Your baby is teething: what to expect and what to do

Teething is a process characterized by the axial movement of teeth from a non-functional position (from the bone jaw tissue) to a functional position (on the surface of the alveolar process and gums). Most often, the formation of a temporary bite causes a lot of inconvenience, not only to the baby, but also to his worried parents. In this article from the “Pediatric Dentistry” section, we will try to figure out in what order baby teeth erupt, and what symptoms accompany the development of this process.

Teething: sequence and timing

Normally, teething in babies occurs according to the scheme below:

• central incisors: at 6 months. – in the lower dentition, at 8 months. – on the upper jaw;
• lateral incisors: at 10 months. – in the top row, at 11-13 months. – on the lower jaw;
• first molars (at one year of age);
• canines in the upper row (1 year 4 months);
• canines in the bottom row (1 year 6 months);
• second molars on both jaws (2 years).

The timing of the appearance of the first teeth can vary under the influence of many factors, including:

• toxicosis during pregnancy;
• the presence of Rh conflict;
• prematurity;
• receiving intracranial injury during childbirth;
• infectious diseases;
• congenital hypothyroidism;
• rickets;
• pathology of the pituitary gland;
• neonatal sepsis;
• refusal to breastfeed the baby;
• noticeable weakening of the immune system.

It has been proven that in first-born children, teething occurs much earlier than in infants born at a later time. Boys' first teeth appear later than in girls, while in children of old-time mothers - significantly earlier than in babies born to young parents.

Your baby is teething: what to expect and what to do

The child has a high fever for four days. Runny nose, cough, rash, vomiting, diarrhea... - Doctor, we didn’t want to bother you at all, but we’re already starting to worry!
Somehow this teething took a long time... - So you think these are teeth? (“Have you eaten too much henbane?!” This expression fully reflects what I would like to say, but the clinical pediatrician kept it to himself.) - Well, maybe not teeth in their pure form, but they reduce immunity, but this means that infection easily sets in... - Come on, what else is this about decreased immunity from teeth?! Do you think dentation is tantamount to HIV infection, or what? Teething does not cause any special symptoms. Someone deceived you!

Symptoms of teething

The maximum that can be expected during teething is a bad mood of the child due to unpleasant sensations, increased salivation and a desire to chew on everything. And most new teeth are discovered completely by accident, that is, their birth is not accompanied by any symptoms at all.

It's sad if you come across a pediatrician who loves this word - "teeth" - so much that he tries to explain to them everything that happens to your child. Of course, maybe the doctor is simply sparing your nerves by giving the reassuring “These are teeth,” otherwise there are questions about his professionalism.

Nevertheless, popular rumor ascribes numerous problems to dentition. They start asking the pediatrician “what to prepare for when teething” almost immediately after giving birth. At the same time, people are stocking up on various drugs.

Teething symptoms

There is an opinion that the appearance of the first teeth is accompanied by the development of a whole complex of pathological processes (fever, the appearance of a rash, abnormal stool, vomiting, convulsions, etc.). In fact, the formation of a temporary bite is a natural process that is not characterized by the symptoms described above. Pathologies detected during the teething period are most often manifestations of infectious diseases or a consequence of changes in diet.

In particular, factors that can lead to the appearance of unpleasant symptoms include:

• introduction of artificial complementary foods;
• hypovitaminosis;
• acute viral infections;
• stomatitis;
• tonsillitis;
• runny nose;
• otitis;
• vaccination, etc.

The true symptoms of teething are:

• hyperemia and gradual swelling of the gums;
• the appearance of a small bluish hematoma on the gum tissue;
• slight bleeding from the gums;
• wet cough;
• mild itching caused by mechanical irritation of sensitive nerve fibers in the gum tissue;
• increased salivation;
• various somnological disorders;
• sharp deterioration in appetite;
• tearfulness, capriciousness.

How to prevent vomiting during teething in children[4]

Following simple pediatric recommendations alleviates the child’s condition and reduces the likelihood of vomiting.

