When Should My Baby's First Tooth Come In? Complete Teething Timeline from Great Neck Pediatric Dentist
- precioussmilespd
- Jan 2
- 16 min read
Your Baby's First Tooth: What to Expect and When
One of the most exciting (and sometimes challenging) milestones in your baby's first year is the appearance of that first tiny tooth. At Precious Smiles Pediatric Dentistry in Great Neck, NY, Dr. Debbie helps Nassau County parents understand the teething timeline, recognize teething symptoms, and navigate this important developmental stage with confidence.
Whether you're in Great Neck, Manhasset, or anywhere across Nassau County, understanding when babies get teeth and what to expect helps you support your little one through this natural process while establishing healthy oral care habits from the start.
When Do Babies Get Their First Tooth? As Discussed by Great Neck Pediatric Dentist
The Typical Teething Timeline
Most babies get their first tooth between 6 and 10 months of age, though the range of "normal" is quite broad. According to the American Academy of Pediatrics (AAP), some babies are born with teeth (natal teeth), while others don't get their first tooth until after their first birthday.
Average timeline:
First tooth appears: 6-10 months (typically lower central incisors)
Range of normal: 3-15 months
Early teethers: Some babies at 3-4 months
Late teethers: Some babies at 12-15 months
As your trusted Manhasset and Great Neck pediatric dentist, Dr. Debbie reassures parents that significant variation in teething timing is completely normal and doesn't indicate any developmental problems.
Which Teeth Come First?
Baby teeth (primary teeth) typically emerge in a predictable order, though individual babies may vary:
Bottom front teeth (lower central incisors):
Usually the first to appear
Ages 6-10 months
Two bottom center teeth
Top front teeth (upper central incisors):
Typically second
Ages 8-12 months
Two top center teeth
Upper lateral incisors:
Teeth beside the front teeth on top
Ages 9-13 months
Lower lateral incisors:
Teeth beside the front teeth on bottom
Ages 10-16 months
First molars (back teeth):
Upper first molars: 13-19 months
Lower first molars: 14-18 months
Canines (pointed teeth):
Upper canines: 16-22 months
Lower canines: 17-23 months
Second molars:
Lower second molars: 23-31 months
Upper second molars: 25-33 months
By age 3, most children have all 20 primary teeth. At regular checkups with your Nassau County pediatric dentist, Dr. Debbie monitors tooth eruption to ensure healthy development.
Complete Baby Teeth Chart and Timeline
Visual Guide to When Babies Get Teeth
Understanding the full teething timeline helps parents anticipate what's coming. Here's a comprehensive breakdown:
Ages 6-12 Months: The First Year
Lower central incisors (6-10 months)
Upper central incisors (8-12 months)
Upper lateral incisors (9-13 months)
Lower lateral incisors (10-16 months)
Ages 13-23 Months: Toddler Teeth
First molars, upper and lower (13-19 months)
Canines, upper and lower (16-23 months)
Ages 24-33 Months: Completing Primary Dentition
Second molars, lower and upper (23-33 months)
Full set of 20 primary teeth by age 3
The American Academy of Pediatric Dentistry (AAPD) provides detailed charts showing typical eruption patterns. At Precious Smiles Pediatric Dentistry in Great Neck, Dr. Debbie can provide a personalized teething chart during your baby's first dental visit.
Signs Your Baby is Teething
Common Teething Symptoms
Recognizing teething signs helps Great Neck and Manhasset parents distinguish normal teething discomfort from illness requiring medical attention.
Classic teething symptoms:
Drooling:
Excessive saliva production
May cause chin or chest rash
Usually starts 2-3 months before tooth appears
Can lead to mild cough from excess saliva
Chewing and gnawing:
Increased desire to bite and chew
Puts everything in mouth
Gnaws on fingers, toys, or anything available
Counter-pressure relieves discomfort
Irritability and fussiness:
More cranky than usual
Easily upset or frustrated
Difficulty settling
Clinginess increases
Swollen, tender gums:
Red, puffy gums where tooth is emerging
Visible bump or ridge on gum
May see white tooth breaking through
Tenderness when touched
Sleep disruption:
Difficulty falling asleep
Frequent night waking
Shorter naps
General sleep regression
Loss of appetite:
Less interest in eating
Painful gums make eating uncomfortable
May prefer cold foods
Nursing strike in breastfed babies
Pulling ears or rubbing face:
Pain can radiate to ears and cheeks
Baby tries to soothe discomfort
More common with molars (back teeth)
Low-grade fever:
Slight temperature elevation (under 100.4°F)
May occur but not always teething-related
High fever (over 100.4°F) indicates illness, not teething
According to the Mayo Clinic, while teething can cause discomfort and fussiness, it should not cause high fever, diarrhea, or severe symptoms. If your Nassau County baby experiences these, contact your pediatrician.
