Teething patterns vary greatly from child to child, but typically the last teeth to appear (the second molars, found in the very back of the mouth on the top and bottom) are coming in by the second birthday. By age 3, your child should have a full set of 20 baby teeth, which shouldn't fall out until her permanent teeth are ready to start coming in, around age 6.
Because your child's molars are bigger and more blunt than the middle teeth that came in first, you might expect their eruption to cause more pain. Actually, it's likely that that your child's final teeth will come in practically unnoticed. Laura Grunbaum, a pediatrician in San Leandro, California, says few parents complain to her about their preschooler's teething, either because they know what to do by now or their child simply isn't in much pain.
In fact, experts disagree about whether teething causes symptoms — like fussiness, diarrhea, and fever — or whether these common symptoms are not related to teething at all and just coincidentally appear at the same time as emerging teeth. Regardless, many parents maintain that their teething children do suffer discomfort (though some children get through the process with no problems at all). If your preschooler does have teething trouble, here are the symptoms she's most likely to experience:
Though many parents report that their children have loose stools, runny noses, or a fever just before a new tooth arrives, most experts don't think teething is to blame for these symptoms. One who does is William Sears, pediatrician and author of The Baby Book. Sears believes that teething can cause diarrhea and a mild diaper rash because your child's excessive saliva ends up in her gut and loosens her stools. Inflammation in the gums, he thinks, may cause a low fever (under 101 degrees Fahrenheit).
On the other hand, child development experts such as Penelope Leach assert that teething cannot cause fever, diarrhea, vomiting, or loss of appetite and that these are signs of illness that should be checked out. Noted pediatrician T. Berry Brazelton says such symptoms are probably due to an infection unrelated to teething, but that the stress associated with teething could make your child more vulnerable to infection right before a new tooth appears.
The one thing experts agree on is that you should call your child's doctor if your preschooler has symptoms that worry you or a rectal temperature of 102 degrees F or higher. The doctor can help determine whether your child is showing signs of a problem that needs medical attention, like an ear infection. If your preschooler has loose stools — but not diarrhea — don't worry. The condition will clear up on its own.