First Cutting Teeth

While all these symptoms tend to crop up in the few days before and after a tooth’s emergence from the gums, the process of developing teeth starts much earlier.

In-utero roots: Around the second trimester of pregnancy, tooth buds begin to form under the gums in your baby’s mouth. Eventually, the roots begin to grow, forcing the crown up. “The tooth puts pressure on the tissues above it, and they slowly begin to break down,” says Dr. Hanna. “The tissue gets thinner and thinner until it breaks and the tooth pops through.”

Top and bottom debut: The first teeth to pop up are usually the two bottom front teeth (central incisors), followed by the four upper teeth (central and lateral incisors). Because these are thinner with a knifelike edge, they often slide through fairly easily.


Molar mayhem: But that’s just the calm before the storm: Around baby’s first birthday, the first molars will start to arrive in the back of the mouth; then come the canines (the pointed teeth between the molars and incisors); and then around age 2, the second molars, behind the first set.

“The molars are often much more painful because they are a big, fat, broad-surfaced tooth,” says Dr. Hanna. “Those are the ones where you tend to see bulging gums.” In some cases, fluid can build up, creating a bluish cyst over the unerupted molar. When the tooth breaks through and pops the cyst, your baby may wind up with a mouthful of blood, but it looks a lot worse than it is, says Dr. Hanna. “Once the sac erupts and the fluid comes out, it’s over. The situation has corrected itself.”