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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CT-scan-machine
CT – Computed Tomography Scan CT scan or computed tomography scan is an diagnostic imaging technique where cross-sectional images of body are obtained…
kidney stones
Kidney stones Kidney stones are solid substances made up of crystals. They can be of various sizes. Treatment depend on…
Trisodium Phosphate: How a paint thinner made its way into your breakfast Ever thought how toxic chemicals find their way into our foods? How can they harm our body? And…
ureteroscopy
Ureteroscopy Ureteroscopy is the diagnostic procedure which is used for the detection of the kidney stones in addition to…
Rubella IgM test
Rubella IgM Test The Rubella IgM test is a blood test that is performed to diagnose the presence of the rubella…
lp-pla2
LP-PLA2 Test The LP-PLA2 test is a test which is carried out to assess the levels of Lipoprotein-Associated Phospholipase A2…
shiitake mushrooms healthy
What are Shiitake Mushrooms and why should you eat them? Shiitake Mushrooms are well known for their smoky and robust taste. However, did you know they are replete…
beta hcg test
Beta hCG Test A Beta hCG test measures the level of human gonadotropin hormones present in the blood that is primarliy…
Tart Cherry: The healthiest excuse for taking that second serving of pie Tart cherry has been traditionally used in delectable desserts such as pies. Recent studies have revealed that its…
yoga health benefits
How to practice yoga for astounding health benefits Can a 5000-year-old system be the ultimate body healer? Did you know yoga can make you smarter and…
Vitamin b12
Vitamin B12 Test Vitamin b12 is an essential nutrient required for healthy functioning of the nervous system and also development of…
Chlorella: Therapeutic powers of the billion-year-old algae now within your reach Chlorella - A billion year old nutrient-rich algae that can potentially ward off cancers and high cholesterol; the…
Chest X-Ray A chest x-ray is a diagnostic test that uses x-rays to visualize the structures inside your chest. It…
social media adddiction
Your health in the age of Social Media: Why is digital detox a necessity? Did you know that more than 400 million people are dangerously addicted to social media? Are you one…
hepatitis B envelope antigen
Hepatitis B Envelope Antigen (HBeAg) The HBeAg or hepatitis B envelope antigen test is a screening test used to diagnose the onset of…
Exercises or diet? Find out the healthiest way to gain weight Tired of being called skinny all the time? Looking for healthy ways to beef up? Why not try…
blood elements analysis
Vitamin Profile Your doctor will recommend you undergo the vitamin profile test if you are showing signs of either vitamin…
woman with abdominal pain holding ovulation calendar
Ovulation – facts to know about ovulation Learn how and when ovulation occurs, demystify common misconceptions, identify symptoms, methods of detection and right period for…
beta 2 glycoprotein 1 igm
Beta 2 Glycoprotein 1 IgM The Beta 2 glycoprotein 1 IgM test detects IgM class of antibodies in the blood.The presence of beta-2…
beta alanine energy powder
Beta-alanine: A powerhouse of proteins to charge up your workout How can a simple amino acid be a crucial health supplement for champion athletes? Find out how you…
apolipoprotein a1 test
Apolipoprotein -A1 (APO-A1) Test Apolipoprotein A-I (Apo-A1) constitutes 70% of protein content in high-density lipoprotein (HDL) and helps in lipid metabolism.
Low fat diets
A complete list of low-fat diets and how to follow them Low-fat diets help you lose weight in a healthy way, but it works only with regular exercise and…
Mood swings
The real reasons for your mood swings and how to overcome them Are you prone to heated moods frequently? Do you also feel bouts of depressive feeling creeping up on…
anti-chlamydia antibody tets
Anti-Chlamydia Antibody -IgG Test Anti-Chlamydia Antibody - IgG test is performed by collection of urine or genital fluids as sample for testing…
Find all the instant ways to get rid of blackheads Blackheads - Not only are they aesthetically unappealing but if left untreated these can cause bacterial overgrowth on…
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…
antiHEV IgM test
Anti hepatitis E virus (Anti HEV) IgM Test Anti HEV IgM test determines the level of the IgM antibodies in the blood, The disease is often…
Creatine: Is this the right peak athletic-performance supplement for you? Creatine is the amino acid that boosts our energy. Did you know creatine supplements can help you reach…
Bloodtestalbumin
Albumin Test Albumin test or blood serum test is a liver function test that measures the amount of the protein…
GERD heartburn
Heartburn: What are the exact symptoms and the best home remedies? There are easy home remedies for heartburn, which not only acts as a first aid when you experience…
Balneotherapy jacuzzi
5 things you didn’t know about balneotherapy and how you can do it at home Sauna baths have been popular since a long time. But how much more beneficial can balneotherapy be as…
eating disorder anorexia
Eating Disorders: Lifestyle choice or a psychological condition? Is eating disorder just a harmless bad habit? Or does it represent grim psychological disorders? Do you want…
hidden causes obesity
8 hidden causes of obesity you probably didn’t know! Did you know that around 2 billion people worldwide are either overweight or obese? Are you too a…
myelogram
Myelography Myelography is an important diagnostic tool that is used to investigate and identify abnormalities in the spine and…
tonometry
Tonometry Tonometry uses a device called tonometer to measure the pressure inside the eye. This pressure is depends upon…
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…

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