What is NOT Caused by Teething
Parents often attribute various symptoms to teething, but Nassau County pediatric dentists want you to know these symptoms warrant medical evaluation:
❌ High fever (over 100.4°F)
❌ Diarrhea or vomiting
❌ Congestion or runny nose (unless minor)
❌ Cough (unless from drooling)
❌ Rashes on body (other than drool rash)
If your baby shows these symptoms, contact your pediatrician rather than attributing them to teething.
Natural Teething Relief: Holistic Approaches from Great Neck Pediatric Dentist
Safe, Effective Teething Remedies
Dr. Debbie's holistic approach to pediatric dentistry includes gentle, natural teething relief strategies for Nassau County families.
Cold therapy:
Chilled washcloth: Wet and refrigerate (not freeze), let baby gnaw
Refrigerated teething toys: Provide cooling relief
Cold foods (if eating solids): Applesauce, yogurt, mashed banana
Gentle gum massage:
Wash hands thoroughly
Use clean finger to gently rub baby's gums
Circular motions with light pressure
Provides counter-pressure that soothes
Safe teething toys:
Firm rubber teething rings
Textured teething toys
Wooden teethers (smooth, untreated)
Silicone teething jewelry for parents to wear
Chamomile remedies:
Chamomile tea (cooled) on washcloth
Gentle, natural calming properties
Anti-inflammatory benefits
Breastfeeding mothers can drink chamomile tea (benefits pass through milk)
Distraction and comfort:
Extra cuddles and attention
Singing and playing
New toys or activities
Skin-to-skin contact
For more detailed natural teething remedies, see our comprehensive guide to holistic teething relief on the AAPD website. As your Manhasset pediatric dentist, Dr. Debbie provides personalized holistic teething support for your family.
What to Avoid
Never use:
❌ Teething tablets with belladonna (FDA warning issued)
❌ Benzocaine teething gels (dangerous for babies under 2)
❌ Amber teething necklaces during sleep (strangulation risk)
❌ Homeopathic teething remedies with inconsistent ingredients
❌ Frozen solid items (too hard, can damage gums)
❌ Alcohol on gums (dangerous for babies)
The Food and Drug Administration (FDA) provides important safety warnings about teething products. Your Great Neck pediatric dentist can recommend safe alternatives.
When to Worry: Unusual Teething Patterns
Delayed Teething
What's considered delayed?
No teeth by 15-18 months may warrant evaluation
Family history of late teething is often the cause
Usually not a concern if baby is healthy otherwise
Possible causes of delayed teething:
Genetics (runs in families)
Nutritional deficiencies (rare with adequate diet)
Hormonal issues (very rare)
Developmental conditions (uncommon)
When to see Nassau County pediatric dentist:
No teeth by 15 months
One tooth erupted but no others after several months
Concerns about overall development
Family history of dental problems
At Precious Smiles Pediatric Dentistry, Dr. Debbie evaluates delayed teething with X-rays if needed, checking that tooth buds are present and developing normally beneath the gums.
Early Teething
Natal and neonatal teeth:
Natal teeth: Present at birth (1 in 2,000-3,000 babies)
Neonatal teeth: Erupt within first month
Usually lower central incisors
May be extra teeth or early primary teeth
Concerns with early teeth:
Risk of aspiration if tooth is loose
Difficulty breastfeeding (can injure mother's breast)
Tongue ulceration from sharp edges
Usually need evaluation by pediatric dentist
If your baby has natal or neonatal teeth, contact your Manhasset or Great Neck pediatric dentist for evaluation. Dr. Debbie will determine if the tooth should remain or be removed.
