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.

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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