What Causes Late Teething in Babies And When To See A Doctor?

check_icon Research-backed

The process of eruption of milk teeth is called teething. While teething follows a set pattern, it is not uncommon to see late teething in babies. The exact cause behind it is usually not always known. Nevertheless, most late teething cases are benign and do not need any intervention. Your pediatric dentist can help you rule out any other conditions that may require treatment.

Read this post to learn more about the causes and complications of late teething and when to see a doctor for it.

In This Article

Normal Teething Chart For Babies

The first teeth to erupt in a baby’s mouth are the lower front teeth

Image: Shutterstock

It is essential to understand normal teething patterns in babies to determine delayed teething. The first teeth to erupt in your baby’s mouth are the lower front teeth, and they do so around six months of age. The upper front teeth are the next, followed by other teeth that emerge within their respective age range (1).

Lower TeethUpper Teeth
Central incisor: 6-10 monthsCentral incisor: 8-12 months
Lateral incisor: 10-16 monthsLateral incisor: 9-13 months
First molar: 14-18 monthsFirst molar: 13-19 months
Canine: 17-23 monthsCanine: 16-22 months
Second molar: 23-31 monthsSecond molar: 25-33 months

What Is Delayed Teething?

Teething is defined as the process of primary teeth eruption from the gums (2). If the teeth do not erupt during the usual age range or there is a significant deviation from their expected time of eruption, then the baby is considered to be experiencing delayed teething (3).

Several signs and symptoms accompany the process of a tooth’s eruption. Babies with delayed tooth eruption also display delayed signs and symptoms of teething.

Should You Be Concerned If Your Baby Starts Teething Late?

According to the Australian Dental Association, some babies may begin teething at an early age of four months, while some may start teething as late as ten months (1). There is usually no need to be concerned if your baby experiences delayed teething.

Each baby achieves developmental milestones at a different age, and it is the same with teething. A baby can achieve teeth eruption at any age within the specified age range. Therefore, you may wait since the baby could eventually experience teething on attaining the upper limit of the age range.

When To Consult A Doctor?

If your baby’s first teeth do not erupt after 12 months, see a pediatric dentist

Image: IStock

If your baby’s first teeth (lower central incisors) do not erupt even after the age of 12 months, see a pediatric dentist. Some babies are late bloomers and experience delayed teething for no specific reason. However, in some cases, delayed teething may occur due to underlying problems, which require diagnosis and treatment.

Other developmental milestones may not be related to teething; thus, do not wait for your baby to achieve teething with other milestones before taking them to a dentist (4).

What Causes Late Teething In Babies?

The following conditions may cause delayed teething in babies. Some of the reasons are pathological abnormalitiesiXAbnormality in structural or functional aspects of the body’s tissues or organs. and may require treatment to commence teething.

1. Hereditary factors

If you or your partner had similar late teething issues at the same age, it could likely be that your baby experiences similar issues.

2. Poor nutrition

Poor nutritional status can affect teeth eruption

Image: Shutterstock

Studies have shown that low birth weight or poor nutritional status or nutritional insufficiency can affect teeth eruption. The nutritional status of the body influences teeth in their pre-eruptive phase. Any deficiency in calcium and the vitamins D, C, B, and A can significantly impact your baby’s teething (5).

3. Thyroid disorders

Babies with thyroid disorders, especially hypothyroidismiXA condition caused due to thyroid gland's inability to produce sufficient amounts of thyroid hormone. , could have delayed teeth eruption. If they have any existing teeth, they may also have other dental problems, such as enamel hypoplasiaiXTooth abnormality that leads to reduced enamel (covering of the tooth crown) production. , open-bitesiXA dental condition where the top and bottom teeth do not meet when the mouth is closed. , or cross-bites (6).

4. Fibrosis

Fibrosis is a condition characterized by thick gums that impede or prevent the teeth from erupting. This could cause a delay in teeth eruption in some babies.

5. Hormonal issues

Problems in the secretion of the growth hormone, a hormone released by the pituitary gland, may significantly affect the development of facial structures, including the eruption of teeth. Hypopituitarism is one of the conditions that can cause the pituitary gland to secrete low levels of the growth hormone, leading to delayed teething, among other problems (7).

6. Systemic diseases and medication

Systemic disorders such as sickle cell anemia may delay teething

Image: Shutterstock

Many systemic disorders, such as iron-deficiency anemia and sickle-cell anemiaiXA genetic disorder characterized by abnormally shaped red bed cells and low levels of hemoglobin. , may delay teething (8). Certain long-term medications may also interfere with tooth eruption.

7. Injuries

Any trauma to the jaw could affect the tooth buds and delay teething. Injuries may also lead to fibrosis, which also causes delayed teething.

8. Impacted teeth

Milk teeth may also become impacted like permanent teeth. An impacted milk tooth may fail to erupt and stay lodged within the jaw or gums. A baby with impacted teeth is likely to experience other signs and symptoms, such as gum redness, gum swelling, and pain.

9. Absent or missing teeth

In rare cases, a baby may have a missing tooth, which could be mistaken for delayed teething (9).

10. Genetic disorders

Genetic conditions, such as amelogenesis imperfectaiXA rare genetic and developmental disorder indicated by abnormal enamel formation. and dentinogenesis imperfectaiXA rare genetic disease characterized by discoloration of teeth. , may affect the baby’s teeth and gums, increasing the risk of delayed teething. Premature babies may also be at risk of experiencing delayed teething due to genetic reasons.

