Teething must rank among one of the biggest mysteries of childhood. What, exactly, is going on there? We asked Dr Natasha Padayachee of Prana Kids Paediatrics, to answer some of your questions.
Q: How do you know when babies are actually teething? My child didn’t show any symptoms like dribbling, nappy rash or fever.
A: Teething is the process by which an infant’s teeth erupt, or break through, the gums. Teething is also referred to as ‘cutting’ teeth. The onset of teething symptoms typically precedes the eruption of a tooth by several days. While a baby’s first tooth can appear between 4 and 10 months, the first tooth usually erupts at approximately 6 months of age.
Teething is generally associated with gum and jaw discomfort as the infant’s tooth prepares to erupt through the gum surface. As the tooth moves beneath the surface of the gum tissue, the area may appear slightly red or swollen. Some babies may not experience any concerning changes, whereas for others, teething may cause the following symptoms:
- Increased drooling
- Restless or decreased sleep due to gum discomfort
- Refusing food, due to sore gums
- Fussiness that comes and goes
- Bringing hands to the mouth
- Mild rash around the mouth due to skin irritation caused by excessive drooling
- Rubbing the cheek or ear region because of referred pain during the eruption of the molars.
Importantly, teething is not associated with the following symptoms:
- Fever(especially over 38.5°C)
- Diarrhoea, runny nose and cough
- Prolonged fussiness
- Rashes over the body.
Q: My 18-month-old toddler is usually so happy, but lately she’s been crying incessantly. Are eye teeth more painful?
A: 18 months is usually the age when the canine teeth first appear and, yes, they may be associated with more discomfort and pain because of their shape.
Q: How long does teething last?
Children generally have variable discomfort during the few days before tooth eruption through the gum line. Some babies are bothered by this more than others.
Primary teeth generally appear in the following order:
- Central incisors: 6-12 months
- Lateral incisors: 9-16 months
- Canine teeth: 16-23 months
- First molars: 13-19 months
- Second molars: 22-24 months
Q: My second child has 6-8 dirty nappies a day when he is teething, which usually leads to nappy rash. Why does this occur! I know it’s quite common but my first child didn’t experience this.
A: It is a commonly held belief by parents that teething causes diarrhoea. The thinking is that the excess saliva caused by teething somehow affects the gastrointestinal system. Current medical opinion, however, is that there is no evidence of a causal relationship between a child’s teething and any issues with the alimentary tract. But what is a parent to think when diarrhoea seems to inevitably follow erupting teeth? The answer may lie in the fact that teething children tend to pick up bacteria and viruses that can cause diarrhoea, probably because they place a lot of different objects in their mouths as they try to soothe the pain. Often, these objects carry germs that cause loose, frequent stools.
Q: Why does teething interrupt sleep?
A: Many parents have reported that teething pain appears to become more intense at night. It has been reasoned that this happens because children feel the symptoms of pain and discomfort most acutely when they have fewer distractions, and are exhausted. It’s the same reason adults feel more chronic pain at night.
Q: Why does my paediatrician say there is absolutely no scientific evidence supporting any side effects of teething like temperatures and snotty noses.
A: While some parents believe that teething can cause a fever, there’s no evidence to support this idea. It’s true that teething may slightly increase a baby’s temperature, but it won’t spike enough to cause a fever.
If your baby has a fever at the same time as they are teething, another, unrelated illness (like a viral infection, which may occur independently, yet at the same time as tooth eruption) is likely the cause. The debate and studies continue; however, research to date has been unable to show a causal relationship between teething and the development of a fever.
It’s also worth noting that the symptoms that concern parents, like fever, fussiness and diarrhoea are common – just as teething symptoms are common. Rather than assuming that these troubling symptoms are caused by teething, consult your doctor.
Q: How effective are teething necklaces and medication?
A: You may have heard that amber teething necklaces release a pain reliever when heated. However, this has not been proven, and doctors generally agree that these necklaces are not a good idea because they carry their own dangers. Not only can they strangle children; the beads present a choking hazard if the necklace breaks.
If you do choose to use one, make sure to:
- Put it on a wrist or ankle, not around her neck.
- Always watch your baby when she’s wearing it.
- Take it away when you are not watching your baby, even for a very short time.
As for teething medication: medicine applied to a baby’s gums may not help because it washes away quickly in the mouth.
Stay away from over-the-counter teething gels and liquids containing the ingredient benzocaine. The FDA says this ingredient shouldn’t be given to children under the age of 2 because it can cause rare but serious side effects.
More about the expert:
Prana Kids Paediatrics is a specialist paediatrics practice based @Fourways Life hospital lead by specialist Paediatrician Dr Natasha Padayachee-Govender. Learn more about the practice here.
In her 16 years as journalist, Lisa Witepski’s work has appeared in most of South Africa’s leading publications, including the Mail & Guardian, Sunday Times, Entrepreneur and Financial Mail. She has written for a number of women’s magazines, including Living & Loving, Essentials and many others, across topics from lifestyle to travel, wellness, business and finance. She is a former acting Johannesburg Bureau Chief for Cosmopolitan, and former Features Editor at Travel News Weekly, but, above all, a besotted mom to Leya and Jessica. Lisa blogs at whydoialwayscravecake.blogspot.com and lisa.witepski.blogspot.com, and tweets at @LisaWitepski.