Teething

     Infants usually begin teething about 4 months of age. An infant can be born with teeth (these are extra teeth and are usually removed right after birth) or still not have teeth at 9 months, but the average is 4 months. This is confused by the fact that all 4 month-old infants drool a lot and chew on anything that comes within a foot of their mouth because chewing and drooling are mistakenly identified as signs of teething. Actually it is just nature getting the infant ready for solid foods.

     Teeth come in gradually – pressure builds up and they move up and then stop for a while and move up again. Every infant responds to teething differently. Some infants don’t seem to feel a thing – one day the tip of a tooth just appears. Other infants have a horrible time with every tooth. They can be miserable for a day or two and some infants even develop low-grade fever or congestion, which is impossible to tell from a regular cold. When a parent asks me whether a fever is due to a viral infection or teething, I ask if the child has had fevers with previous teething episodes. If not, it is unlikely that the current fever is due to teething. As the tooth is moving up, it can cause a blue blister that appears on the gum and can sometimes bleed when the tooth pops through.

     The front teeth usually come through first (upper or lower). It is also not unusual for some of the front teeth to come in and then have some back teeth come in leaving a gap – don’t worry they’ll all come in eventually.

     A dose of any oral pain reliever can help children through teething. For younger children or children with a family history of asthma or allergy, I recommend ibuprofen (see the article on “Acetaminophen”). Cold teething rings also seem to help but chewing on anything helps. People who don’t want to use medication can use frozen fruits or vegetables as long as they are large enough so that the infant won’t choke on them. Tying a knot in a washcloth, getting it wet and freezing it works as something to chew on, too. Cloves have been used for centuries for local pain relief, and the most commonly used orally applied commercial product for teething contains eugenol – the ingredient in cloves. Using clove oil is more worrisome because the dose in the product you buy in an alternative medicine store can vary, and too much clove oil can be dangerous. People who believe in homeopathic medicines can use these, but the fact is that the dose in most homeopathic medicines is so small that they are only water. When you use them, the pain will go away because it always does, anyway. I also wouldn’t recommend Grandma’s suggestion of brandy on the gum. Save the brandy for yourself.