Teething

Dr. Parang Mehta, MD.

Teething produces teeth.

It does not produce fever, colds, or loose motions.  As the teeth pierce the gums, there is some pain and swelling, and the child may be fussy.  The child may also produce saliva in larger amounts, and may drool.  The assumption that a child's fever or diarrhoea is because of teething, often prevents medical care, sometimes with dangerous outcomes.

Management of teething

Nothing much needs to be done.  Some children go through teething with no trouble at all, but some children have soreness of the gums at the time, and become very irritable.  A rubber ring to chew on is enjoyed by some children.

There are no medicines that can make teething easier, and probably none are required.

Teeth at birth

Known as natal teeth, and seen in one in two thousand babies.  They are usually attached loosely to the gums, and do not have deep roots.  They can make feeding difficult for both baby and mother, and may need to be removed.

There is a risk of these teeth getting detached on their own and being swallowed (perhaps into the windpipe -- very dangerous).

Timing of milk teeth eruption

Lower central incisors 5-7 months
Upper central incisors 6-8 months
Lower outer incisors 7-10 months
Upper outer incisors 8-11 months
Lower first molars 10-16 months
Upper first molars 10-16 months
Lower cuspids 16-20 months
Upper cuspids 16-20 months
Lower second molars 20-30 months
Upper second molars 20-30 months

Late eruption of teeth

There is a wide variation in the time when teething is expected to start (see sidebar).
However, if no teeth have appeared by the age of 13 months, it is considered delayed teething.  Delayed teething often runs in families, but may be caused by defects of the thyroid and parathyroid glands, poor nutrition, vitamin D deficiency (rickets), or calcium deficiency.  Some children have no identifiable cause for delayed teething.

An individual tooth may be delayed because of obstruction to eruption.  This could be because of crowding of teeth, or hardening (fibrosis) of the gums.

 

Last Revision: May 12, 2020