What you should know about your teething baby

Teething is one childhood milestone that brings mixed feelings. The baby’s parents and caregivers are excited that their little one is growing, but the period is riddled with concern as the baby suffers discomfort and sometimes many other symptoms. Most times, these long and varied symptoms, ranging from fever, diarrhoea and conjunctivitis to irritability, are generally attributed to the teething process. While parents and the society hold strongly to their various beliefs about teething, experts say most of such beliefs are mere myths and misconceptions.

Myth 1: Teething causes fever

One symptom that cuts across several cultures as being prevalent during teething is fever. However, experts say teething is not a direct cause off fever. During the teething period of an infant’s life, passive immunity due to maternal antibodies wanes and exposure to a wide variety of childhood illnesses occurs, some of which are accompanied by fever.

Dr Comfort Adekoya-Sofowora of the Department of Child Dental Health, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, said, “At approximately six months of age, when the primary teeth are about to erupt, maternal antibodies upon which young children depend begins to decrease while they build up their own antibodies which are not yet sufficient to defend them against infections.” It’s most of such infections that come with fever.

However, paediatricians say an increase in body temperature is common during teething. However, upon careful inspection, it will be noticed that the temperature increase is actually very small and can be dismissed. They state that symptoms that are associated to teething are not serious and presence of fever (higher than 38.5OC) or other clinically important symptoms are unlikely causes of teething.

Myth 2: Teething causes diarrhoea

Ask most mothers why their teething babies have diarrhoea and with incredulous looks, you would be served the answer that the teething is the cause. However, experts say the teething process does not cause diarrhoea. Dr Olubunmi Bankole of the Department of Child Oral Health, University of Ibadan, Ibadan, Nigeria said, “it is widely believed that “Igbe-gbuuru” literally meaning loose stool is naturally caused by eruption of children’s teeth. This teething process is believed usually to cause the body temperature to rise causing stomach upset and subsequently leading to diarrhoea. It is also postulated traditionally that the teething process generates a lot of saliva in the mouth and the increased swallowing of the saliva contributes to the child’s ill state by causing frequent passage of stool. This they also believe subsequently causes fever, loss of appetite, persistent crying and restlessness in infants. However, these are all myths. The timing of eruption of the primary incisors (six – 12 months) coincides with the period of reduction of circulating maternal humoral immunity in the infant thus predisposes the child to a variety of infections. Also, children at this stage are crawling, resulting in placement of contaminated objects in their mouths, making them more prone to having diarrhoea.”

Myth 3: Babies have a fixed age for the start of teething

Teething occurs when a tooth nears completion of its journey into the oral cavity, a journey which begins early in foetal development. Typically, teething starts at about six months till about three years. However, there have been reported cases of natal teeth (those teeth that are present at the time of birth) and neonatal teeth (those teeth that erupt within the first 30 days of life). Because each baby is different, there is no fixed age a child would begin to grow teeth. Experts say the rate at which baby’s teeth come through will depend mostly on its genetic blueprint (hereditary transmission). Other factors include endocrine disturbances, nutrition, environmental factors. But when a baby gets to 13 months and still has not produced his first teeth and you have confirmed that delayed teething doesn’t run in the family, it is time to see his paediatrician.

Myth 4: Teething causes drooling

Drooling (which refers to an unintentional loss of saliva and other oral contents from the mouth) is normal in the first two years of life as infants don’t often develop full control of swallowing and the muscles of the mouth until they are between 18 and 24 months old. However, because this sign coincides with when teething begins, it is usually misconstrued as a cause. Dr Adekoya-Sofowora said, “The normal salivary gland development which occurs at about two to three months of age when the salivary glands of infants begin functioning contributes to constant drooling. Mothers may misinterpret as a sign of teething.”

Deal with the discomfort of teething

Annetta Tsang of the University of Queensland, School of Dentistry, Australia, in the journal, International Dentistry, suggests pharmacological and non-pharmacological approaches. Non-pharmacological strategies against teething pain aim either at cooling the teething site and/or rubbing the site. Cooling may reduce inflammation by causing constriction of dilated blood vessels and by temporarily numbing the gums.

In contrast, pressure from chewing and massaging the gums may reduce pain by overwhelming the sensory receptors.

Pharmacological strategies for teething generally aim to achieve analgesia, anaesthesia, sedation or a combination of these.

Do’s and Dont’s of teething

=Do massage sore little gums with your clean finger or a cool cloth.

=Do give your teething infant a cool rubber teething ring. Ensure it is kept clean.

=Do start cleaning your child’s gums and new teeth in order to protect their teeth from cavities. Before your baby’s first tooth becomes visible in the mouth, you should wipe the mouth every day with a soft, moist washcloth. As soon as teeth become visible in the mouth, brush the teeth with a small, soft bristle toothbrush that contains a pea-sized smear of fluoride-containing toothpaste.

=If your baby is a heavy drooler, the constant contact with saliva may cause the skin around the chin and mouth to become irritated. Gently wipe your baby’s mouth and chin periodically throughout the day to help prevent chapped skin and rashes.

=Don’t self-prescribe antibiotics. Dr Bankole pointed out that “among the local populace from the lower social class, tetracycline popularly called “capsule” is given to babies to cure “teething diarrhoea.” Tetracycline is known to be taken up by calcifying tissues which can lead to grayish discolouration of teeth. Also, the implication of the indiscriminate use of antibiotics among infants is that the child is at risk of developing adverse reactions such as hypersensitivity to the antibiotic and there is the potential for building of resistant bacterial strains.”

=Don’t administer local concoctions. “Many of these are not scientifically tested with undetermined doses and content; it may be of danger to the health of the child. Documentations have revealed that the use of concoctions have sometimes led to some fatalities in children,” Dr Bankole said.

=Don’t put your baby to bed with a feeding bottle in his/her mouth (unless it’s filled with water). The sugars in formula and breast milk will sit on his teeth all night and can lead to baby-bottle tooth decay.