Tooth Eruption In Lafayette, CO

Q: Can teething cause a fever?

No. A rectal temperature of 100.4F (38C) or higher is a true fever. Teething may raise a baby's temperature slightly, but it does not cause a true fever.

Q: Is Orajel safe for my teething baby?

No. The FDA warns that benzocaine products such as Baby Orajel can cause methemoglobinemia and should not be used for teething pain in children. Use a chilled firm teether and gum pressure instead.

Q: Do amber teething necklaces work?

No, and they are dangerous. The FDA warns of choking and strangulation risks, and the American Academy of Pediatrics does not recommend infant jewelry.

Q: My baby has no teeth at 12 months. Should I worry?

Probably not. Eruption timing varies widely. No teeth at all by 18 months warrants an evaluation and sometimes an x-ray to confirm the teeth are present.

Q: My child's permanent tooth is coming in behind the baby tooth. Is that normal?

Yes. It is common between ages 5 and 7 and is often called shark teeth. In most cases, the baby tooth loosens on its own. If it remains solid after 2 months or your child cannot chew on that side, call us.

Most children get their first tooth between 6 and 10 months, and all 20 baby teeth are usually in by age 3. In Colorado, that first tooth starts a clock: the state ties its covered infant dental evaluation to the 6 months after it breaks through, not to the first birthday.

Below is the full chart, what teething actually causes, what is safe to put in your child's mouth, and when to call. Written and reviewed by Dr. Alison Grover, board-certified Diplomate pediatric dentist.

When Baby Teeth Come In, and When They Fall Out

Twenty primary teeth arrive between roughly 6 and 33 months. Most timelines you find online skip the canines. Here is the full set.

Central incisors (the front two, top and bottom)

Upper: come in at 8 to 12 months, fall out at 6 to 7 years
Lower: come in at 6 to 10 months, fall out at 6 to 7 years

Lateral incisors (either side of the front two)

Upper: come in at 9 to 13 months, fall out at 7 to 8 years
Lower: come in at 10 to 16 months, fall out at 7 to 8 years

Canines, also called cuspids (the pointed ones)

Upper: come in at 16 to 22 months, fall out at 10 to 12 years
Lower: come in at 17 to 23 months, fall out at 9 to 12 years

First molars (the first back teeth)

Upper: come in at 13 to 19 months, fall out at 9 to 11 years
Lower: come in at 14 to 18 months, fall out at 9 to 11 years

Second molars (the last baby teeth to arrive)

Upper: come in at 25 to 33 months, fall out at 10 to 12 years
Lower: come in at 23 to 31 months, fall out at 10 to 12 years

What counts as normal variation

Plenty. Upper teeth before lower ones. Canines before lateral incisors. One side running months ahead of the other. A tooth that shows up 3 months off the range in either direction. None of that is a problem on its own, and none of it predicts anything about the permanent teeth.

Two things in that table surprise parents. The canines land between 16 and 23 months, right in the gap most charts leave blank, and they are often the ones that make a toddler miserable. And every tooth has a departure date. A 6-year-old losing a bottom front tooth is on schedule. A 4-year-old losing one is not.

When a missing tooth needs a look

The threshold is 18 months with no teeth at all. Before that, a late first tooth is usually nothing. At 18 months we want to look, and sometimes take a single x-ray to confirm the teeth are there and on their way. Coming in early matters too: a baby born with a tooth, or one that appears in the first weeks, should be checked for looseness before it becomes a choking risk.

Teething: What It Does, and What It Does Not

The signs that are actually teething

A meta-analysis of 16 studies published in Pediatrics in 2016 found symptoms in about 70% of children during eruption. The 3 most common were gum irritation at 86.8%, irritability at 68.2%, and drooling at 55.7%. Add biting, mild gum swelling and broken sleep and that is close to the whole list.

Symptoms cluster in roughly an 8-day window around each tooth, then stop. If a child has been miserable for 3 weeks straight, a tooth is not the explanation.

Teething does not cause a fever

The American Academy of Pediatrics defines a fever as a rectal temperature of 100.4°F (38°C) or higher, and states that teething does not cause a true fever. Teething can nudge a baby's temperature slightly, into the 99 to 100.3 range. It does not cross 100.4.

