# Children's teeth

> When baby and adult teeth come through, what helps with teething, how to protect young teeth from decay, and when a child should first see a dentist.

Source: https://www.nazemalioussef.com/en/patient-guides/childrens-teeth/  
Updated: 2026-09-28

Patient guide

A baby's first tooth usually comes through at around six months, and most adult teeth are in place by the early teens. Baby teeth are temporary, but children chew and learn to speak with them, and they hold the space for the adult teeth. Sugar can cause decay, pain and infection even in baby teeth, so the habits that protect them are worth starting early.

From the professional website of Dr Nazem Al Ioussef Published 28 September 2026 Last reviewed 28 September 2026

## When teeth come through

Baby teeth, also called milk teeth, usually start to come through at around six months, sometimes earlier or later. There are 20, and most children have them all by about two and a half to three.

Adult teeth begin at around six, with large molars at the very back that do not replace any baby teeth. From six or seven the baby teeth start to fall out, usually the lower front ones first. Most adult teeth are through by around 14; wisdom teeth, which not everyone gets, usually appear between 18 and 25. These ages are typical, not fixed.

Each adult tooth forms in the jaw beneath the baby tooth it will replace. As it grows upwards, the root of the baby tooth dissolves; the baby tooth loosens and falls out, and the adult tooth takes its place.

### How an adult tooth replaces a baby tooth

1. **Baby tooth.** The baby tooth sits in the gum, and the adult tooth that will replace it is forming in the jaw beneath.
2. **Adult tooth.** The root of the baby tooth has dissolved and the baby tooth has come out; the adult tooth is coming through in its place.

Simplified drawing, not to scale.

## Teething

A teething baby may have sore gums, dribble more than usual and chew on fingers or toys. The NHS suggests:

1. **A teething ring.** Some can be cooled in the fridge first. Never put one in the freezer, and never tie one around a baby's neck.
2. **Something healthy to chew.** From six months, a baby eating solid food can chew raw fruit and vegetables; stay with them in case of choking. Avoid rusks, which nearly all contain sugar.
3. **Comfort.** Cuddling or play can distract a baby, and gently rubbing the gums with a clean finger may help.
4. **Pain relief, if needed.** A children's painkiller that contains no sugar: paracetamol from 2 months, or ibuprofen from 3 months, as the instructions say. Children under 16 should not have aspirin.

There is little evidence that teething gels work; if one is used, it should be made for young children. Homeopathic teething products are not recommended. If you are worried, ask a pharmacist, a doctor or your dental team.

## Sugar, drinks and bottles at night

Sugar is the main cause of tooth decay, and how often a child has it matters as well as how much. Less saliva flows during sleep, so a bottle at night is a particular concern. The sources advise:

- do not add sugar to bottles or drinks, or give sugary drinks in a bottle;
- do not let a baby fall asleep with a bottle. The American Academy of Pediatric Dentistry (AAPD) also advises against nursing a child to sleep, and against anything but water in a bedtime bottle;
- never dip a dummy or teething ring in honey, syrup or sugar;
- as children grow, keep sugary food and drinks, and fruit, to mealtimes rather than snacking through the day.

## Helping children brush

Start brushing as soon as the teeth appear, last thing at night and at least one other time in the day. How much toothpaste to use at each age is in the guide to [cleaning your teeth](https://www.nazemalioussef.com/en/patient-guides/cleaning-your-teeth/).

- **Babies and toddlers:** sit the child on your knee, facing away from you, and support the chin. Up to 3, an adult does the brushing.
- **Older children:** stand behind them and cradle the chin. Guiding their hand lets them feel the right movement.
- Use a small, soft brush in small, gentle circles, including the gums and behind the teeth. Spit the toothpaste out afterwards, without rinsing.

From about 3, let children brush while you supervise. The Oral Health Foundation advises supervising until at least 7, and the NHS suggests watching older children too.

## A child's first dental visit

The NHS advises taking a child to the dentist once their milk teeth start to appear, or before 12 months; the AAPD, when a child's first tooth appears and no later than their first birthday; the Oral Health Foundation, by the age of 1.

An early visit helps a child get used to the dental surgery and can find problems early. After that, the AAPD recommends a check-up every six months; the Oral Health Foundation, as often as the dental team recommends.

## Fluoride varnish and fissure sealants

Fluoride varnish, painted onto baby or adult teeth, strengthens the enamel against decay. The NHS advises that children be offered it at least twice a year from the age of 3, and younger children if their dentist thinks they need it.