Very early teething (3-4 months):
Earlier than average but usually normal
Monitor for proper eruption
Begin oral hygiene as soon as teeth appear
Schedule first dental visit by first birthday
Other Unusual Patterns
Teeth erupting out of order:
Usually not concerning
May be genetic
Monitor at regular dental visits
Great Neck pediatric dentist can assess
Teeth erupting in pairs:
Can cause more discomfort
Double the teething symptoms
Provide extra comfort and relief measures
Normal pattern for many babies
Gaps between teeth:
Normal and often desirable in baby teeth
Allows room for larger permanent teeth
Not a cause for concern
Nassau County pediatric dentist monitors development
Caring for Baby's First Tooth
Starting Oral Hygiene Early
The moment your baby's first tooth appears, oral care begins. According to the American Dental Association (ADA), you should start brushing as soon as the first tooth erupts.
For babies 6-12 months (first teeth):
Brushing:
Use soft-bristled infant toothbrush
Rice-grain-sized smear of fluoride toothpaste
Brush twice daily (especially before bed)
Gentle circular motions on all tooth surfaces
Parent does all brushing
Toothbrush selection:
Extra-soft bristles
Small brush head for tiny mouth
BPA-free materials
Replace every 3 months
For specific toothbrush recommendations, see our guide to best toothbrushes for babies and toddlers or ask Dr. Debbie at your Great Neck pediatric dentistry appointment.
Toothpaste:
Fluoride toothpaste from first tooth (AAPD recommendation)
Tiny amount (rice-grain size)
Safe if swallowed in small amounts
Increases to pea-size at 18 months
See our detailed post on best toothpastes for children ages 3 and under for specific product recommendations from your Nassau County pediatric dentist.
First Dental Visit by First Birthday
The American Academy of Pediatric Dentistry recommends establishing a dental home by your baby's first birthday or within 6 months of the first tooth erupting, whichever comes first.
Why visit Great Neck pediatric dentist so early?
Preventive care:
Early cavity detection
Fluoride varnish application for high-risk babies
Professional assessment of development
Prevents problems before they start
Parent education:
Proper brushing technique demonstration
Nutrition counseling for oral health
Teething guidance
Habit counseling (pacifiers, bottles)
Establishing dental home:
Positive early experiences prevent dental anxiety
Dr. Debbie knows your baby's history
Emergency dental care available when needed
Continuity of care through childhood
Developmental monitoring:
Bite and jaw development assessment
Tooth eruption pattern evaluation
Early orthodontic screening
Identifying potential concerns early
At Precious Smiles Pediatric Dentistry in Great Neck, Dr. Debbie's gentle, holistic approach makes first dental visits positive experiences for both babies and parents throughout Nassau County and Manhasset.
Teething and Nutrition
How Teething Affects Eating
Teething can temporarily impact your baby's eating habits, which concerns many parents.
Common feeding changes during teething:
Decreased appetite:
Sore gums make eating uncomfortable
May prefer softer foods
Smaller portions but more frequent
Usually temporary (few days around eruption)
Nursing strikes (breastfed babies):
Discomfort makes latching painful
May refuse breast temporarily
Continue offering with patience
Consider expressing milk if strike continues
Preference for cold foods:
Cold temperatures soothe gums
Offer refrigerated applesauce, yogurt
Cold purées provide relief
Frozen breast milk in mesh feeder
More nighttime nursing:
Comfort nursing increases
Pain worse at night when distracted less
Normal temporary behavior
Return to previous pattern after tooth emerges
Best Foods During Teething
For babies eating solids, certain foods provide both nutrition and teething relief:
Cold, soft foods:
Cold applesauce
Chilled yogurt
Mashed banana (refrigerated)
Smooth purées
Teething-friendly finger foods (for babies ready):
Cold cucumber spears (supervised)
Chilled carrot sticks (whole, large, remove when pieces break off)
Frozen banana in mesh feeder
Cold melon slices
Foods to avoid:
Hard crackers (choking hazard with few teeth)
Sugary foods (promote cavities)
Sticky foods (difficult to clean from teeth)
Very hot foods (irritate tender gums)
Your Manhasset and Great Neck pediatric dentist can provide specific dietary guidance for your teething baby's age and development stage.
Teething Myths and Facts
Separating Truth from Fiction
Nassau County pediatric dentists hear many teething myths. Let's clarify:
MYTH: Teething causes high fever and diarrhea
FACT: While teething may cause slight temperature elevation (under 100.4°F), high fever indicates illness. Diarrhea is not caused by teething. Source: Mayo Clinic
MYTH: All babies teethe at the same age
FACT: Normal teething ranges from 3-15 months for first tooth. Variation is normal and genetic.