If your baby is 3 months or younger with a rectal temperature of 100.4°F or higher, call your pediatrician immediately. At any age, a fever at or above 100.4, diarrhea, vomiting, or a rash means something other than a tooth is going on.

What Is Safe for Teething Pain, and What Is Not

What works

A clean teether, firm rubber, not liquid filled, chilled in the refrigerator. Not frozen. Frozen teethers get hard enough to bruise gum tissue.

Counter-pressure with a clean finger or damp gauze on the gum. It is the most effective thing you can do at 2 in the morning and it costs nothing. A cold damp washcloth does the same job and most babies chew one longer.

Acetaminophen or ibuprofen at the dose your pediatrician gives you, for a night nobody is sleeping through. Ask first, because age matters for ibuprofen.

Start brushing the day the first tooth arrives. Rice-grain smear of fluoride toothpaste until 3, pea-sized after. Floss once any 2 teeth touch.

What to throw out

The FDA has active warnings on 4 products parents reach for first.

Benzocaine gels, including Baby Orajel and Anbesol. The FDA states they "can lead to a serious, and sometimes fatal, condition called methemoglobinemia" and should not be used for teething pain in children. The agency moved to take them off the market for teething use in 2018.

Viscous lidocaine. The FDA says it should not be used for infant teething and can cause heart problems, seizures and brain injury.

Amber teething necklaces and teething jewelry. The FDA warned against these in December 2018 after reports of choking on broken beads and the strangulation death of an 18-month-old wearing one during a nap. The American Academy of Pediatrics does not recommend that infants wear any jewelry.

Homeopathic teething tablets, which the FDA names among teething products that can be dangerous to children.

If any of these are in your house, get rid of them. We would rather have that conversation now than in an exam room.

The Colorado First-Tooth Clock

Three rules about that first tooth that most Lafayette parents never hear. Two of them are written into state programs.

The 6-month clock starts at the tooth, not the birthday. Colorado's Medicaid rule describes the covered oral evaluation for a child under 3 as preferably occurring within the first six months of the eruption of the first primary tooth (10 CCR 2505-10, section 8.202). The American Academy of Pediatric Dentistry standard is the same: age 1, or 6 months after the first tooth, whichever comes first. Note which comes first. A baby who cuts a tooth at 5 months is due at 11 months.

Fluoride varnish is meant to start at the first tooth. Cavity Free at Three, the Colorado Department of Public Health and Environment program, trains providers to begin varnish when the first tooth erupts and to reach 4 or more applications by age 3. Newly erupted enamel has not finished mineralizing, which is exactly why the first 3 years matter most for protecting new enamel.

Nobody checks at kindergarten. California requires an oral health assessment for kindergarten entry. Colorado's school entry requirements cover immunizations only, and Boulder Valley School District does not add one. An eruption problem gets caught at a dental visit or it does not get caught.

The practical version: write down the date the first tooth broke through. Book by that date plus 6 months or the first birthday, whichever lands first. Then every 6 months after, because on a baby tooth a cavity takes about 6 months to form. That is the whole reason the recare interval is what it is.

When to Call Us

Shark teeth. Between 5 and 7, a permanent lower incisor often erupts behind a baby tooth that has not loosened. It is common and it usually resolves. Watch it for 2 months. If the baby tooth is still solid after that, or your child cannot chew on that side, call. It is usually a simple extraction in one visit.

An eruption cyst. A soft bluish bump over a tooth that is coming through. It looks alarming and almost always resolves on its own.

Facial swelling, a fever that will not come down, or a child who will not drink. That is an emergency, not teething. Existing patients can call (303) 500-3202 and press 2 to reach the Mini Miners pediatric dentist on call. We hold same-day emergency appointments for patients of record.

Your Child's First Visit

An infant visit takes about 30 minutes and looks nothing like an adult appointment.

Your baby lies on a padded infant bed, so your child is looking at your face the whole time. We use child-sized instruments and sensors, because adult ones do not fit. You stay in the room. Every treatment at Mini Miners, at any age, is one a parent can sit in on.

