months |
| Second molars | Around 24 months |
Bottom teeth usually erupt before the matching upper teeth.
• Most children have all 20 milk teeth by 2–3 years.
• Timing varies widely – some infants teethe before 4 months and a few not until after 12 months.
• Occasionally a baby is born with a tooth.
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