Teething: Myths versus oral care

Each and every community has its own folklore, myths and old wives' tales about teething. Some are useful; others neutral while some are outright dangerous. Through out history teething has been blamed for many childhood illnesses from refusal to feed to fevers, convulsions and even death!

The Process of Teething

Before a baby is born, the first set of teeth (milk teeth) is already forming inside the jaws. Normally, teething begins near or around the age of six months and continues until the baby is about 3 years old. This is not a rule though as some children start having teeth at birth or about 4 months, while others have none even up to the age of one year.

I would like to reassure parents that if a child is growing normally and there is a delay in the teething process, there should not be much concern, as some children will naturally get theirs late. It has been however noted that girls tend to get their teeth earlier than boys and the patterns tend to be hereditary.

The front teeth usually appear during the first year, while the teeth at the back (molars) do so between ages 1 and 3 years. Babies' teeth also tend to appear in pairs and we should expect 20 teeth by the time a child is 3 years old.

Signs of Teething

Teething is can certainly be uncomfortable to the child as the affected gums swell, and are painful to touch just before the teeth "break" through the gum. This may result in restlessness and even irritability. The effects are usually most dramatic with the first teeth (new experience for the child) and with the molars at the back due to their larger size.

The signs of teething vary from child to child but usually include:

*Gums - these can become sore, swollen and tender. They can even get a bluish hue around the emerging tooth

*Baby can show loss of appetite, be a little moody and even have difficulty sleeping throughout the night.

*Saliva production increases, resulting in excessive drooling

*Chewing - they almost always start chewing on their fingers, toys and other objects

*Rejection of the breasts or feeding bottle, usually because it causes discomfort to the tender gum

It is important to note that there are other signs which are normally attributed to teething BUT which can be the first signs of serious illness. These include:

*FEVER- is not directly related to teething. If a child has a low-grade fever that lasts for more than 48 hours (two days), or if the fever is very high, see a doctor immediately.

*DIARRHEA - does not come because of teething. If present, the parent should seek a doctor's help as it makes the child lose water very rapidly. Some can be life threatening.

*SLEEP PROBLEMS- when this is prolonged then there is definitely another problem beside the discomfort of teething. Much of evening crying though is due to bad habit formation and mismanagement of the child. Especially from first parents, the child discovers that if they cause a fuss they will be carried, played with and given a thoroughly good time!

Treatment

Various methods are now recommended to relieve the discomfort of teething. Some have been around for a long time and have been modified for safety.

Chewing on a clean, cool, hard object will give relief to the sore gums. The types of objects that can be used are limitless and can include cleaned and chilled carrots, teething rings, cold wet flannels. Teething biscuits are not recommended as the child may develop a taste for them and be at risk of early tooth decay.

Teething gels are also available and contain safe chemicals, which lessen the discomfort in the gums. The effectiveness of these is short-lived due to the rapid washing away by saliva in the mouth. They should not be used alone and not too often; up to four times a day should be sufficient.

Some words of caution:

1.Teething does NOT cause high fever, diarrhea or serous sleep problems. When these occur consult your doctor

2.While many foods (carrots, apples etc) can provide relief, chunks of them can pause a choking problem. The infant should be under constant surveillance.

3.Never apply any alcohol to baby's gums. It can be a serious poison for infants.

4.When drooling is excessive, give the baby plenty of fluids to replace the one being lost through saliva.

5.Never tie a teething ring around the baby's neck!