Baby’s Top Teeth Coming In: What to Expect and How to Soothe Them
The first top baby teeth, the two upper central incisors, usually emerge between 8 and 12 months, a few months after the bottom ones. Teething is the gradual process of teeth breaking through the gum, and while it makes your baby uncomfortable, it does not make them ill. Expect more drooling, more urge to bite and more restless nights. Knowing what to expect during this stage will help you support them with calm.
In short
- The upper incisors usually come in between 8 and 12 months, always after the two bottom central ones.
- The real symptoms are swollen gums, drooling, biting objects and more frequent wakings, but not high fever or diarrhoea.
- Soothe with chilled teething rings, gum massage and plenty of closeness, and see the paediatrician if the discomfort lasts more than two or three days.
My baby is teething: how to recognise that dentition is starting
Many families notice a change in behaviour a few weeks before a tooth appears, and think their baby has suddenly become “difficult”. It is usually the teeth pushing from inside. The gum becomes inflamed, the area turns sensitive and the baby seeks relief by biting everything they find.
What you see at home, week by week
About three weeks before eruption, the gum looks redder and the baby keeps putting their fist to their mouth. Drooling arrives, which can irritate the chin. And when the tooth is about to come through, the gum shows a bluish-white line. The top ones are usually more uncomfortable than the bottom ones, because the upper lip is thicker and the pressure is felt more.
It is common for babies to wake more at night during upper teething and to seek relief by biting. Gently checking the upper gum may show it swollen and sensitive before the upper central incisors appear. A chilled teething ring during the day and a gentle gum massage before bedtime usually help sleep return to calm.
When the symptoms are not teething
Teething explains a lot, but not everything. If you notice any of these signs, don’t put them down to teeth:
- Fever. A baby’s temperature may rise slightly while teething, but a true fever is not associated with teething. According to the American Academy of Pediatrics, it is a sign of an illness or infection that may need treatment. If it lasts more than 24 hours in a child under 2, the AAP advises calling the paediatrician.
- Refusing food or feeds. If your baby does not want to eat, or is not their usual self and you’re worried, the NHS advises getting urgent medical advice. If they show no interest in feeding, are not responding as they normally do, or are drowsy and hard to wake, call emergency services (112 in Spain).
- Signs of dehydration. Fewer than six wet nappies a day, a dry mouth, fewer tears when crying or a sunken soft spot on the head are reasons to call the paediatrician straight away, according to the AAP.
- Teeth that are very late. Most children have all 20 baby teeth by their third birthday. If your child’s teeth are coming in much more slowly than that, Nemours KidsHealth recommends speaking to your doctor.
Truths and myths about children’s teeth
Three myths worth retiring
- Myth: teething causes diarrhoea. There is no evidence that eruption alters bowel movements. If stools are loose for more than a day, look for another cause.
- Myth: you should rub the gum with alcohol or anaesthetic. It is dangerous. The FDA warns that benzocaine or lidocaine gels should not be used for teething pain, as they can cause serious harm. A gentle massage with a clean finger is all you need.
- Myth: if the tooth is late, something is wrong. The timeline varies greatly. What matters is not the exact date, but the order and symmetry.
What is true
Intense drooling is real, and it is often accompanied by mild coughing from saliva the baby cannot manage. It is also true that the pain comes in waves: there are better days and worse days depending on how the tooth is pushing. So do not be alarmed if one day they improve and the next they are uncomfortable again.
From the Montessori approach we observe these changes with respect for their rhythms. In our Nido (0-3 years) in Sotogrande we offer safe materials to bite and observe each phase closely with families from the Campo de Gibraltar.
Teething in children, explained for mums and dads
The usual order is clear: first the two bottom central incisors, then the two top ones, then the laterals, the molars and finally the canines. The first top baby teeth appear right at the second stage of that journey.
Indicative teething timeline
| Tooth | Approximate age | Key care |
|---|---|---|
| Bottom central incisors | 6-8 months | Start cleaning with gauze |
| Top central incisors | 8-12 months | Chilled teething rings and massage |
| Lateral incisors | 9-13 months | Watch for symmetry of eruption |
| First molars | 12-19 months | Soft brush twice a day |
This table is a guide, not a rule. Some babies are born with a tooth and others reach their first birthday with none. Both cases fall within normal development.
A typical mistake and how to fix it
One of the most common mistakes is waiting for the last tooth to come through before starting to clean the mouth. That is not the way. From the first tooth you clean with a small brush and an amount of toothpaste the size of a grain of rice, twice a day. Spain’s General Council of Dentists, the Consejo General de Dentistas, specifies a toothpaste with 1,000 ppm fluoride. The toothless gum should also be wiped with damp gauze once a day. This habit prevents early childhood caries and gets the baby used to brushing.
How to support them with calm
Keep a silicone teething ring in the fridge (not the freezer, which can burn the gum). If your little one already eats fruit and is ready for solid foods, check with your paediatrician before offering cold options such as well-ripened fruit pieces in a mesh teether, and always under your supervision. And do not underestimate the power of your arms: skin-to-skin contact calms better than any toy.
The American Academy of Pediatrics recommends the first dental visit before the first birthday, right when the upper incisors usually appear.
Frequently asked questions
At what month do the top teeth come in?
The upper central incisors usually erupt between 8 and 12 months, about four months after the bottom ones. It is a wide range because every baby has their own pace. If none has appeared by the first birthday, your paediatrician can assess whether anything else needs to be observed.
Can teething cause a fever when the top teeth come in?
Temperature may rise slightly, but a fever above 38.5 °C cannot be explained by teething. If your baby has a high fever, seems lethargic or refuses food for more than a day, see the paediatrician to rule out another cause and do not assume it is the teeth.
How do I soothe my baby’s sore gums?
Use a chilled teething ring from the fridge, give gentle massages on the gum with a clean finger and offer plenty of physical contact. Skip anaesthetic gels, which the FDA says should not be used for teething, and never rub alcohol on the gum. If the discomfort is intense or lasts more than two or three days, book an appointment with the paediatrician.
In what order do the milk teeth come in?
The typical order is: lower central incisors, upper central incisors, lateral incisors, first molars, canines and second molars. The first top baby teeth mark the second step of that sequence. The full set of twenty milk teeth usually completes around age three.