Fissure sealants are thin plastic coatings that keep germs and food out of the grooves on the chewing surfaces of the back teeth. The NHS notes they can be applied as the permanent back teeth come through, usually at about 6 or 7, and again between 11 and 14.

## Dummies and thumb-sucking

The Oral Health Foundation advises avoiding dummies where possible, choosing an orthodontic teat if one is used, and discouraging thumb or finger sucking, which can change the shape of the mouth and may make braces more likely later. The AAPD notes that these habits generally cause problems only if they go on for a very long time; for a child still sucking a thumb or finger after 3, a dentist may suggest an appliance.

## Knocks and broken teeth

A knocked-out baby tooth is never put back, because that can damage the adult tooth developing underneath. A dentist should still check the mouth, as for a chipped or loosened baby tooth. The guide to [dental emergencies](https://www.nazemalioussef.com/en/patient-guides/dental-emergencies/) explains what to do, including for a knocked-out adult tooth.

## When to see a dentist

See a dentist between check-ups if a child has:

- toothache, or pain that disturbs sleep or eating;
- swelling of the gum or face;
- a tooth that has been knocked or has changed colour;
- white, brown or dark spots, or holes, on the teeth;
- teething pain that is severe or lasts longer than expected.

Until then, a children's painkiller given as directed can ease the pain; never put aspirin on the teeth or gums. Swelling that spreads, or comes with a high temperature, needs urgent care. The page on [tooth decay](https://www.nazemalioussef.com/en/patient-guides/tooth-decay/) explains how decay starts.

## Questions patients ask

**When will my baby's first tooth come through?**

Usually at around six months, but some babies get teeth earlier and some later. Most children have all 20 baby teeth by the age of about two and a half to three.

**Why look after baby teeth if they fall out anyway?**

Children need them to chew and to learn to speak clearly, and they hold the space for the adult teeth. Decay can cause pain and infection even in baby teeth, and if baby teeth are lost too early, the adult teeth may come through crooked or out of place.

**Can my baby fall asleep with a bottle?**

The sources advise against it. The Oral Health Foundation advises not letting a baby go to sleep with a bottle, and the American Academy of Pediatric Dentistry advises putting nothing but water in a bedtime bottle. Drink left on the teeth during sleep, when there is less saliva to protect them, makes decay more likely.

**Are teething gels worth trying?**

The NHS says there is little evidence that they work, and suggests trying a teething ring or a children's painkiller first. If you do use a gel, choose one made for young children and ask a pharmacist: general oral pain-relief gels are not suitable for children.

**When should a child first see a dentist?**

By their first birthday. The NHS advises a visit once milk teeth start to appear, or before 12 months; the American Academy of Pediatric Dentistry, when a child's first tooth appears and no later than their first birthday; the Oral Health Foundation, by the age of 1.

## What this page rests on

This guide rests on patient information from the NHS, the Oral Health Foundation and the American Academy of Pediatric Dentistry. Where their advice differs, as on thumb-sucking and on how often children need check-ups, the page says what each advises. It is general information: what applies to a particular child is for a dentist who has examined them to say.

General health information, not a diagnosis or a treatment recommendation for any individual.

### Sources

1. NHS — [Children's teeth](https://www.nhs.uk/live-well/healthy-teeth-and-gums/taking-care-of-childrens-teeth/)
2. NHS — [Tips for helping your teething baby](https://www.nhs.uk/baby/babys-development/teething/tips-for-helping-your-teething-baby/)
3. Oral Health Foundation — [Baby teeth](https://www.dentalhealth.org/baby-teeth)
4. Oral Health Foundation — [Children's teeth (aged 3+)](https://www.dentalhealth.org/childrens-teeth-3)
5. American Academy of Pediatric Dentistry — [Frequently asked questions (FAQ)](https://www.aapd.org/resources/parent/faq/)

## Related pages

- [Bad breathWhere bad breath usually comes from, what helps, and when it needs a dentist.](https://www.nazemalioussef.com/en/patient-guides/bad-breath/)
- [Teeth grindingGrinding and clenching, often at night: the signs, the causes and what can help.](https://www.nazemalioussef.com/en/patient-guides/teeth-grinding/)
- [Mouth ulcersWhy mouth ulcers appear, how to ease them, and when one needs checking.](https://www.nazemalioussef.com/en/patient-guides/mouth-ulcers/)