Teething is a normal physiological process involves tooth movements inside the jaw(bone) until the time they come into the oral cavity(mouth) by piercing the gum.
The first set of teeth that erupts into the oral cavity are called milk teeth or primary teeth. Teething starts from 6 months of age, while a variation of plus or minus 6 months is considered normal.
Teething begins with the lower-front tooth (central incisors) at the age of 6 months. Occasionally a lower-front tooth may even be present at birth called as natal tooth and if tooth erupts into mouth within the first month they are called as the neonatal tooth.
The first set of teeth completes their eruption by 3 years of age with a total of 20 primary teeth. The second set of teeth or permanent teeth starts erupting into the mouth from 6 years of age and continues until 12 to 13 years of age. Wisdom tooth however typically erupts during late teens to adolescence.
For few babies teething can be distressful, considering pressure from erupting teeth leave the child to uncomfortable gum irritation and in some babies, teething can even be pain full; excessive saliva lead to drooling, disturbed sleep, stomach upset (vomiting, diarrhoea), loss of appetite(hunger) etc are frequently related tooth eruption.
Babies between 6-12 months are more susceptible to the above-mentioned symptoms.
The Teething window is typically an eight-day duration; four days before the eruption of tooth followed by three days after tooth eruption or tooth emergence. In the first four days, the teething associated pain is constant, dull in nature with growing intensity until the emergence of the tooth followed by a fast decrease in pain unless associated with inflammation. In the case of inflammation, it might require a little longer time to resolve.
Excess saliva production and drooling are associated with teething and cause wetting of lower lip & chin, which might further lead to the formation of rash around the lips. This should be cleaned or wiped away as and when required.
Piece of ice wrapped in a towel placed on gum over the erupting teeth for 1-2 min of time.
Teething rings: Teething rings can provide relief for some time, rings are best when they are chilled to freezing temperature. Teething rings are attached to the child’s clothes.
Solid silicone rings are preferred over fluid-filled rings as they may leak.
Massaging the child’s gum: Parents asked to massage with their clean fingertips or very soft finger toothbrushes for 1-2 min.
Frozen fruits and vegetables or even chilled spoon can also be used to relieve pain.
Topically applied gum soothing gels can be used. Around peanut-sized amount of gel should be taken over a clean finger or cotton bud and applied by gently massaging on painful gum region for about 15 – 20 min, 4-5 times a day.
Sugar-free plain paracetamol syrup is another choice for teething infants. The dose can be repeated every six-hourly intervals with a maximum of four doses a day.