Teething

Teething crib

Last Updated December 20th, 2021

Overview of teething

There are several milestones in the growing years of a child. These include- crawling, walking, the growth of teeth and the development of speech. Among all these milestones, teething seems to be the most unpleasant and painful experience for a child. It is an indicator of the development of a child’s first set of teeth. Medically, teething is not a disease. But there are numerous complications related to this condition that a child has to cope with. It usually starts at the age of 4 months and can extend up to 8 months. Teething marks a very important stage in the dental development of a child. Parents should take care so that no oral or dental disease develops during this period.

 

What is teething?

Teething cribTeething or “difficult dentition” or “dentition difficilis” is the natural phenomenon of the eruption of the first few teeth in the earliest stage of a child’s development. It starts with the appearance of upper and lower incisors. Normally, the process starts at the age of 4 months and is almost complete at the age of 8 months. The process is fully complete within the age of 30-36 months, with the eruption of the second primary molars. Usually, the two front teeth present in the bottom are the first ones to erupt. Around 4-8 weeks later, the four front teeth present in the upper gum appear. Within 3 years of age, almost all children have their 20 primary teeth formed. 

 

How does teething occur?

The phenomenon of teething involves two main processes- bone formation and bone resorption. An eruption pathway is generated on opposite sides of the dental follicle. The common tooth germs from within the dental follicle at this stage. A reduced enamel epithelium forms over the dental follicles. The enamel epithelium and the oral epithelium merge at the cusp of the erupting tooth. In the next stage, the upper layer (of fused epithelium) degrades. The development of the periodontal ligament, pulp, and roots of the teeth occurs in the next stage. Finally, the tooth crown emerges and the process of growth of teeth is complete.

 

What are the factors regulating teething?

There are numerous factors that regulate the mechanism of teeth development. Some of these factors may accelerate the process, while some may delay it. The commonly studied factors are listed below-

  • Genes: A particular variety of gene called C-FOS is responsible for “protein-coding” in the early years of a child’s development. Mutations or abnormal activities of this gene can adversely impact the process of teeth development.
  • Hormones: Some important hormones that are regulators of the teething mechanism are- Thyroid hormones, Parathyroid hormones and Pituitary Growth Hormones. These hormones also regulate the functioning of the salivary glands which become overactive during teeth development.
  • Growth factors: Certain growth factors such as Transforming Growth Factors β1 (TGF- β1), Colony Stimulating Factor-1 (CSF-1), Epidermal Growth Factor (EGF) are directly related to “teething”. Infants feeding on breast milk for a long period of time usually have a healthy and timely teething. On the other hand, malnourished children usually exhibit an extremely delayed teething with numerous complications.
  • Cytokines: A few harmful chemicals are released into the child’s body during the “teething period” that lead to the complications associated with teething. These chemicals are called cytokines. A few examples of these types of chemicals are- Interleukin 1α (IL-1α), Interleukin 1β (IL-1β), Tumour Necrotising Factor α (TNF- α) and Interleukin 10.
  • Proteins: A few proteins are closely related to “teething”. These are- Immunoglobulin-A (IgA), Parathyroid Hormone related Peptide (PTHrP) and Monocyte Chemotactic Protein-1 (MCP-1). Defects in protein-coding can lead to complications in the teething period. 

 

What are the common signs and symptoms?

Teething painTeething is accompanied by two main types of symptoms- localized and systemic. The localized symptoms include- irritation and swelling of gums, rubbing of gums and constant thumb-sucking. The systemic manifestations include- excessive drooling, poor appetite, restlessness, constant crying, fever, and irritability. The symptoms are discussed in details below-

  • Drooling: In a few infants, excessive drooling occurs within the age of 3-4 months. This occurs due to the generation of excess saliva in the mouth.
  • Biting: A baby in its teething period tends to bite and nibble at every solid object around it. This helps relieve the pressure of emerging teeth under the gums.
  • Rubbing: A teething baby is often found to rub its cheeks and pull its ears frequently. This happens due to pain in the gums radiating to the cheeks and ears. This symptom is more prominent when the back molars start erupting.
  • Coughing: A baby is found to cough constantly during the teething period. This occurs due to the accumulation of excess saliva in the mouth.
  • Irritation: Irritation and inflammation of gums occur during the teething process. This is also accompanied by soreness and redness of gums when the molars erupt.
  • Rashes: Red patches and tiny reddish dots may appear on the chin and around the mouth. This is often a result of excessive salivation and constant drooling that irritates the sensitive skin of the child.
  • Flu-like symptomsA child may be found to have a low-grade fever and an extremely runny nose, with constant itching during the teething period. A proper diagnosis should be carried out to check whether the symptoms are associated with teething or any other infection.
  • Disturbed sleep: Interrupted sleep occurs especially at night, due to increasing pain caused by the developing molars.
  • Bowel incontinence: Some children show Diarrhoea-like symptoms during teething. This is caused by the swallowing of excess saliva that increases the liquidity of the stool.
  • General malaise: The child may exhibit restlessness, irritability and constant crying. 

