Should Your Child See a Doctor?

Teething

Definition

  • Questions about teething, the normal process of new primary teeth working their way through the gums
  • Teeth come in between 6 and 24 months of age
  • Caution: At least one tooth should be visible before using this topic.

Symptoms  

  • Main symptoms are increased saliva, drooling and desire to chew on things.
  • Occasional symptoms: mild gum pain. Usually, not enough to cause crying or interfere with sleep.
  • Does not cause fever, diarrhea, diaper rash, ill appearance or lowered resistance to infection.
  • Caution: Blaming teething for fevers can lead to a delayed diagnosis of ear infections, urinary tract infections, meningitis and other infections.
  • Caution: Blaming teething for crying can lead to a delayed diagnosis of ear infections or other causes of pain.
  • There are 2 reasons for the onset of infections between 6 and 12 months of age: The loss of transplacental antibodies and the developmental milestone of chewing on everything.

When to Call Your Doctor for Teething

Call Your Doctor Now (night or day) If

  • Your child looks or acts very sick
 

Call Your Doctor During Weekday Office Hours If

  • You think your child needs to be seen
  • You have other questions or concerns
 

Parent Care at Home If

  • Normal teething and you don't think your child needs to be seen
 

Home Care Advice for Teething

  1. Reassurance:
    • Teething is a natural process.
    • It's harmless and may cause a little gum pain.
    • It doesn't cause fever or crying. If present, look for another cause.
     
  2. Gum Massage:
    • Find the irritated or swollen gum.
    • Massage it with your finger for 2 minutes.
    • Do this as often as necessary.
    • Putting pressure on the sore gum can reduce pain.
    • You may use a piece of ice wrapped in a wet cloth to massage the gum.
     
  3. Teething Rings or Teething Biscuits:
    • Infants massage their own sore gums by chewing on smooth, hard objects.  
    • Offer a teething ring, pacifier or wet washcloth that has been chilled in the refrigerator, but not frozen in the freezer. A piece of chilled banana may help.
    • Avoid hard foods that could cause choking (e.g., raw carrots).
    • Avoid ice or popsicles that could cause frostbite of the gums.
     
  4. Cup Feeding: If your infant refuses nipple feedings, use a cup, spoon or syringe temporarily.
  5. Pain Medicine: If the pain increases, give acetaminophen (e.g., Tylenol) orally for 1 day. Special teething gels are unnecessary and are not recommended. They can cause allergic reactions or choking.
  6. Call Your Doctor If:
    • Develops unexplained crying
    • Develops fever
    • Your child becomes worse
     

And remember, contact your doctor if your child develops any of the "When to Call Your Doctor" symptoms.

References

  1. Anderson JE. Nothing but the tooth: dispelling myths about teething. Contemp Pediatr. 2004;21(7):75-88.
  2. Jaber L, Cohen IJ, Mor A. Fever associated with teething. Arch Dis Child. 1992;67:233-234.
  3. Macknin ML, Piedmonte M, Jacobs J, Skibiski C. Symptoms associated with infant teething: A prospective study. Pediatrics. 2000;105:747-752.
  4. Schuman AJ. The truth about teething. Contemp Pediatr. 1992;9:75-80.
  5. Wake M, Hesketh K and Allen MA. Parent beliefs about infant teething: A survey of Australian parents. J Paediatr Child Health. 1999;35:446-449.
  6. Wake M, Hesketh K, Lucas J. Teething and tooth eruption in infants: A cohort study. Pediatrics. 2000;106:1374-1379.

Disclaimer

This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 8/1/2010

Last Revised: 9/23/2010 1:41:59 PM

Copyright 1994-2011 Barton D. Schmitt, M.D.