“Teething children suffer from itching of the gums, fevers, convulsions, and diarrhea, especially when they cut their eye teeth and when they are very corpulent and costive” – Hippocrates (4^th century BC)

Teething in a baby is one of the oldest described problems in various civilizations. Many health problems in a child have been attributed to teething. In fact until the nineteenth-century, doctors continued to believe that teething is the cause of life threatening health problems. Though now doctors understand quite well that teething is not life threatening, it does cause discomfort to a child. But if the symptoms are more serious than mere distress, then probably there is some other problem or infection. Even in modern times, there is lack of complete understanding about teething.

Understanding teething 

Teething is a process in which an infant starts getting the first pair of teeth; it is a process that generally starts in the first six to ten months of life and may continue well up to three years. These new teeth start appearing in the order given below:

• 6 to 12 months: the central incisors (the teeth in the center of jaws, lower one come first, followed by the upper pair)
• 9 to 12 months: the lateral incisors (the teeth next to the central incisors)
• 16 to 22 months: canines
• 13 to 19 months: the first molars
• 25 to 33 months: the second molars

Symptoms of teething

When teething starts, there is usually a mild rise in body temperature, but not very high, generally within the range of 100–101°F (37.8–38.3 °C). If the temperature is higher, there can be other infections or causes. Other symptoms that are often related to teething are as follows:

• Pain and inflammation of the mucous membrane overlying the tooth – meaning that a child may cry more often.
• Gum rubbing/biting/sucking – child may start biting fingers or things more They may even bite the mother’s breast.
• General irritability/malaise
• Disturbed sleep/wakefulness – child may wake up more often at night, and may even cry for no apparent reason.
• Facial flushing – the face of the child may appear rosier than usual.
• Drooling- newborns drool a lot as they still do not know how to swallow their saliva, but they stop doing it. On teething, your child may start drooling again, as more saliva is secreted to protect and lubricate the tender gums.
• Bowel upset - ranging from constipation to loose stools and diarrhea
• Loss of appetite/alteration in volume of fluid intake
• Ear rubbing on the same side as the erupting tooth

Medical treatment of teething

In most cases, these symptoms won’t require medications or any special help. In some cases, the doctor may prescribe a paracetamol/ibuprofen suspension for controlling the pain and fever. One may also apply pain-relieving gels. Many of these gels contain a local anesthetic, therefore one must avoid over-application as any medication can have side effects on the tender organism.

If the fever is high, or other symptoms like diarrhea persist for long, it is a reason for seeking urgent medical attention. It is common for parents to confuse some infection or other health problems with teething.

About the author:
Dr. Preet Bhinder (M.D.)

Dr. Preet is a family physician, and he has been practicing medicine for last 15 years and often sees children with teething in his day-to-day practice. He understands the worries of the mothers and the possibility of other health problems that can be masked by teething. He is also a passionate writer.