 

What are the necessary diagnostic tests?

Dental caries may develop at an advanced stage when the child has already grown a few teeth. Dental probe and dental radiograph are recommended by the dentists in such cases.

 

Treatment and management

Teething infantThere are no treatments for teething. However, the sore gums of the baby can be managed by the following methods:

  • Hard foods– Giving the baby chilled solid foodstuffs to bite on (such as a peeled cucumber or carrot) can ease the irritation.
  • Teething toys– Hygienic and cold teething toys can be given to the baby to ease the sore gums. A cold washcloth, a cold spoon etc. can also help to relieve the discomfort. Use of fluid-filled teething rings should be avoided. The teething toy should be safe for the baby.
  • Gum massage– Massaging with a mild pressure can help in relieving the discomfort. A clean finger or a moistened gauze pad can be used to massage the baby’s gums.
  • Over-the-counter remedy- In cases where the baby becomes cranky and irritable, over-the-counter medications such as ibuprofen or acetaminophen can be given.

As teething is a natural phenomenon occurring while the teeth erupt in the mouth, there are no methods to prevent it.

 

Dos and Don'ts

Dos
  • Massage your baby’s gums. Massaging with a mild pressure can help in relieving the discomfort. A clean finger or a moistened gauze pad can be used to massage the baby’s gums.
  • Give chilled solid foodstuffs such as a peeled cucumber or carrot to ease the irritation.
  • Take your baby for a regular dental checkup as soon as the first tooth erupts in the baby’s oral cavity.
Don'ts
  • Leave the baby unattended after giving hard foods such as carrots or cucumbers. A broken piece might cause choking.
  • Use homeopathic teething medications and medications which have benzocaine or lidocaine. They might be harmful to the baby and even prove fatal in some cases.
  • Ignore symptoms such as a high fever, diarrhea, rash etc. Consult a pediatric dentist.

 

 

 

