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Teething Symptoms

Teething is the term which describes symptoms associated with the emergence of new teeth through the gum line. It is typical in infants when the primary teeth are erupting and also in children around the age of 6 years when the first permanent molars erupt. These teething symptoms may include localized discomfort, generalized irritability, swelling of the gums, drooling and a low-grade temperature (less than 101 F). Anecdotally, there often seems to be an associated loosening of the stool; this may be from an alteration in the child’s diet during the teething rather than a direct effect . An alternate definition of “teething” is the chewing or “gumming” behavior which occurs because of the sensation caused by the emerging teeth.

The sensation of teething is an interesting one. While no one knows what an infant “feels”, teething “discomfort” may occur on two levels. The first may be more of an “irritation”. The infant seems to maintain a happy demeanor and seems to desire “gumming” or gnashing on objects. However, in the course of this behavior the infant may reach a point where true pain is inflicted by the “gumming” behavior, causing the infant to stop gumming, withdraw the teething object and perhaps cry out briefly.

Treatment to help with Teething Symptoms

Medications

  • Acetaminophen (Tylenol, Tempra and others) is useful for the pain. It is important to check your child’s temperature before giving tylenol for teething pain because you do not want to mask a fever.
  • Ibuprofen (Motrin, Advil, and others) is useful for the pain and lasts longer than Tylenol. It is important to check your child’s temperature before giving the ibuprofen for teething pain because you do not want to mask a fever. Ibuprofen should be taken with food and should not be given to children who are dehydrated.
  • Topical benzocaine (Baby Orajel, Baby Anbesol and others) is a topical anesthetic which can reduce the gum discomfort. A tiny drop should be rubbed into the gums where the teeth are erupting. These medications work very quickly but do not last very long.
  • Teething tablets, because of their size and the risk of choking, shouldnot be used.

Teething objects

  • Teething Rings–these and similar objects manufactured just for this purpose are the safest objects for infants to use. Care must be taken to keep the objects clean.
  • Cool, wet washcloths can provide comfort. Rub your child’s gums with the cool washcloth or let him chew on it.
  • Teething biscuits are probably the favorite object of teething infants. However, infants must be under constant supervision while using these because of the risk of choking. Once your child has some upper and lower teeth, teething biscuits may be easily broken and thus present a choking hazard. These older infants should be given teething rings.
  • Bagels (frozen or otherwise) usually can be gummed for long periods of time without breaking apart. They should not be cut, but given whole, so that small pieces cannot be chewed off by the infant. Constant supervision is again required.
  • Pieces of fruit should not be used because of choking risk. There is a new device which places fruit into a mesh-like holder, thus preventing large pieces from breaking off. This may be a safe exception.