Teething

Are you looking for information and solutions for your teething baby or child? Here Dr. Emil give answers about teething and oral care in babies and young children.

The deciduous teeth are the first set of teeth which develop in children. They are also called the milk teeth. In total, there are 20 milk teeth that develop between the age of 3 months and 3 years.

As the adult teeth develop, they push the milk teeth out of the way and loosen them until the milk teeth eventually fall out, leaving space for the permanent teeth to grow.

Teething refers to the appearance of an infant’s teeth through the gums. It is a perfectly normal process which all children go through. Although the entire process takes around 2 ½ years, children only usually show signs of pain and irritation for the first few months. This is possibly due to the infant’s ability to adjust and adapt to the discomfort.

Of all of the developmental milestones, teething is one of the most unpredictable as the age at which it begins and the duration of the process can vary significantly from chid to child.


The first teeth usually begin to show at around the age of 3 months. However, the teeth begin to form much longer before they appear. Some children may develop their milk teeth earlier than 3 months whilst others may go through teething as late as 9 months. Although it is very uncommon, some children may even be born with their milk teeth. Both boys and girls begin to go through teething at around the same time, making it one of the few developmental milestones that both genders experience more or less simultaneously.

The first teeth to begin to appear are usually the 2 lower central incisors. These appear between the ages of 4 to 7 months. The next teeth to appear are the upper central incisors and these are followed by the upper lateral incisors. The 4 upper teeth appear between the age of 8 and 12 months. Between 12 and 15 months, the lower lateral incisors appear and the 1st molars appear at around the same time. The canines appear between the age of 16 and 20 months. Lastly, the 2nd molars appear. These can appear as early as 20 months or as late as 3 years.

Not all babies experience teething symptoms. For some babies the process appears to be quite painless whilst others may experience symptoms that are severe enough to cause the parents to seek medical advice.

Symptoms associated with teething include:

Irritability:
This is likely a result of the pain and inflammation felt as the teeth push through the gum line. Irritability usually manifests as sleeplessness, restlessness and crying. This can be quite distressing for new and young parents and a thorough explanation and reassurance does a lot to ease their worries.

 Salivation:
The production of saliva usually increases during teething. This often results in excessive drooling.

Fever:
Some infants develop a fever during teething. It is currently debateable whether or not the fever is a result of the teething and associated inflammation, or if it is due to an unrelated infection. A mild fever appears to be relatively normal during the teething process. However, the young immune system is constantly reacting to new stimuli and the occurrence of both a fever and teething is most likely just a coincidence. Also, the stress of teething can weaken the immune system, leaving the infant more susceptible to infection.

Please remember that an infant with a high temperature, especially when associated with other warning signs such as failure to thrive, loss of appetite, weight loss, diarrhoea, dehydration or apathy, should always be examined by a suitably trained healthcare practitioner.

Advice for parents:

Many babies appear to show an improvement in their symptoms when given something soft to chew on. It is important to keep small objects which can be swallowed and can cause choking, away from teething children. Also, it is important not to let infants chew on items which are breakable or which contain chemicals. A damp cloth that has been left in the freezer for 15 minutes is a safe item to chew on, and the coldness will help to alleviate inflammation.

Gently dab any drool of the face with a soft cloth as excessive drool may result in skin irritation.

Cleaning infant’s teeth
Clean your baby’s teeth from as young an age as possible. Even though the deciduous teeth fall out and are replaced, they still need to be properly cared for. If the deciduous teeth fall out too soon, as a result of decay or disease, the gap that is left may shrink. This may result in insufficient space for the adult teeth, which in turn may cause all sorts of dental problems later in life.

Cleaning infant teeth must be done very gently, with a very soft infant toothbrush or a sterilised and clean cloth and warm water. Do not use toothpaste in infants as they are not able to spit it out as ingestion of toothpaste causes an upset stomach as well as a number of other undesirable effects on the health.

Diet is also important. Excess sugar and acidic juices can cause tooth decay. Don’t let children fall asleep with a bottle in their mouth as the juice pools behind the teeth and the prolonged contact can damage the teeth with “Baby Bottle Caries” as the result.

Constant thumb, dummy or bottle sucking during the day and throughout the night can result in the development of an over bite and should therefore be gently discouraged from a young age.

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