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6 arguments in favour of glucosamine and where can you find it Studies have shown that glucosamine works by preventing the breakdown of cartilage of the joints. This is usually…
Spinach: The ultimate way to boost health with this green superfood! Spinach is a green superfood that ranks high in both taste and nutrition. Read more to discover how…
Ca 19.9 test
CA19.9 Test CA 19.9 is a cancer antigen that exists on the surface of cancer-causing cells. The levels of CA…
Top 6 remedies to treat a razor burn at home Symptoms of razor burn include bumps on the skin, redness, and irritation of the skin. Find easy and…
hYdroxycut pills
Hydroxycut: How safe are these so-called weight loss supplements? Hydroxycut is a blend of several different ingredients formulated to promote weight loss; powered by a key weight…
top 10 deadliest diseases
What are the top 10 deadliest diseases and what is causing them? What are the largest killers of human lives across the globe? Which diseases are the most fatal ones?…
kefir bottle
Kefir: Top reasons why this probiotic drink should be consumed by you Yet another remarkable fermented food, kefir is a much healthier version of yogurt. These chewy white grains can…
Kava: Is it the healthy substitute for alcohol you have been waiting for? Native to the beautiful South Pacific islands, Kava is a famous beverage rooted in the local culture. It…
Fibromyalgia fatigue
HCG Diet: The dangers of using this diet to lose weight HCG is a natural hormone produced by both men and women that corresponds to fertility. But how is…
EMG electromyography
EMG- Electromyography EMG detects the presence, location, and extent of diseases that damage the nerves such motor neuron disease. Electromyography…
glutamine workout
Glutamine: Why is this the right choice for muscle-gain supplement? Glutamine can help you gain muscles and build higher immunity. Read more to find out how you can…
HSV-IgM test
Herpes Simplex Virus (HSV)-IgM Test The HSV-IgM class antibody is produced by the body a few days after an initial HSV infection and…
These are the top foods to increase your hemoglobin count It is important to add iron-rich foods into your diet in order to increase hemoglobin. Deficiency of hemoglobin could…
alcohol toxic
7 startling facts that will make you quit alcohol today Does drinking really make you friendly and happy? How many calories does a can of cold beer add…
blood elements analysis
Vitamin Profile Your doctor will recommend you undergo the vitamin profile test if you are showing signs of either vitamin…
Turner syndrome and infertility
Infertility profile (women) The infertility profile tests in women are conducted to form a complete picture of the hormonal balance and…
tonometry
Tonometry Tonometry uses a device called tonometer to measure the pressure inside the eye. This pressure is depends upon…
complement c4 test
Complement 4 (C4) Test The Complement 4 or C4 test measures the level of the protein in the bloodstream, and is primarily…
ureteroscopy
Ureteroscopy Ureteroscopy is the diagnostic procedure which is used for the detection of the kidney stones in addition to…
shakeology woman
Meal replacement or protein drink? Learn all about Shakeology and its claims Shakeology from Beachbody claims to be the most suitable shake that can aid in weight loss, regulate blood…
Bronchoscopy procedure
Bronchoscopy Bronchoscopy is a procedure where in a scope is inserted into the lung pathway to observe any growth…
Keto diet healthy
Keto Diet: Did you know you could eat fats to burn fats? Keto diet - A wonder diet that lets you eat fats and lose weight too! Read on to…
green poop causes
Green poop : What are the reasons and how can you correct it Ever sneak a peek down the toilet only to shockingly find green poop? Why does our poop turn…
Echocardiogram
Echocardiography – ECHO Echocardiography (commonly known as ECHO) is an imaging modality (similar to ultrasonography) used to visualize the interior of…
creatinine
Creatinine Test The level of creatinine in the blood is a significant indicator of the health of your kidneys. This…
Jack in the box fast food
Jack In the Box : The perils of surging fast food culture in the USA Jack in the Box - How a culture of fast-food can clog your arteries, weaken your heart, fatten…
beta hcg test
Beta hCG Test A Beta hCG test measures the level of human gonadotropin hormones present in the blood that is primarliy…
Proteinuria and blood pressure
Hypertension Profile Hypertension profile is a panel of blood tests done to analyse the cause of hypertension or high blood…
Crossfit with rope
CrossFit: Now get the perfectly sculpted body with this explosive gym routine CrossFit is a fitness regimen that makes use of high-intensity exercises in a shorter period to achieve muscle…
GM Diet: The fastest way to lose weight or yet another hoax diet? General Motors started this trend of extreme dieting for 7 straight days to ensure its employees were able…
vital organ diseases
Common diseases that could cripple your vital organs Brain, heart, kidney, lungs, and liver - these vital organs are indeed vital for your survival. However, these…
free thyroxine ft4
Free thyroxine test (FT4) The FT4 or free thyroxine test is used to detect the level of free thyroxine of FT4 thyroid…
How to correctly perform nasal irrigation using a Neti Pot? Neti pot has been a part of Ayurveda since centuries. This ancient tool is extremely effective in treating…
Top reasons why you need to pay attention to your vitamin B6 intake Vitamin B6- An essential water-soluble vitamin. Its deficiency leads to physical changes such as sores & glossy tongue…
Dragon Fruit – Blessing from Nature’s Basket Dragon fruit is packed with nutrients but low on calories. It is the dream food that can help…
blood ketone test
Blood Ketone (D3HB) Test The Blood Ketone Test measures and monitors the levels of ketone in the blood which is usually performed…
Milk Thistle skin
Milk Thistle: Find possible cures for fatal diseases in these purple blooms Milk thistle is well-known for treating liver conditions. However, did you know that it comes with a plethora…
aspartame or sugar
Aspartame – Hidden truths about this storm in a teacup Aspartame, the artificial sweetener, has gone under the scanner on several occasions for allegedly doing more harm than…
understanding addiction
Addiction explained: An obsession that could cost you your life Is addiction a behavioral disorder? Or is it a chronic disease? How does addiction cause chemical and structural…
amylase test
Amylase Test Amylase test is done by checking the level of this protein in the blood sample and also in…
kidney stones
Kidney stones Kidney stones are solid substances made up of crystals. They can be of various sizes. Treatment depend on…
cytomegalovirus igm test
Cytomegalo Virus (CMV) – IgM Test The CMV antibodies include both IgM and IgG antibodies which are the immune system's response to a CMV…
folate test
Folate test The Folate test measures and monitors the levels of folic acid in the blood. This test is also…
Okra: How can this nutrient-dense vegetable help you fight diabetes? Okra is a food which is rich in nutrients and minerals which are extremely essential for a healthy…
Juice Plus: Can you really replace actual fruits with pills?  Juice Plus supplements intend to fill nutritional gaps present in our daily diet. But how successful have they…
stress depressed anxiety
Are you depressed or just stressed? Know when to see a doctor Why are some people more anxious than others? Is being depressed the same as feeling sad? Have you…
Cardiolipin Antibody (ACL) –IgG Test The cardiolipin antibody IgG are responsible for the abnormal formation of clots in veins and arteries or phlebitis…
lipoprotein A
Lipoprotein (A) Test Lipoprotein (A) test is used to measure and monitor the levels of LDL(Low-Density Lipoprotein) in the bloodstream in…
Diabetes blood test
Diabetic Profile The diabetic profile is a set of tests used for testing and monitoring the various kinds of Diabetes…
Anti-Inflammatory foods: 18 foods to a disease-free you Anti-inflammatory foods are the foods which are known to reduce the inflammation as well as the pain from…

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