Teething is the term commonly used to address eruption of primary teeth or as some call it “milk teeth.” It is an important milestone in a baby’s development.

In most cases, the eruption of teeth causes no discomfort or distress to the infant or the parents. However, in some cases, there may be minor local irritation that could adversely affect the baby’s daily routine.

The common complaint is the baby teething fever. The baby usually exhibits an increased body temperature along with crankiness, irritability, and loss of appetite.

Parents tend to try all possible home remedies as well as professional techniques to alleviate their baby’s discomfort.

Practical ways to keep the fever in check include administering physician prescribed fever medication, plenty of rest and proper nutrition.

How do you know when your baby is teething?

The eruption of primary or deciduous dentition usually occurs between 4th to 6th months of a child’s life. At times, an infant may be born with precociously erupted teeth. These are classified as premature teeth.

They may either be neonatal (erupted before birth) or natal (erupted shortly after birth). (1)

The parents eagerly await the appearance of healthy teeth since it marks an important landmark in the child’s growth.

Associated signs and symptoms

At the onset of teething, your baby may exhibit an increase in body temperature. The fever is mostly mild. Body temperature over a 100F is a sign that the infant is sick.

The fever may be accompanied by a few other manifestations such as –

  • Red, swollen gums
  • Excessive drooling
  • Redness and flushing of the cheeks
  • Loss of appetite
  • Disturbance in sleeping patterns
  • Irritability, crying and general fussiness
  • Increased urge to bite, suck and chew on objects
  • Increased thirst
  • Circumoral rash- rash around the mouth.
  • Fever
  • Vomiting
  • Diarrhea

In certain acute cases, the eruption may be accompanied with formation of an eruption cyst or hematoma.

How to alleviate the fever?

It is any parent or care-giver’s primary concern to relieve a baby’s affliction. Many suitable approaches have been developed and successfully tested in the management of teething problems.

  • If your child is running a temperature over 100-100.4 F for over 24 hours, make sure you consult his/her, pediatrician, to administer medication for the fever.
  • Use a thermometer to check on the baby’s temperature. Monitor the temperature at regular intervals.
  • Administer physician recommended analgesic or antipyretics as per prescribed dosage to lower pain and fever associated with teething.
  • Acetaminophen, paracetamol, and ibuprofen are safe drugs for kids. It is not wise to give a child any adult medication even if it is a smaller dosage.
  • In addition to drug therapy, keep your baby adequately hydrated as dehydration could also cause the fever to go up.
  • Sponging and bathing the baby with lukewarm water will also help to keep the temperature in check.
  • Avoid giving the baby, cold water baths as they may run the risk of catching a cold.
  • The baby’s surroundings should be cool and comfortable. Use a cooling fan in case the room is too warm or poorly ventilated.
  • A common mistake parents make is the excessive layering of the baby’s clothing. Avoid the extra layers of clothing.
  • Dress the baby in single layers and use a blanket to keep him/her warm if needed.
  • Avoid taking the baby outdoors until the fever subsides. Proper rest and nourishment will be most effective in reinstating the child’s good health.

Adjunctive therapies to relieve other teething problems

Maintaining the baby’s oral and overall body hygiene

  • Keep the gums in a healthy and clean state.
  • Wipe gums after each meal preferably with some formulation of a mild antiseptic.
  • The baby’s diet should be balanced with the right proportions of vitamins, minerals, proteins so that the body’s immune system is secure.

Home remedies

  • Variety of objects have been advocated to satisfy the baby’s desire to chew on hard objects, e.g., hard, non-sweetened rusks, toasted bread, hard fruits such as apple, pear, and guava.
  • Mild purgatives such as castor oil are also found useful in the treatment of teething.
  • Allow your child to chew on a wet, cold washcloth to provide relief.
  • Massage their gums gently with your clean finger to help reduce discomfort. (2)

Medical Management

  • Specially manufactured objects and teething toys such as teething rings, teething keys and necklaces are readily available in the market and have proven effects in curbing teething problems.
  • Use of pacifiers which act as vehicles to deliver formulations such as xylitol or fluorides provides a valuable two-pronged approach to the problem.
  • Topical application of glycerine and benzyl alcohol is also an effective method to alleviate pain and discomfort.

Surgical Management

As mentioned above, in certain acute extreme cases, teething may be accompanied by eruption cyst or hematomas. These require a minor surgical intervention.

The technique includes making two minor incisions around the emerging crown, and the interfering tissue lying over the unerupted crown is removed using forceps.

Take away message

Teething usually begins at the age of 4-6 months. It is usually preceded with uncomfortable signs and symptoms such as fever, loss of appetite, sleeplessness, drooling and fussiness.

The fever can be effectively treated with pediatrician prescribed medication and home remedies such as sponge baths, proper hydration and plenty of rest.

Avoid traveling outdoors with the baby and keep the baby’s surroundings cool and comfortable.

Once the teeth erupt, gently brush the new teeth with a soft bristled brush to maintain the baby’s good oral health.

At the onset of teething, your baby may exhibit an increase in body temperature. Body temperature over a 100 F is a sign that infant is sick.