Delayed teething

Simon Strachan (paediatrician) answers:

The first set of teeth comprises 20 teeth that start to erupt from about six months of age, but I do
occasionally see children with teeth from four months of age. The order of eruption is usually: central lower incisors, central upper incisors, outer upper incisors, outer lower incisors, first premolars, canines and lastly the first molars. These last molars erupt between 24 and 30 months of age.

However, it’s not unusual for the order of appearance as well as the time of eruption to be outside of the norm. Many children only start teething from nine months, and I have certainly seen children
with no teeth at 18 months who then go on to develop a full set. The definite way to know whether the teeth are present or not is to do an X-ray. The condition of missing a tooth or missing multiple teeth is exceptionally rare, and no child has no teeth.

Babies will start to mouth and bite on everything in sight from three months of age. This happens because they have developed the ability to reach and grab things and then, as part of exploration,
move things to the mouth and gnaw. This will be accompanied by a lot of drooling. It is from this time that someone is bound to suggest that your child is teething. From this age on absolutely everything that can possibly go wrong with your baby will be blamed on teething.

The truth is that between about six months and two-and-a-half years a child will have an average of 20 teeth appear in his mouth. This happens at about one tooth every six weeks. So at any point
in this time your child will be teething. This is, however, also the time when they become more socially aware, start to call out and shout, go to crèche and get lots of illnesses. This is the time when you will start to teach them how to sleep or not, when they have unexplained fevers from time to time and when they learn to eat. So there is a huge amount of stuff going on at the same time that they are teething. It is fairly obvious therefore why it is so easy to blame everything on teething.

No medication, gels or powder will help the teeth erupt quicker. I was once told that bicarbonate of soda helps teeth rise quicker– clearly this is not true. Teeth medication of all types only give relief
either by the physical action of rubbing the gums or numbing the gums for a few minutes. If you think your child has pain, then use paracetamol syrup given by mouth as it is far more effective to
treat pain