Certain genetic disorders could affect the musculoskeletal growth of the body, affecting even the eruption of the teeth. Some genetic disorders associated with delayed teething are Down syndrome, Turner syndrome, Gardner syndrome, Hutchinson-Gilbert syndrome (Progeria)iXA rare genetic condition marked by accelerated aging. , and Bloch–Sulzberger syndromeiXAn uncommon genetic disorder affecting several organs, including the eyes, skin, teeth, and central nervous system.  (10). A baby with these disorders is likely to experience other significant symptoms as well.

protip_icon Quick fact
Cleidocranial dysplasia is a condition that affects the bone and teeth development. It may cause late teething (12).

Complications Of Delayed Teething

Complications of delayed teething may depend on the underlying reason. Delayed teething due to no apparent reasons or due to benign reasons may not lead to complications.

In some cases, delayed teething may cause the following complications.

  1. Jaw bone deformity and asymmetrical face: Delayed teething also causes a delay in permanent teeth eruption. This leads to misalignment of jaws leading to long-term issues, such as an asymmetrical face. This complication may usually arise in babies who experience delayed teething due to severe problems, such as genetic disorders.
  1. Delay in chewing food: A delay in the emergence of primary teeth could delay the age at which you add solid food to your baby’s diet. It could cause a delay in learning how to chew solid food. Inability to eat solid food may increase the risk of other issues, such as malnutrition.
  1. Formation of cysts: Impacted or embedded teeth increase the risk of developing a cyst around them. It could cause intense pain and may require surgical intervention.
  1. Crowded permanent teeth: Primary teeth work as placeholders for permanent teeth. Any issues in primary teeth could also impact permanent teeth. The untimely eruption of primary teeth may interfere with the eruption of permanent teeth, affecting their alignment or causing them to become impacted.
Untimely eruption of primary teeth may affect the alignment of permanent teeth

Image: Shutterstock

protip_icon Point to consider
Teeth play an important part in speech (13). Late teething may cause delayed speech.

Frequently Asked Questions

1. How can I make my baby’s teeth come faster?

The tooth eruption process could be innately fast or slow among babies. There are no definitive ways of making a baby’s teeth come faster. If you feel your baby’s teeth are coming slowly, speak to a pediatric dentist.

2. How many teeth should a one-year-old have?

Most babies may develop at least one tooth until their first birthday. However, some might not have any as well (11).

3. Does a pacifier cause delay in teething?

A pacifier is generally safe for children and does not lead to delayed teething (14). However, using dirty pacifiers or their improper or excessive use may cause infections and injuries leading to tooth decay, misaligned teeth, and other oral or dental problems in later stages of the child’s life (15) (16).

If your baby hasn’t grown their teeth, do not hit the panic button, as late teething in babies is not uncommon. Since babies develop at their own pace, a few may show signs of delayed teething. However, delay in teething could hinder their nutritional intake and affect their overall growth and development. The delayed growth could be benign, but sometimes it may call for medical attention. Hence, be patient and consult a doctor if they do not grow teeth even after 12 months of age.

Infographic: Common Misconceptions About Delayed Teething

Late teething is common in some babies and is not always a reason to worry. In such cases, it is crucial not to believe in non-scientific misconceptions, as this infographic mentions. Seek a pediatrician or pediatric dentist’s advice to understand the underlying reasons and solutions for delayed teething.

misconceptions about delayed teething in babies (infographic)

Illustration: Momjunction Design Team

Get high-quality PDF version by clicking below.

Download Infographic in PDF version Download Infographic
Download Infographic in PDF version

Key Pointers

  • A baby is said to be experiencing late teething or delayed teething when their teeth do not emerge within the typical age range.
  • The delayed emergence of teeth does not always indicate a problem since some babies have late teething with no underlying issues.
  • Malnutrition, hormonal problems, and thyroid disorders are a few severe problems that may cause late teething in some babies.

References:

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.
1. Teething chart; Australian Dental Association
2. Teething; Stanford Children’s Health
3. LokeshSuri, EleniGagari, and HeleniVastardis, Delayed tooth eruption: Pathogenesis, diagnosis, and treatment; American Journal of Orthodontics and DentofacialOrthopedics
4. NehaVerma et al., Effect of Developmental Milestones on Patterns of Teeth Eruption; International Journal of Scientific Study
5. AparnaSheetal et al., Malnutrition and its Oral Outcome – A Review; Journal of Clinical & Diagnostic Research; NCBI
6. S Vucic et al., Thyroid Function during Early Life and Dental Development; NCBI
7 GauravAtreja et al., Oral manifestations in growth hormone disorders; Indian Journal of Endocrinology and Metabolism; NCBI
8. Caroline Maria Igrejas Lopes et al., Enamel defects and tooth eruption disturbances in children with sickle cell anemia; NCBI
9. Teething: Common Concerns; C.S. Mott Children’s Hospital
10. Choukroune, Tooth eruption disorders associated with systemic and genetic diseases; Journal of Dentofacial Anomalies and Orthodontics
11. Baby’s First Tooth: 7 Facts Parents Should Know; American Academy of Pediatrics
12. Nagarathna C et al., Cleidocranial dysplasia presenting with retained deciduous teeth in a 15-year-old girl: a case report; Journal of Medical Case Reports
13. Speech Problems; Nemours Children’s Health
14. Pacifiers (soothers): A user’s guide for parents; NCBI
15. Using Pacifiers Safely; U.S. Department of Health and Human Services
16. The Effects of Extended Pacifier Use by Infants; Sensory Solutions
Was this article helpful?
thumbsupthumbsdown
The following two tabs change content below.