Teasing out Teething – Part 1

Medical history can be a funny thing sometimes.  Take for instance this quote by Hippocrates (c. 440 B.C.),

“At the time of dentition there is pruritus of the gums, fever, convulsions, diarrhoea, especially when cutting the canine teeth and in those who are particularly fat and have constipated bowels.”

Many of those physicians that followed Hippocrates shared similar thoughts about teething even going so far to recommend cutting open the gums to “relieve” teething pain.  Well, thankfully in the 21st century with great advances in medicine, we have learned that such extreme measures are, of course, not helpful and in fact, clearly harmful, but even today there is much discussion about the process of teething and just what symptoms, if any, infants and children can be expected to experience.

“Within the first 2-3 years, children will have 20 teeth emerge in their little mouth.”

The eruption of teeth generally begins between 4 months and 12 months of age, but even if your child has not a single pearly white in their mouth by their first birthday, do not worry.  They are most likely coming.  Within the first 2-3 years, children will have 20 teeth emerge in their little mouth.  Teeth are present from early on in fetal development, and gradually, they make their way to the surface with the most common age for first tooth eruption to be 6-7 months.  The first teeth to come in are usually the central incisors, which are those teeth in the middle of mouth either on the bottom or top, and on average, the process of actual tooth eruption takes about 1 week.

“Interestingly, these studies show that no more than 35% of infants experience any one single symptom of teething meaning that just as each child is unique, so will be their “teething experience.””

I have heard or read that teething will cause a vast array of medical ailments from fever, to diarrhea, to making your normally happy child into a snarling and drooling monster.  Well, take a moment to think about this…your child will lose most of those first baby teeth and then “teethe” again when their permanent teeth come in.  Do older children get to say that their bad behavior at school is because they are “teething?”  Is “teething” in the discussion when a 7 year old has diarrhea for a few days? Not likely, but the process of getting permanent teeth is just the same.

Several studies have been done in regards to teething and the symptoms it may cause.  Interestingly, these studies show that no more than 35% of infants experience any one single symptom of teething meaning that just as each child is unique, so will be their “teething experience.”  These studies also found that some children may experience mild symptoms such as drooling, gnawing on items, increased fussiness, and temperature elevation (not true fever necessarily), but these symptoms are usually present only on the day the tooth is erupting and in the few days before and after eruption occurs.  So basically, these symptoms will not be present for weeks or months on end.

So let’s talk about a few of those symptoms that teething supposedly causes…

• Teething does not cause temperatures 101 or higher.  Plain and simple.  If your child has a temperature of 101 or higher and they have a tooth coming in, guess what? They probably also have a virus or another source for that fever.
• Will there be drool when your child has a tooth emerging? ABSOLUTELY!! Your little one will probably be drooling from the time they start chewing on their hands, which from a developmental standpoint, should begin around 4 months of age.  If your child is chewing on something, whether it is their hands, a toy, or food, their body thinks they are eating.  What is the first step in the process of digestion? Saliva production i.e. drool.  So once your infant starts chewing on things, have that bib ready to go.
• Now, diarrhea is another symptom that I hear attributed to teething, and this one is a bit tougher.  If your child is having more saliva produced, is it possible that the rest of the gastrointestinal tract gets “revved” up which could lead to looser stools? Maybe so, but this is a bit of a long shot, and for sure, multiple blow-out diapers a day are not a result of a tooth breaking through. So what is more likely the culprit of this diarrhea?  Once again, those lovely viruses are likely rearing their ugly head, as let’s face it, when infants are teething, EVERYTHING goes in their mouth including germs!
• Finally, does teething cause fussiness in infants?  That is really a great question and one that is difficult to answer since infants aren’t really talking to let me know what is bothering them (boy, that would make my job a bit easier).  I think it is a good bet that the few days prior and after tooth eruption, infants may have some discomfort and therefore, fussiness could be expected.  However, I do not think it will cause continual fussiness for months on end.

Teething is one of those rites of passage that every child will go through, but some do it with more “grace” we shall say.  If you think your child is teething but they start running fever 101 or higher, they are not eating, or just are much more fussy than usual, a visit to your pediatrician is likely needed.  Stay tuned for the next installment of “Teasing out Teething” where I will discuss some of my favorite “remedies” for teething infants as well as those that you should stay away from.