MYTH: Late teething means developmental delay
FACT: Teething timing doesn't correlate with other development. Einstein didn't get teeth until 18 months!
MYTH: Teething causes serious illness
FACT: Teething causes discomfort but not serious symptoms. Consult pediatrician for concerning symptoms.
MYTH: You shouldn't brush baby teeth because they fall out anyway
FACT: Baby teeth need care to prevent cavities, pain, and infections. They hold space for permanent teeth. Great Neck pediatric dentists emphasize early oral care.
MYTH: Amber necklaces are safe and effective
FACT: No scientific evidence of effectiveness. Strangulation and choking risks. Not recommended by pediatric dentists.
MYTH: Rubbing alcohol on gums helps
FACT: Dangerous for babies. Never use alcohol on baby's gums.
Teething and Sleep
Managing Sleep Disruptions
Teething often coincides with sleep regressions, challenging for Nassau County families.
Why teething disrupts sleep:
Pain intensifies when baby is still and undistracted
Increased saliva production may cause discomfort
Nighttime is when inflammation peaks
Less environmental stimulation = more focus on discomfort
Strategies for better sleep:
Bedtime routine:
Give pain reliever 30 minutes before bed (if approved by pediatrician)
Extra-long bedtime routine with cuddles
Calm, soothing environment
Consistency despite disruption
Comfort measures:
Cold washcloth before bed for gum massage
Gentle rocking or motion
White noise machine
Room-sharing for easier comfort
When to offer pain relief:
Acetaminophen (Tylenol) for babies 3+ months
Ibuprofen (Motrin/Advil) for babies 6+ months
Only if recommended by pediatrician
Follow dosing instructions carefully
Not for regular use, only when truly needed
What NOT to do:
Don't use numbing gels (benzocaine dangerous for babies)
Don't let baby sleep with teething toys (choking hazard)
Don't use amber necklaces during sleep (strangulation risk)
Don't assume every sleep issue is teething
If sleep problems persist beyond a few days, consult your pediatrician. Your Great Neck pediatric dentist can also evaluate whether dental issues are contributing to sleep disruption.
Special Considerations
Teething in Premature Babies
Premature babies may follow a different teething timeline based on their adjusted age.
Adjusted age for teething:
Calculate from due date, not birth date
Premature baby born 2 months early may teeth 2 months later
Follow adjusted age for developmental milestones
Discuss with your Nassau County pediatric dentist
Special considerations:
May have enamel defects from prematurity
Early dental visit recommended
Close monitoring of tooth development
Nutritional support important
Dr. Debbie's training at Stony Brook University Hospital includes expertise in treating premature babies and their unique dental needs.
Teething in Children with Special Needs
Children with developmental differences may experience teething differently.
Special considerations:
Children with Down syndrome:
Often delayed teething (may not start until 12-24 months)
Teeth may erupt in different order
Regular monitoring by Manhasset or Great Neck pediatric dentist
May need extra oral hygiene support
Children with sensory processing differences:
May be extremely sensitive to teething discomfort
Or may not show typical pain responses
Oral sensory tools helpful
Behavior changes may indicate teething
Children with physical disabilities:
May have difficulty self-soothing with hands/toys
Need adapted teething solutions
Positioning important for comfort
Caregiver provides extra support
Dr. Debbie's fellowship in special needs dentistry at Stony Brook makes Precious Smiles uniquely qualified to support Nassau County families with children who have diverse needs.
When Baby Teeth Don't Fall Out (Shark Teeth)
Understanding Retained Primary Teeth
Sometimes, permanent teeth erupt before baby teeth fall out, creating a "double row" called shark teeth.
What causes shark teeth:
Permanent tooth erupts behind baby tooth
Baby tooth root doesn't dissolve on schedule
More common with lower front teeth
Usually resolves naturally
When to see Great Neck pediatric dentist:
Baby tooth still firm after 2-3 months
Permanent tooth erupting at wrong angle
Discomfort or difficulty eating
Concerns about alignment
Most cases resolve without intervention, but Dr. Debbie can evaluate and extract the baby tooth if needed. This is covered more extensively in our blog post on tooth loss timeline and what to expect.
