Is it Really Teething?

It's common to hear parents use excessive gnawing and drooling as a sign that their baby is teething.

However, this increase in drooling and oral exploration occurs as part of infant development around 4 months of age and lasts until about 9 to 10 months of age; the period in which teeth tend to erupt. 

Increased saliva (drool) is produced to aid digestion but babies’ mechanical process of swallowing is not sufficiently developed resulting in the overflow of excess drool.

By the time your baby turns 2 she’ll have a mouthful of beautiful pearly white teeth. For some infants teeth arrive with considerable discomfort while for others they appear without any give-away signs or symptoms at all.

There is no way of telling who will suffer specific symptoms and who won’t.

However, there seems to be a genetic link of ear infections with teething, largely due to the shape and slope of the Eustachian tube. Most baby teeth break through at around 6 to 10 months of age. However, it is not unusual to see first teeth appear as early as 4 months of age. Very occasionally, babies are born with a tooth but these are generally loosely embedded and need removing.

While it is obvious that teeth appear at different ages, there is inconsistency between health professionals as to what signs and symptoms are directly associated with teething and what comforting remedies are safe and useful to use.

Over the years of working with many babies and first-hand experience of raising five of my own children, I have definitely seen teething related signs and symptoms but whether these have been due to other causes has not always been clear. For this reason, each episode of suspected teething symptoms should be given individual attention with the diagnoses of ‘teething’ as only one of many possibilities.

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Infants’ increased oral motor ability improves by 9 months and as a result drooling is reduced. But whether drool is part of teething or not, saliva does have properties that cool and lubricate the gums bringing comfort for many babies who are teething.

Moisturising the face with suitable non-fragrant creams can prevent cheek, chin and neck rashes developing from exposure to excess saliva. Gnawing and biting down on anything gives counter-pressure and pain relief to erupting teeth so make sure you provide cold washers and hard toys to bite on. Large amounts of saliva contain increased amounts of enzymes necessary for digestion, which may upset your baby’s digestive system. This can cause her poo to be loose and offensive, and she’ll often refuse to eat.

Her poo can be quite acidic making her bottom sore and red, which can turn fungal if not given regular nappy free time and her skin not protected with a natural barrier cream. With a disrupted digestive system, ear aches and painful gums just before teeth erupt, your baby can feel miserable, irritable, and insecure making her clingy. Giving her extra cuddles provides the comfort and reassurance she needs. Cuddles should come before using any of the increasing varieties of natural and pharmaceutical remedies on the market for teething relief. However, if you do choose to use teething remedies, use only with professional instruction and avoid using any on a long term basis.

Your baby’s unsettled days often lead to unsettled nights but rarely is teething the cause of poor sleep if your baby is happy and content during the day.

Teething pain is generally not causing night waking but it can prevent him from going back to sleep after waking for other reasons. Hunger or the reliance on props such as dummies, feeding, and rocking to settle to sleep are common reasons for night waking from 6 months.

A clear nasal discharge is another common symptom often associated with cutting teeth. Nevertheless, it is also important to consider other possible childhood illnesses because from 6months of age the maternal antibodies provided from birth have reduced in your baby’s system, lowering her immune levels, leaving her more susceptible to illness in general.

When teething, gums can be inflamed and swollen or bluish from an underlying haematoma. Hence, a low grade fever is not uncommon with teething as fever is the body’s reaction to all inflammation. Fever lasts about 24 hours and occurs just as teeth push through the gum. A higher fever (above 40°C) or a lower fever lasting for longer than three days requires further professional assessment.

Suspected teething or not, always be alert to any deterioration in behaviour, low urine output and lethargy, and seek medical assistance immediately. Teething often gets the blame for disruptive behaviours but don’t use teething as an excuse and forget to consider other causes for night waking, fever, digestive issues, biting, and irritable behaviour.

Seek advice from your child health professional if any ‘teething symptoms’ persist for weeks with no teeth to show for the abnormal symptoms and irritable behaviour.

References: http://pediatrics.aappublications.org/content/128/3/471.full.pdf+html http://pediatrics.aappublications.org/content/105/4/747 http://smartpediatricadvice.com/teething http://www.moderndentistrymedia.com/sept_oct2010/tsang.pdf

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Jan Murray has been committed to studying and working as a Registered Nurse, Midwife and Child Health Nurse for over 25 years. Jan has a bachelor of Behavioural Science, is a mother and nanna, who co-founded and directs Settle Petal. Jan provides information and support for parents to develop their knowledge base and confidence.

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