Teething Symptoms, Causes and Treatment: Help Parents Make Informed Decisions
Claudia Anrig, DC
Many pediatricians, scientists, researchers and parents have disagreed about the concept of teething, but any mother of a little one will tell you that whether or not it's just a coincidence, their babies are miserable when their teeth start coming in. Let's review the symptoms of teething, particularly symptoms that mimic other childhood conditions commonly treated with antibiotics; and discuss natural options for treating this normal stage of childhood development.
Teething 101
When newborns are born they have "teeth buds" just under the gums, and while there is no set time that those teeth will begin to appear, typically their first tooth will begin to break through between 5 and 7 months of age. Some infants can begin teething as early as 3 months; some as late as 9 months to even a year.
Typically the incisors (top and bottom middle teeth) appear between the ages of 6-7 months. Between the age of 7 and 9 months, the incisors will come in on each side of those first teeth that appeared. By around the age of 8 months, a baby may have eight teeth. The first molars begin to break through at 10-14 months and the canines at 15-18 months. Finally, the second molars will come in, typically between the ages of 2 and 3 years.1
Teething Symptoms
Many experts actually disagree about whether or not teething even has symptoms, but most parents report unique changes prior to the appearance of their infant's teeth. For instance, when a baby is teething, their saliva production increases. This has caused many symptoms including drooling, which can sometimes cause a rash on their chin; coughing or gagging on the excess saliva; and loose bowels due to swallowing that excess saliva.
Additional, teething symptoms can manifest as irritability or a desire to gnaw on anything within grasp. The pressure of the tooth trying to break through the gums can cause discomfort, leading to irritability. Many babies instinctively reach for something to gnaw on, as pressure on the gums will sometimes counteract the pressure caused by the teeth.
Misdiagnosing Teething
Most problematic for young parents is that teething symptoms may often be mistaken for common childhood disorders. Pain from the gums can travel to the cheek and even the ear, causing an infant to rub their cheek or tug on their ear. Many young parents are taught to watch for this as a sign of an ear infection, so in response, a parent will take their child to their pediatrician.
The problem is that an irritable, teething infant will probably have been crying as well. Combined with the effects of teething, this can lead to red ear, commonly leading to a misdiagnosis of otitis media and an unnecessary prescription for antibiotics.2-3
It is extremely important that parents do not accept this diagnosis without asking their doctor more questions. Even the American Academy of Pediatrics (AAP) set new guidelines in 2013 to regulate overly prescribed antibiotics in the treatment of otitis media, after finding that prescriptions were being written when they were not necessary.4
The AAP suggests waiting 72 hours before giving a child antibiotics, as typically fluid behind the ear (or teething symptoms) can cause a false diagnosis. Another way to avoid getting an unnecessary antibiotic prescription: Tell parents to request a culture test. There really is truly no way to confirm otitis media without one.
Common Cold or Cutting Teeth?
Another common childhood disorder confused with teething is the common cold. Since teething can lead to runny nose, mild / low-grade fever, and coughing or sneezing, many infants have been treated for a cold or allergies when it was nothing more than a breaking or cutting tooth. It's important for your parents to realize that our bodies were designed to do things in a certain way; not everything needs to be treated medically.
OTC Options for Teething
Recognizing there really isn't anything that can be done medically is little comfort to a parent dealing with a fussy, cranky, miserable little baby. Knowing what to do to ease their discomfort and relieve some of the pain is empowering to a concerned parent who potentially feels powerless.
The first thing to understand is that there are natural, holistic choices, and it is never going to be necessary to resort to pain relievers or gum-numbing agents. These items can actually do more harm than good, and aspirin should never be given to a baby even to rub on their gums, as it has been linked with the potentially deadly condition called Reye's syndrome.5
Acetaminophen should also never be used, as the long-term effects of the chemicals in pain relievers on infants have not been recorded.
With regards to gum-numbing agents, while they have been found to be effective, they may be potentially dangerous. Popular pediatrician Dr. William Sears says on his website, "We do not recommend commercial gum-numbing substances because it is difficult to learn their exact contents and find research that validates their safety."2
Alternative Relief
Teething tablets are the only over-the-counter teething treatment approved by homeopathic and holistic professionals. Designed specifically to help babies with their teething symptoms, these tablets dissolve immediately in the mouth and naturally relieve swelling and pain. Additionally, there are many home remedies that can help to relieve pressure, pain and discomfort.
The first thing to understand is that the baby's gums are sore and aching. A sharp tooth is trying to push through the gums, causing the discomfort and resultant fussiness. Anything that will counterbalance that pressure is going to bring relief.
Many parents have reported that a clean, wet washcloth put in the freezer for a short time, then given to the baby to gnaw on, brings welcome relief. The cloth can be dipped in water or strong chamomile tea. Tea is a calming agent and is soothing to an infant's tummy. Similarly, a frozen banana given to the baby will give them something natural to gnaw on.
Keep in mind that any item which might be used by the parent to help their child should not be so small that the child could choke on it.
Ice placed in a sandwich bag and then wrapped in a cloth also works well. For the older child who is already eating solid foods, cold, soft foods such as applesauce or diced papaya can bring relief.
Other Home Remedies: Amber teething necklaces have been used in Europe for some time and have recently become popular in North America. This fossilization of resin from ancient trees is touted to have natural calming, relaxing and analgesic properties.
And in her book Natural Baby and Childcare, Dr. Lauren Feder, a holistic medical doctor, recommends several homeopathic remedies: belladonna for teething accompanied by sudden fever; Calcarea carbonica for chubby and sweaty babies, especially while nursing or during sleep; Calcarea phosphorica for delayed teething; and chamomilla for swollen, inflamed and tender gums.6
Educate Your Patients
It's important for parents to understand it's not necessary to interfere with the natural routine of teething. Every child is different, but teething has been proven to be hereditary. If an infant's parents' first tooth appeared when they were 3 months old, then it's safe to assume this will be generational. Educating young parents in advance about what to expect – and to recognize the body's innate ability to work as it was designed – you can serve as a helpful guide for parents as to natural ways to care for their children.
References
"Is My Baby Teething?" The New Parents Guide.
"Is Baby Sick or Teething?" Ask Dr. Sears.
Ear Infection Causes and Symptoms: Ear Infections vs. Teething. Kidspot.com.au - Family Health: Pain Relief Zone.
Lieberthal AS, Carroll AE, Chonmaitree T, et al. American Academy of Pediatrics Clinical Practice Guideline: the diagnosis and management of acute otitis media. Pediatrics, 2013 Mar 1;131(3):e964-e999.
"What Is the Role of Aspirin in Triggering Reye's?" National Reye's Syndrome Foundation.
Feder L. Natural Baby and Childcare: Practical Medical Advice and Holistic Wisdom for Raising Healthy Children. Hatherleigh Press, March 17, 2006.
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