Teething FAQs from Nassau County Parents
Common Questions Answered by Great Neck Pediatric Dentist
"My baby is 4 months old and seems to be teething, but no tooth yet. How long does teething last?"
Teething symptoms can begin 2-3 months before a tooth actually erupts. The process of a tooth moving through the gum takes time. Symptoms typically intensify in the few days right before the tooth breaks through, then resolve within a day or two after eruption.
"Can I give my teething baby over-the-counter pain reliever?"
With pediatrician approval, acetaminophen (Tylenol) can be given to babies 3+ months, and ibuprofen (Motrin/Advil) to babies 6+ months. Follow weight-based dosing carefully. Reserve for times when baby is truly uncomfortable, not for preventive use. Your Manhasset pediatric dentist and pediatrician can guide appropriate use.
"Should I be concerned if my 11-month-old has no teeth yet?"
Not necessarily. While the average first tooth appears at 6-10 months, some healthy babies don't get teeth until 12-15 months or later. If your baby is meeting other developmental milestones and is healthy, late teething is usually just genetic. Schedule a visit with your Nassau County pediatric dentist if no teeth by 15 months for evaluation.
"My baby's gums are bleeding where the tooth is coming through. Is this normal?"
Minor bleeding when a tooth breaks through the gum is normal. The gums may look slightly red or purple before a tooth erupts (eruption cyst/hematoma). This resolves once the tooth comes through. If bleeding is significant or doesn't stop, contact your Great Neck pediatric dentist.
"Does teething pain really get worse at night?"
Yes, many babies experience more teething discomfort at night. During the day, activities and stimulation distract from discomfort. At night, with fewer distractions and in still, quiet environment, babies focus more on the pain. Additionally, inflammation may increase at night.
"When should I schedule my baby's first dental visit?"
The American Academy of Pediatric Dentistry recommends a first dental visit by your baby's first birthday or within six months of the first tooth appearing. At Precious Smiles Pediatric Dentistry in Great Neck, we welcome babies for their first visits and make the experience positive and educational for Nassau County families. Call 516-330-0671 to schedule.
Protecting Your Baby's New Teeth
Cavity Prevention from Day One
Even tiny baby teeth can get cavities. Great Neck and Manhasset pediatric dentists emphasize early prevention.
Risk factors for early childhood caries:
Prolonged bottle use (especially at bedtime)
Sippy cups with juice throughout the day
Frequent snacking on sugary foods
Lack of oral hygiene
No fluoride exposure
Prevention strategies:
Oral hygiene:
Brush twice daily from first tooth
Use fluoride toothpaste (rice-grain amount)
Wipe gums before teeth appear
Begin flossing when teeth touch
Feeding practices:
Never put baby to bed with bottle (unless water only)
Wean from bottle by 12-18 months
Limit juice to 4 oz daily, only with meals
Offer water between feedings
Avoid sippy cups as "all-day bottles"
Nutrition:
Limit sugary snacks and drinks
Choose tooth-healthy snacks (cheese, vegetables)
Avoid sticky, sugary foods
Rinse mouth or brush after sugary foods
Regular dental care:
First visit by first birthday
Professional cleanings every 6 months
Fluoride varnish applications
Early cavity detection
The Centers for Disease Control and Prevention (CDC) provides extensive resources on preventing early childhood cavities. Your Nassau County pediatric dentist is your partner in keeping your baby's teeth healthy.
Creating Positive Dental Experiences
Building Good Habits Early
How you approach teething and early dental care shapes your child's lifelong attitude toward dentistry.
Make toothbrushing fun:
Sing songs during brushing
Let baby hold their own toothbrush while you use another
Make funny faces in the mirror
Celebrate after brushing
Read books about dental care
Establish routine:
Same time and place daily
Part of bedtime/morning routine
Consistency reduces resistance
Predictability comforts babies
Positive language:
Talk about "healthy strong teeth"
Avoid scary words like "pain," "hurt," "drill"
Make dental visits sound exciting and positive
Never use dentist as threat or punishment
Model good habits:
Brush your teeth with your baby
Show enthusiasm about your own dental care
Let baby see you go to dentist happily
Talk positively about Great Neck pediatric dentist visits
At Precious Smiles Pediatric Dentistry, Dr. Debbie creates welcoming, positive experiences that help Nassau County children develop comfort with dental care from their very first tooth.
