Parents often anticipate a baby's first tooth as a major milestone in their little one's life. You might start looking for the first pearly white in that rosebud mouth long before the tooth actually arrives. The age of tooth emergence varies considerably from baby to baby. But if you wait in vain month after month for the clink of the spoon against enamel, your anxiety may rise as you imagine your child toothless forever. Several factors can cause tooth delay; usually, the teeth will appear in good time without any help on your part.
Normal Tooth Eruption
Most babies start getting teeth around age 6 months, according to the Gale Encyclopedia of Children's Health. Generally, boys get teeth later than girls, who show off their budding teeth 6 percent earlier than their brothers, on average, the same source reports. If your baby has no teeth by age 18 months, it's prudent to see a dentist, the American Academy of Pediatrics recommends. Baby teeth -- also called primary, milk or deciduous teeth -- generally appear in pairs, one on each side.
A congenital absence of any teeth at all, called adontia, occurs only rarely and generally affects the permanent rather than the baby teeth, says WebMD. Adontia generally occurs as part of a congenital syndrome rather than as an isolated problem. If your baby has no other health issues, it's unlikely that his teeth are actually missing completely. Hypodontia, the absence of between one and six teeth, and oligodontia, the absence of six or more teeth, are more common and often genetic. Between 0.5 to 0.9 percent of babies have one or more missing baby teeth, Dr. Lokesh Suri of Tufts University reports in a 2004 issue of the "American Journal of Orthodontics and Dentofacial Orthopedics."
Teething late can run in families, so dig out your old baby books and see if your mother wrote down when you and your siblings got teeth. Health issues, including cerebral palsy or anemia, prematurity, low birth weight or certain congenital syndromes, such as Down syndrome, can cause delayed teething. Cysts or tumors in the gums can also prevent teeth from erupting on time. Ankylosis -- the fusion of the alveolar bone and dentin and cementum in the tooth -- can cause baby teeth to remain embedded; this most commonly affects the molars, according to Dr. Suri.
Your baby needs teeth, not only to give him a normal facial appearance but also to aid with eating and speech. If his teeth haven't made an appearance by 18 months, finding a reason and correcting the problem, if possible, becomes paramount. Make an appointment with a pediatric dentist to evaluate the issue. An x-ray can determine whether the teeth have formed in the gums. If the baby teeth have formed but are abnormal in some way that's preventing them from penetrating the gums, your dentist might suggest removing them, but this occurs more commonly with permanent teeth, Dr. Suri explains.