Teething troubles for tots

Teething is a rough time for little mouths. Throughout history, teething has been the source of much anxiety and confusion amongst medical authorities. There has been a long held association between teething and illness, from the ancient Sumerians to the 19th century practitioners. Now we know nearly all cases of illness in tots are attributed to other causes.

Signs and symptoms of being ‘short in the tooth’

A baby is born with about half the tooth already formed, you just can’t see it. There is no firm consensus on why the teeth will spontaneously start shooting through but parents will know that when they do, the ‘why’ doesn’t matter – only what we can do about it.

So watch out for symptoms like:

Daytime restlessness;
Thumb-sucking;
Gum-rubbing;
Drooling; and
Loss of appetite.

It has also been suggested things like slight fever, facial rash, sleep disturbance and ear rubbing may all be associated with teething, but this hasn’t been confirmed. Symptoms will show about 1 or 2 days before and after teething.

Treatment – you can’t handle the tooth!

Teething rings are popular and commercially available. By chewing on the ring, pain relief is provided by the pressure it provides. It’s best to chill them first, and they should always be attached to your bub’s clothing rather than around the neck to avoid any risk of strangulation.

Some home remedies include chewing breadsticks, hardened bread, frozen breads, or a variety of fresh and frozen fruit and vegetables. You can also pop a pacifier in the little teether’s mouth for temporary pain relief. Even just applying a small amount of pressure with a cold spoon, or a clean finger with perhaps some gauze around it, can relieve pressure.

If these remedies aren’t doing the trick then some parents may move onto medications – although they only last a few minutes, so their effectiveness is questionable.

The most common medication is sugar-free paracetamol. There is also lignocaine hydrochloride, which works as a local anaesthetic so should be used very carefully to prevent overdose. Choline salicylate, a product similar to aspirin, is also used, but Reye’s syndrome is related to aspirin use in children so this is now largely avoided.

Big no-nos for teething woes

Adding sugar, honey or jam to a feeding bottle or dipping a pacifier in honey or jam has absolutely no pain relieving effect and will cause tooth decay. Also, keep babies away from the whiskey, because repeated use of alcohol is ineffective and, due to an infant’s small body weight, may lead to severe health problems.

What to expect when expecting … some teeth

In teething, hyperthyroidism (overactive thyroid gland) can accelerate tooth eruption. Other disorders such as neurofibromatosis may also be linked with the primary teeth coming through early. Teething delays can also occur in hypopituitarism, hypothyroidism, Down’s syndrome, cleidocranial dysostosis, Gardener’s syndrome, cerebral palsy and some other conditions.

Eruption cysts – she’s gonna blow!

Eruption cysts are a type of fluid-filled sac that forms on the top of a tooth that is coming through. The cysts are often blue, raised, able to be compressed and oval-shaped. They may form during the period of eruption of the primary or adult teeth. More often than not, eruption cysts go away as the tooth comes through, so often they are left alone. If they don’t, then see your dentist.

Neonatal and natal teeth

Natal teeth (those which come through around the time of birth) can happen but are not common. Most of the natal and neonatal teeth (those which are present at birth) are normal teeth that just come through more quickly than usual, so don’t be alarmed if your little angel comes out with chompers.

There is a chance that the natal or neonatal tooth is actually an extra tooth (supernumerary tooth). This is usually the case in 1–10% of newborns. A dentist can remove the extra tooth to make sure it doesn’t fall out and go down the throat.

Riga-Fedes syndrome occurs in 6–10% of cases of neonatal or natal teeth, and can cause ulceration and infant discomfort. It is often managed by;

Extraction of the offending tooth;
Grinding or discing to remove the roughness, bumps and any sharp edges associated with any given tooth;
Coverage of the tooth with a filling material (composite resin) to provide a smooth rounded surface; and/or
Stomahesive wafers to cover the teeth and provide a smooth surface for the tongue to pass over during suckling.