TEETHING

DEFINITION

Questions about teething, the normal process of new primary teeth working their way through the gums
Teeth come in between 6 and 24 months of age

Symptoms

Main symptoms are increased saliva, drooling and desire to chew on things.
Occasional symptoms: mild gum pain. Not enough to cause crying or interfere with sleep.
Does not cause fever, diarrhea, diaper rash, ill appearance or lowered resistance to infection.
Caution: Blaming teething for fevers can lead to a delayed diagnosis of ear infections, urinary tract infections, meningitis and other infections.
There are 2 reasons for the onset of infections between 6 and 12 months of age: The loss of transplacental antibodies and the developmental milestone of chewing on everything.

See More Appropriate Topic (instead of this one) If

Main symptom is crying, see CRYING CHILD OLDER THAN 3 MONTHS OLD.
FEVER is also present.

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WHEN TO CALL YOUR DOCTOR

Call your doctor now (night or day) if:

Your child looks or acts very sick

Call your doctor during weekday office hours if:

You think your child needs to be seen.
You have other questions or concerns

Parent care at home if:

Normal teething and you don't think your child needs to be seen.

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HOME CARE ADVICE

Reassurance:

Teething is a natural process.
It's harmless and it causes little if any pain.
It doesn't cause fever or crying. If present, look for another cause.

Gum Massage:

Find the irritated or swollen gum.
Massage it with your finger for 2 minutes.
Do this as often as necessary.
You may use a piece of ice wrapped in a wet cloth to massage the gum.

Teething Rings or Teething Biscuits: Infants massage their own gums by chewing on smooth, hard objects.

Offer a teething ring, pacifier or wet washcloth that has been chilled in the refrigerator, but not frozen in the freezer. A piece of chilled banana may help.
Avoid hard foods that could cause choking (e.g., raw carrots).
Avoid ice or popsicles that could cause frostbite of the gums.

Cup Feeding: If your infant refuses nipple feedings, use a cup, spoon, or syringe temporarily.
Pain Medicine: If the pain increases, give acetaminophen (e.g., Tylenol) orally for 1 day. Special teething gels are unnecessary and we do not recommend them. They can cause allergic reactions or choking.
Call Your Doctor If:

Develops unexplained crying
Develops fever
Your child becomes worse

And remember, contact your doctor if your child becomes worse or develops any of the "Call Your Doctor" symptoms.

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REFERENCES

Anderson JE. Nothing but the tooth: dispelling myths about teething. Contemp Pediatr. 2004;21(7):75-88.
Jaber L, Cohen IJ, Mor A. Fever associated with teething. Arch Dis Child. 1992;67:233-234.
Macknin ML, Piedmonte M, Jacobs J, Skibiski C. Symptoms associated with infant teething: A prospective study. Pediatrics. 2000;105:747-752.
Schuman AJ. The truth about teething. Contemp Pediatr. 1992;9:75-80.
Wake M, Hesketh K and Allen MA. Parent beliefs about infant teething: A survey of Australian parents. J Paediatr Child Health. 1999;35:446-449.
Wake M, Hesketh K, Lucas J. Teething and tooth eruption in infants: A cohort study. Pediatrics. 2000;106:1374-1379.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

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