Waiting on a baby’s first tooth is a pain, unless they happen to born with them.

Like most infant milestones, those involving baby teeth are far from precise. The age when babies get teeth varies from child to child. Some babies are born with a tooth or two. Some babies may not have their first tooth emerge until 12 months. In between those extremes baby teeth come in anytime between 4 and 10 months, with an average of around 6 months for typical babies. Genetics is largely responsible for when teeth emerge, but the timing of the first tooth can also have serious implications on infant health.

“If the teeth come in a few months early or a few months late there are no concerns, usually,” explains orthodontist Dr. Kami Hoss, founder of The Super Dentists and Howard Healthcare Academy who serves on the Board of Counselors at UCLA School of Dentistry. “If the timing is extreme it can be an issue. Very early teeth, for instance, can interfere with breastfeeding.”

That’s a serious consideration, Hoss explains because breastfeeding is really important for oral health. Not only does it help shape a baby’s facial-musculature growth, breastmilk results in fewer cavities.

Very early teeth can also indicate the supernumerary teeth — the presence of extra teeth. “I’ve seen from one to a dozen extra teeth in children,” Hoss says. “An extra tooth that doesn’t have room to come in can cause regular teeth to be crowded or have gum damage.”

If it’s caught early enough, supernumerary teeth aren’t too much of an issue. If they haven’t started causing damage they can simply be removed.

A serious delay in the emergence of teeth could be linked to several factors. In some instances, a tooth might be stuck behind another tooth. In other cases delayed teeth may be linked to missing permanent teeth. In either circumstance, x-rays are required to determine the issue and possible treatment options.

That said, Hoss urges calm if parents aren’t seeing the first baby teeth on time. “There are some families that usually get their teeth late,” he says. “So if I see one child that has teeth coming in significantly late, then I usually start asking when the other family members got teeth. Typically it’s that their biological clock is ticking slower.”

And in those cases that biological clock is likely slower across development. So the same children may reach all their milestones at a leisurely pace from walking to puberty. That’s why it’s important for parents to place milestones in the context of their child’s unique developmental pace.

Hoss notes that baby oral health issues can be easily managed. But success is completely dependent on catching the issue early enough to be corrected.

“The American Academy of Pediatric dentists recommends that every child has seen a pediatric dentist by 6-months of age,” say Hoss. “But personally, after 25 year in my practice, that the latest that parents should see a pediatric dentist. My personal recommendation is that during pregnancy parents should find a dental home for their coming baby.”

This article by Patrick Coleman was posted on fatherly.com on March 12, 2021.