1. Calm the baby down. Physical well-being directly depends on his emotional state, especially with an excitable nervous system. If he is breastfed, during teething, do not wean him from the breast, do not introduce new types of complementary foods. The baby may ask for the breast more often than usual, since sucking has a sedative effect, but immediately throws it away and cries due to unpleasant sensations in the gums. Therefore, doctors do not recommend changing the feeding regimen.
2. Give your baby a teether that he can gnaw and chew. It can be filled with liquid to cool the gums and relieve swelling, then it is kept in the refrigerator. Some children do not show interest in soft silicone and latex teethers, preferring to chew on crib railings or any other hard objects. In this case, a wooden teether is suitable. It is best for it to be perceived as a toy that is interesting to be distracted by. It is washed with clean water and given to the child under the supervision of parents 3-4 times a day for a short time. Make sure that the teether is intact so that your baby does not get hurt or choke on a piece of wood.
3. If the pain and itching are too severe, you can use external and internal anti-inflammatory drugs (as prescribed by your doctor) to reduce them. A popular solution is special dental gels, available in pharmacies without a prescription. However, they should not be rubbed into the gums more than 2-3 times a day and you should familiarize yourself with the contraindications before use.

Some dental gels can be purchased without a prescription.
Many are made with benzocaine (check the product label). The US Food and Drug Administration (FDA) warns against using them without medical supervision. FDA recommends that parents of children under 2 years of age not use medications containing benzocaine American Dental Association [6]

4. Using damp cotton swabs, clean the child's nose of secretions to allow him to breathe freely and prevent a secondary infection. Pediatricians also recommend rinsing the nose with saline or sterile sea water, which can be purchased at the pharmacy in the form of drops or sprays.

First aid for teething

When baby teeth appear, the baby may require not only parental care, but also medical attention. The dentist may recommend that parents use anesthetic dental gels and treat the affected areas of the gums with decoctions of sage, oak bark or soda solution. If the pain is severe, the baby may be prescribed paracetamol, ibuprofen and other systemic painkillers.

To ease the discomfort that a child experiences when teething, it is necessary to use teethers - specialized devices made of rubber or plastic that the baby can bite and gnaw on without risking damage to the soft gum tissue. In addition, it is advisable to regularly massage the child’s gums with a finger wrapped in a clean, damp bandage.

What are normal teething symptoms?

It should be understood that teething is an ordinary physiological process that in itself does not cause serious health problems. However, children during this period may experience anxiety, be capricious, and exhibit a number of alarming symptoms. First of all, in the place where the tooth erupts, swelling and increased sensitivity of the gums are observed. The child begins to actively suck, chew and bite surrounding objects. He has increased salivation, which can irritate the skin around his mouth. These are the main symptoms that are observed in almost all babies. Fever, hyperexcitability, loss of appetite and sleep disturbances are common, but they do not appear with every new tooth. Suffice it to remember that the complete dentition is usually formed by the age of three, and children usually experience severe anxiety only in the first year of life.

For reasons unrelated to teething, the following symptoms may appear:

• increased body temperature;
• frequent bowel movements;
• nausea, vomiting;
• nasal congestion.

First of all, it is necessary to take into account the individual characteristics of the child. The symptoms inherent in a particular constitution can be summarized in a table [3].

Vomiting and high fever during teething, caused by the constitution, are characteristic only of the neuro-arthritic type. Only 13.1% of children fall into this category. The main types are lymphatic-plastic, its share is 53.5%, and allergic - 33.4% [3]. Thus, if a child belonging to these two types begins to vomit during teething, it is most likely due to an associated respiratory infection. However, children of the neuro-arthritic type are not protected from infection. The period of teething coincides with the introduction of complementary foods, the baby receives fewer antibodies from mother's milk, and immunity decreases. Therefore, in any case, if the body temperature rises above 38°, vomiting, or thick greenish discharge from the nose, you should call a doctor so as not to miss the onset of pneumonia, pyelonephritis or meningitis.

Teething syndrome is included in the International Classification of Diseases, but is a diagnosis of exclusion. Its signs:

• liquid transparent nasal discharge caused by excess mucus production against the background of gum inflammation (no more than 5 days);
• loose stools up to 5 times a day as a result of salivation, which increases intestinal motility;
• short-term increase in temperature, no more than 38°;
• vomiting, if infection is excluded and the child belongs to the neuro-arthritic type.

