Introduction:
Teething or the eruption of the first teeth in the oral cavity is considered a milestone in a child’s development. The period associated with teething can be stressful for both the child and the parent. Even with modernization, many unexplained teething myths prevail across the world. Therefore, it is essential to regard teething as a normal developmental process.
What Is Teething?
Teething is the eruption of teeth into the oral cavity from the gums and bone; it is also known as odontiasis. The occurrence and the symptoms of teething are different for each baby. The eruption of the tooth is a complex process and can cause discomfort to the baby. The migration of the tooth from the bone to the gums and into the oral cavity is considered a normal physiologic process.
The association of teething with symptoms such as irritability, fever, and diarrhea is a cause of concern for most parents. Although the theory is questionable, some medical practitioners believe that teething is associated with systemic conditions. However, seeking medical help from a dentist is advised to relieve severe teething symptoms.
At What Age Does Teething Occur?
The teething process should start ideally when the baby is three months old. The first tooth has to push the baby’s gums and later erupt into the oral cavity. However, teething can begin as early as four months and last for seven months. If the baby does not display any signs of teething even after seven months, there is no need to worry since teething depends on several factors like genetic factors, the environment of the oral cavity, nutrition, gender of the baby, hormonal factors, systemic conditions, and so on.
What Is the Order of Teething in Babies?
The order of teething in babies is as follows:
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Normally, the first teeth to erupt into the oral cavity are the lower front teeth (lower central incisors).
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One to two months after the eruption of the teeth in the lower front region, the upper front teeth emerge (two central incisors and two lateral incisors).
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Following this, the eruption of the remaining lower front teeth (lower lateral incisors) occurs.
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The first upper and lower molars emerge later.
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The upper and lower canines erupt around the same time after the first molar eruption.
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Lastly, the upper and lower second molars erupt into the oral cavity when the baby is around two years old.
What Are Natal and Neonatal Teeth?
It is common for newborns to be born without any teeth. When a baby is six months old, their first milk tooth emerges into the mouth. Sometimes, the first milk tooth may not appear until the second year. There can be some variations in the teeth eruption sequence, although it usually follows a chronological order.
There are situations where babies are born with teeth. Teeth that are present at the time of birth are known as natal teeth, and the teeth that arise within 30 days after birth are called neonatal teeth. According to some authors, these teeth represent pre-deciduous supernumerary teeth. But in most cases, natal and neonatal teeth simply represent deciduous teeth (milk teeth) that have prematurely erupted.
What Are the Symptoms of Teething?
The general symptoms of teething include:
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Pain.
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Irritation and inflammation of the gums.
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Swollen and sore gums.
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General irritability, babies become cranky and fussy.
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A rise in body temperature.
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Drooling of saliva.
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Rash around the mouth (circumoral rash).
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Disturbed sleep patterns.
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Loose stools or diarrhea.
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Babies tend to bite, suck, or rub their gums.
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Loss of appetite.
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Rubbing ears on the same side of tooth eruption.
The symptoms differ from child to child. Some babies may not experience teething symptoms, while others may be symptomatic. The symptoms of teething vary and can last from several days to weeks. Drooling and chewing are some common symptoms of teething in kids. Besides being irritable for a short time, some babies may be cranky for a long time with crying spells, disturbed sleeping patterns, and disruptions in eating and sleeping routines.
It is normal for a baby to feel uncomfortable during teething, but a visit to the pediatrician (a doctor who treats the diseases of children) is advisable if they seem to be very fussy. It is possible that tender or swollen gums could cause the baby to have a slightly higher temperature than usual. Teething does not usually cause diarrhea or an extremely high temperature. A high fever during teething might be due to other conditions; therefore, one must consult a physician to rule out the other causes.
How Do You Care For Teething Babies?
The current methods for the management of teething include pharmacological and non-pharmacological approaches:
A) Non-Pharmacological Management:
1. A wide range of teething rings are available commercially for babies to gnaw and chew. It is advisable to inspect the contents of the packet to rule out the presence of harmful chemicals.
2. Silicone-based teething rings are advisable compared to liquid-filled rings as they can irritate the gums.
3. Chewing on teething rings can provide temporary relief for babies.
4. Unsweetened and hard rusks made of wheat flour can be given as chewing toys. Fresh, frozen fruits and vegetables such as peeled cucumbers and frozen bananas are good alternatives.
5. Providing a pacifier also gives temporary relief.
6. Reassuring the child can effectively calm a stressed teething child.
B) Pharmacological Management:
1. Topical Agents - This includes local anesthetic agents and analgesics and should be considered after seeking a medical opinion. Before applying the topical agent, parents should wash their hands thoroughly.
2. Lignocaine Products - It is a local anesthetic agent that is rapidly absorbed into the gums. The gel can be applied with clean fingers or using a cotton bud.
3. Choline Salicylate Products - These agents have mild analgesic properties and are similar to local anesthetic-based agents. The gels get rapidly absorbed into the gums and provide instant relief.
4. Systemic Analgesics - Paracetamol syrup (sugar-free) is an alternative treatment if topical agents are not working.
5. Alternative Medicines - Acupuncture, aromatherapy, massage, and homeopathy treatments have been suggested to relieve teething symptoms. However, their effectiveness remains questionable.
Conclusion:
The emergence of teeth into the oral cavity from the gums is called teething. It is also known as odontiasis. Teething can be influenced by genetic factors, the environment of the oral cavity, nutrition, the gender of the baby, hormonal factors, systemic conditions, and so on. As a result, teething symptoms can vary from one baby to another. Common symptoms include pain, tender and swollen gums, irritability, diarrhea, changes in sleep patterns, and so on. Teething can be easily managed by providing the child with silicone-based teething rings, frozen fruits, vegetables, unsweetened biscuits, and so on. Local anesthetic agents and analgesics also offer relief from the symptoms. However, if the baby experiences a high fever, persistent diarrhea, or rashes, medical help should be sought.