The Importance of Baby Teeth
Why Primary Teeth Matter
Some parents wonder why baby teeth need care if they "just fall out anyway." Manhasset and Great Neck pediatric dentists explain why baby teeth are crucial:
Functions of primary teeth:
Chewing and nutrition:
Enable proper eating of varied, nutritious foods
Support healthy growth and development
Allow adequate nutrition during critical years
Speech development:
Necessary for proper pronunciation
Help learn to speak clearly
Tongue positioning against teeth for certain sounds
Space maintenance:
Hold space for permanent teeth
Guide permanent teeth into correct positions
Prevent crowding and orthodontic issues
Jaw development:
Stimulate proper jaw growth
Support facial structure development
Contribute to attractive facial proportions
Self-esteem:
Complete smile boosts confidence
Missing or decayed teeth affect appearance
Social interactions easier with healthy smile
Foundation for permanent teeth:
Healthy baby teeth = healthy permanent teeth
Infections in baby teeth can damage permanent teeth underneath
Early loss can lead to expensive orthodontic treatment
According to research from the National Institute of Dental and Craniofacial Research (NIDCR), untreated cavities in baby teeth can lead to pain, infection, difficulty eating, speech problems, and issues with permanent teeth. This is why your Nassau County pediatric dentist emphasizes early care.
Choosing the Right Pediatric Dentist for Your Baby
Why Specialized Pediatric Dental Care Matters
When your baby's first tooth appears, it's time to establish a dental home with a qualified pediatric dentist.
What makes pediatric dentists different:
Additional specialized training:
2-3 years beyond dental school
Focused exclusively on children's dentistry
Child development and psychology
Behavior guidance techniques
Special needs dental care (like Dr. Debbie's fellowship)
Child-centered approach:
Create positive, fun experiences
Age-appropriate communication
Patience with anxious or resistant children
Understanding of developmental stages
Specialized equipment:
Child-sized instruments and chairs
Kid-friendly office design
Tools specifically for small mouths
Safe, comfortable environment
Comprehensive preventive focus:
Emphasis on cavity prevention
Early intervention strategies
Parent education as priority
Nutrition and habit counseling
Why choose Precious Smiles Pediatric Dentistry:
✅ Dr. Debbie's extensive training: Pediatric residency plus special needs fellowship
✅ Holistic, conservative philosophy: Minimally invasive, whole-child approach
✅ Gentle, compassionate care: Positive experiences from first visit
✅ Convenient Great Neck location: Serving Nassau County and Manhasset families
✅ Expertise in special needs: Fellowship-trained for children with diverse abilities
✅ Comprehensive services: From first tooth through adolescence
Schedule Your Baby's First Dental Visit
Don't wait for a problem to arise. The best time to establish a dental home is when your baby's first tooth appears or by their first birthday.
What to expect at first visit:
Gentle oral examination
Assessment of tooth development
Parent education on oral hygiene
Nutritional counseling
Teething guidance
Fluoride varnish (if appropriate)
Questions answered thoroughly
Benefits of early dental visits:
Prevents cavities before they start
Builds trust and comfort with dentist
Provides personalized guidance for your baby
Catches any concerns early
Establishes lifelong positive dental habits
Preparing for the visit:
Schedule when baby is typically happy and well-rested
Bring comfort items if helpful
Stay positive and calm (baby senses your emotions)
Have questions ready
Complete paperwork in advance if possible
Contact Your Trusted Nassau County Pediatric Dentist
If your baby is teething or has their first tooth, it's time to schedule a visit with Dr. Debbie at Precious Smiles Pediatric Dentistry.
📍 Location: Great Neck, NY (conveniently serving Nassau County, Manhasset, and Long Island families)
📞 Call or Text: 516-330-0671
📸 Instagram: @precioussmilespd @dr.debbiedds
🌐 Learn more: Visit the AAPD website for additional resources
Why Nassau County families trust Precious Smiles:
Fellowship-trained pediatric dentist with special needs expertise
Holistic, conservative, minimally invasive approach
Gentle, compassionate care for babies through teens
Positive, child-friendly environment
Comprehensive teething and oral health guidance
Serving Great Neck, Manhasset, and all of Nassau County
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