Tuesday, 30 October 2018 09:40

Teething Featured

For centuries a variety of behaviours and illnesses in infants and toddlers has been blamed on teething. Some of these now we dismiss out of hand as our knowledge of disease has grown. Serious infections could previously be attributed to a baby teething and indeed teething would be put down on a death certificate in times gone by as a cause of death. However, today many people will still attribute their baby’s ill health to cutting teeth. How valid is this?

To understand this it if first necessary to consider what teething actually is.  It is the process where a child’s first teeth erupt through the gum to become visible in the mouth. It starts at about 6 months of age and the process ends between the ages of 2 and 3 years. The eruption process is thought to take about 8 days and there are 20 teeth to appear in this time period. On average about one tooth comes through each month.

The first point to make is that the total time taken in the process of “teething” when all the days are added up is 160 days. So potentially around 20% of a young child’s life between the ages of 6 months and 2 and half years is spent teething. Admittedly sometimes more than one tooth may be coming through at the same time.

What this means is that there is a lot of time spent teething and the chance that behaviours or symptoms that are commonly said to be associated with or caused by teething could just be coincidence. Many parents will also frequently find a tooth has arisen without of the traditionally ascribed symptoms of teething ever occurring.

The dental and medical studies that have looked at this question have not found a very strong association between teething and particular symptoms traditionally said to be caused by erupting teeth. At most teething may cause minor discomfort, some drooling and slightly unsettled behaviour in an infant. Other symptoms such as trouble sleeping, fussiness, poor feeding, tugging at the ears and nasal congestion are probably not related to erupting teeth and are probably more coincidence than anything else and have another cause.

What the research has shown is that teething does not cause severe pain, fever, diarrhoea or vomiting. To attribute these symptoms to teething runs the risk of delaying the diagnosis of more serious problems.

The other danger of over emphasising the severity of teething symptoms is the unnecessary and generally unhelpful use of medicines. More mainstream options such as local anaesthetic gels and painkillers have risks that would be considered unnecessary in what is a benign and on balance not very distressing process. Others such a homeopathic and naturopathic offerings are unregulated with flimsy scientific research. They could, at best, be considered parental placebos. Any folk traditional remedies such as rubbing the gums with alcohol should be filed in the trash bin of history.

We all start to have our permanent teeth erupt around the age of 6 years and generally the child and the parent consider this a painless process. Although infants and toddlers are at a different developmental stage it is hard to imagine that their experience of teething could be so much more severe to require medication.

So what should a parent do with a young child or infant who is distressed at the time of teething? Some suggestions are:

    • You know your own child. If you think they are ill particularly with symptoms such as a fever, vomiting or seem to have pain from which they will not settle then seek medical help. A well meaning relative or friend trying to reassure you this is just teething risks delaying an important diagnosis.
    • Provide teething rings or similar mouthing objects that can’t be swallowed. Some babies seem to find this helpful and it can’t do any harm. Keeping the teething ring cold may add to the helpfulness of this strategy.
    • Be present for your child if they are upset. Soothing words, touch, a quiet environment and cuddling them have a lot to be recommended. Sometimes using distracting activities such as going for a walk with them may also help.

Often when the above information is discussed, parents will relay their own experiences with their child, which they firmly attributed to teething at the time. Every child and situation is different and as parents we only have the personal experience of our own small sample size of children to make a judgement on the validity of teething symptoms.

Research tries to widen this experience to many children and have the symptoms measured more objectively than just through the recollections or impressions of caregivers. The reliability of this research is not yet perfect but the general information that can be trusted is that teething is a benign and not very uncomfortable process that does not give rise to any serious symptoms or consequences.

More in this category: « Fever in Your Child