Teething Problems Health Article

Definition

Teething is the eruption of the primary set of teeth (baby teeth) through the gums.

Description

Humans are born with two sets of teeth under the gums. Twenty of these are primary, or baby teeth. Occasionally a child is born with some primary teeth already visible, but more commonly, they begin to erupt around the middle of the first year. The timing of eruption is quite variable but tends to be similar among members of the same family. Generally, all 20 primary teeth have come in by two and a half years of age. Lower teeth usually come in before their upper counterparts. Incisors often erupt first (centrals, then laterals), followed by first molars, canines, and then two-year molars. An early or late pattern of getting baby teeth will sometimes correspond with a similar pattern of losing the baby teeth and getting the permanent teeth. Issues of spacing and orientation of these first teeth do not necessarily indicate that there will be a problem with the permanent teeth. Gaps and crookedness will often resolve.

Causes & symptoms

Many symptoms of teething are nonspecific and can occur for weeks or even months before the teeth actually appear. The teething child may be more irritable, particularly at night. Drooling is likely to become heavier when teeth are coming through, which can also cause the stools to become looser. The excess saliva may cause a rash around the mouth and chin, and produce coughing. Some children will run a low-grade fever, typically about 101°F (38.3°C). Commonly the baby will chew on fingers or other objects to relieve the discomfort. This may also include biting during nursing. The areas where teeth are coming through may appear swollen and red. Sucking can be painful for some babies, who may find nursing uncomfortable at the height of teething.

Occasionally, a small, dark blue area will form on the gums where a tooth is about to emerge. This is the result of a small amount of bleeding beneath the surface of the gums, and is not a cause for concern. It will generally resolve without any special treatment, but cold compresses may be used for comfort and to reduce swelling.

Babies may sail through teething with very little apparent discomfort, or may particularly struggle with certain circumstances. Sometimes the first teeth to erupt seem the most bothersome. The parents of other babies find that it is the large molars which cause the most problem, or groups of teeth coming in simultaneously.