Caring for emerging teeth

Teething is an absolute reason for making the first visit to the pediatric dentist. During the consultation, the doctor identifies all deviations in the structure of the child’s dental apparatus, assesses the condition of the frenulum of his lips and tongue, draws up a dental care plan and a plan for preventive visits to the dental clinic.

It is advisable to brush emerging teeth twice a day. Initially, you should use a baby silicone brush or a small piece of gauze without toothpaste for cleaning. A regular toothbrush can be used when the child is one year old, and toothpaste when he reaches two years of age. In addition, it is important to pay attention to the process of enamel mineralization. In particular, it is necessary to limit the consumption of sweets and include foods enriched with calcium, phosphorus and ascorbic acid in the baby’s diet.

What should oral hygiene be like when teething?

Oral hygiene and caries prevention are important to reduce the likelihood of secondary infection. Brush your baby's teeth using a special napkin impregnated with xylitol and anti-inflammatory components (sold in pharmacies without a prescription). Do not give your child sweet food or drink, especially at night; Do not dip the pacifier in honey or sugar. When the first tooth emerges, visit your pediatric dentist to schedule periodic checkups [6]. Maintain a calm atmosphere in the house and carefully follow the pediatrician's instructions, this will help the child cope with teething easier.

What causes the temperature to rise during teething in children?

When babies erupt their first teeth, 2 processes occur that are interconnected:

• In the oral cavity, local immunity decreases, which is why a secondary infection may occur. Stomatitis, sore throat, pharyngitis and other diseases can often occur.
• At the site of tooth growth, the production and release of many biologically active substances necessary for softening the gums occurs.
• Inflammation of the gums and reduced immunity often provoke a protective reaction of the body - body temperature rises to 37-37.5.

In infants, when teething, the body temperature should not be higher than 37.5 degrees (the so-called low-grade fever).

During this period, it is necessary to carefully monitor the general condition of the baby. There are children who tolerate this temperature quite normally. And for others, help is needed in order to survive such an unpleasant period. Sometimes children may be bothered by a slight increase in it, they may cry, be capricious, refuse to eat, or not sleep at night.

Important: keep in mind that if a baby experiences an increase in body temperature to 38-38.5 °C, consult a doctor immediately. In no case should you attribute everything to your teeth, as such a symptom may indicate an additional infection or inflammatory process.

How long during teething do children usually have a fever? Normally this is no more than 1-3 days. Most often it rises at night, does not exceed 38 degrees and is easily knocked down.

Important: if your little one has a fever for more than three days, the temperature is above 38 degrees and does not go down well, seek medical help immediately.

Is the rash associated specifically with teething?

The answer is yes, it happens. As a rule, during this period, the baby is very excited, the inflamed areas of the gums are very itchy, the child does not find a place for himself and his body responds to this severe stress with a decrease in immunity and a deterioration in the general condition of the body. Therefore, if you see that there is a rash on your child’s body, then to find out for sure whether it could be as a result of teething or is it a response to some allergenic component or microbial infection, you need to visit a doctor. The doctor will examine the child, conduct diagnostic procedures and, if treatment is necessary, prescribe it. But if the doctor does not find any other problems other than a reaction to teething, then this is not a reason to think that the rash is not serious.

The main symptoms that occur during teething

During the period when a child is teething, the following is most often observed:

• increased salivation;
• swelling, redness, soreness of the gums;
• irritability;
• sleep disturbance;
• poor appetite;
• need for chewing, biting, sucking.

Rarer symptoms include:

• temperature rise to 380;
• diarrhea;
• rhinitis;
• nausea and/or vomiting.

According to research by scientists from the Federal State Budgetary Educational Institution of Further Professional Education RMANPE of the Ministry of Health of Russia, certain symptoms occur in 60-70% of children. And only 30-40% do not experience any unpleasant manifestations. The symptoms listed above are more pronounced in infants who had low birth weight.

The study authors also concluded that in most cases, fever, runny nose, and diarrhea are not associated with the process of teeth emerging, but with manifestations of infection. If the pediatrician determines that the child’s condition is caused by teething, parents have no particular reason to worry. You just need to help the baby get through this difficult period.