We check every erupted tooth, the gums, the tongue and the frenum, assess your child's cavity risk, and apply fluoride varnish if it is time. Ours lets kids eat and drink immediately afterward, so a nap and a bottle are not on hold. Older kids pick their prophy paste and fluoride flavor from a menu, choose from over 70 movies, and have x-rays taken in the treatment room on a camera-style machine so the movie keeps playing. Everyone leaves with a prize.

If your child is not ready, we do a happy visit instead. They come in, sit in the chair, meet the staff and leave without anyone working on them. The second appointment goes far better.

After that, a cleaning and exam every 6 months.

About Dr. Alison Grover

Dr. Grover is a board-certified Diplomate pediatric dentist. She earned her DDS at the University of Colorado School of Dental Medicine in Aurora, completed a general practice residency, then a two-year pediatric residency, and holds a Pediatric Dental Certificate from UCLA. As a Diplomate she has passed the oral and written examination given by the American Board of Pediatric Dentistry. She also holds a degree in child psychology from Wellesley College, which shows up in how a frightened 2-year-old gets handled.

She and her husband built Mini Miners in 2017. She is a parent herself.

A board-certified pediatric specialist completes additional years of residency after dental school, specifically in infants, children, adolescents and patients with special health care needs. A general dentist who sees kids has not done that residency. If you are choosing a pediatric dentist in Lafayette, that distinction is the one worth asking about.

Insurance and membership

We accept most major dental plans, including Aetna PPO, Anthem, Cigna, Delta Dental, MetLife, United Concordia and United Healthcare, along with more than 100 others. We verify your benefits before the visit, explain what is covered, and handle the paperwork.

For families without dental insurance, the Mini Miners Membership Plan has no waiting periods, no deductibles and no pre-authorizations. Call and we will walk you through it.

Book Your Child's Visit

If your child has a tooth, the clock has already started. A first visit takes 30 minutes and settles the questions you have been reading about at midnight.

Book A Visit

Tooth Eruption FAQs

When should my child first see a dentist?

Age 1, or 6 months after the first tooth appears, whichever comes first. Colorado's Medicaid rule uses the same event, describing the covered under-3 evaluation as preferably occurring within the first six months of the eruption of the first primary tooth. If your baby cut a tooth at 5 months, the visit is due at 11 months, not at the first birthday.

Can teething cause a fever?

No. The American Academy of Pediatrics defines a fever as a rectal temperature of 100.4°F (38°C) or higher and states that teething does not cause a true fever. Teething can raise a baby's temperature slightly, into the 99 to 100.3 range. If your baby is 3 months or younger with a rectal temperature of 100.4 or higher, call your pediatrician immediately.

Is Orajel safe for my teething baby?

No. The FDA warns that benzocaine products including Baby Orajel can cause methemoglobinemia, a serious and sometimes fatal blood condition, and says they should not be used for teething pain in children. Use a chilled firm teether and gum pressure instead.

Do amber teething necklaces work?

No, and they are dangerous. The FDA warned against teething jewelry in December 2018 after reports of choking and the strangulation death of an 18-month-old wearing an amber necklace during a nap. The American Academy of Pediatrics does not recommend that infants wear any jewelry.

My baby has no teeth at 12 months. Should I worry?

Probably not, and it is worth a look. Eruption timing varies widely. The threshold most pediatric dentists use is 18 months with no teeth at all, which warrants an evaluation and sometimes a single x-ray to confirm the teeth are there.

My child's permanent tooth is coming in behind the baby tooth. Is that normal?

Yes, it is common between 5 and 7 and is often called shark teeth. Watch it for 2 months. In most cases the baby tooth loosens on its own as the permanent tooth moves forward. If it is still solid after 2 months, or your child cannot chew on that side, call us.

Will my child's school check their teeth before kindergarten?

No. Colorado's school entry requirements cover immunizations. Unlike California, Colorado has no statewide kindergarten dental exam requirement, and Boulder Valley School District does not add one.

Serving Lafayette Families

Our office is at 61 Erie Pkwy, Unit 101, Erie, CO 80516, in Erie Commons at the corner of Briggs Street and Erie Parkway, just minutes from Lafayette. Parking is surface level and free, right outside the door.

Lafayette is home to roughly 1,570 children under 5. Every one of them is somewhere on the chart above.