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Child Dentistry



Teething Troubles


Teething Troubles

The word “teething troubles” is heard all too frequently, in connection with anything new.
It is remarkable, however, how many babies go through this period without any problem.
The mother suddenly realizes that the baby has a tooth in his mouth.

In India, every problem of the baby, from diarrhoea to a cold or fever or loss of weight, is attributed to teething.
Many ignorant parents do not consult a doctor or take the baby to a clinic or hospital for treatment of illness during the teething period of 6 months to 2 years, because they feel it is inevitable and has to be suffered, and that it is all a part of teething.

It is true the gums may become red and sore because a tooth is trying to come through and the baby may become peevish, may not wish to suck because of the pain and may cry more than usual.

Common signs of teething are drooling, gnawing, biting and general fussiness and irritability.
The baby may feel a bit feverish at times, but no further serious illness should be attributed to teething.

He needs more cuddling because of his discomfort.
He may wake up more often at night and may want to sleep next to his mother.
All this is part of his pain and discomfort, and he should be comforted and solaced.

Mothers are anxious about the teething and from the time baby is 3 months old, they want the doctor or the nurse to tell them whether the baby is teething.
You will yourself find this out when the teeth erupt, because you will be able to see them just as the doctor will.
The first teeth to erupt between 6 to 9 months are the lower central incisors.
The gums look a bit swollen for a few days, and then a tiny white spot appears, which is the tooth.

During this period, after consulting a clinic or a doctor, some baby aspirin may be given to relieve discomfort.
Poking around in the baby’s mouth with your finger to see if the teeth are there, is a bad practice and may lead to infection.
The baby’s smile with his two tiny teeth is lovely, and something to cherish.

Over the next 3-4 months the teeth erupt with great rapidity, the lower central pair, the upper central pair, and then two more on eithers side in the lower and upper jaws making a total of 8 incisors.

Sometimes the pattern is changed, and the outer incisors may erupt earlier than the central ones. The rest of the teeth erupt in the manner shown in the table below, till the baby has 20 teeth.

Central incisors 6 to 8 months
Lateral incisors 8 to 12 months
First molar 12 to 18 months
Cuspids 16 to 20 months
Second molar 20 to 30 months

The entire set of 20 teeth erupt by the age of 2 years. These are primary teeth.

Sometimes, there is a delay in the eruption of teeth, and a baby may not have any teeth till even one year. This is nothing to worry about and certainly there is no need to stuff the child with calcium, vitamins and other tonics.
The foundation of the primary teeth is laid while the baby is still in the womb, and so the health and nutrition of the mother during pregnancy may have some effect on their development.

Teeth care :
By the age of one-and-half to 2 years, the teeth should be cleaned twice a day, using a toothbrush.
Toothpaste is not necessary to begin with.
Later, any pleasant-tasting toothpaste can be used.
The mouth should be rinsed every time after eating anything.
This age-old Indian habit is excellent for the care of teeth, and needs to be encouraged.

Caries and Cavities :
Caries is very common even in small children, and needs attention at all ages.
The belief that temporary teeth are going to drop off and so do not need attention for caries, is wrong.
Caries can lead to infection and pain and can cause infection of the permanent unerupted teeth.
So consult a dentist whenever necessary.

Diarrhoea and teething :
There is a widespread belief that teething leads to diarrhoea, and mothers want some medicine that would ease the process.of teething and prevent diarrhoea.
All sorts of teething powders, drops and syrups are advertised, and the manufacturers make a fortune due to the ignorance of the public.
There is really no medicine which will help teething; nor is one necessary.
What the baby needs is a little more comafort and cuddling when uncomfortable, or a little baby aspirin when in pain.
Because the gums feel sore and itchy, the baby likes to chew on things such as rubber or plastic toys.
It is also the time in baby’s development when he wants to put everything into his mouth to explore it. So all kinds of things, none too clean, go into his mouth and may result in diarrhoea.
While one cannot ensure a sterile environment for the baby and nor is it necessary, but, one should ensure a reasonable amount of cleanliness of the things that go into his mouth, including his own fingers and nails.
It is advisable to give the baby something to chew on, such as a piece of toast, a carrot, or a clean teething ring.
Diarrhoea, if it occurs, is the result of infection and not due to teething.
Mild diarrhoea will respond to a clean environment, but if it persists, you will have to consult your doctor.

Malocclusion of teeth :
Sometimes, there is faulty meeting of the upper and lower teeth or jaws.
Normally, the upper teeth are a little in front of the lower ones.
At times this difference may be more pronounced and the upper lip may look prominent and the chin seems to recede.
At other times the upper jaw is forward and so the chin looks prominent and the upper lip seems to recede.
This is just a variation of development and does not cause any difficulty in eating or chewing or biting.

Permanent teeth :
By the age of 6-7 years, the first erupted teeth, starting with central incisors, begin to drop off.
The tooth becomes loose and falls off without giving any pain or discomfort.
Most families have a ritual about hiding teeth, the child keeping the tooth under his pillow, only to be replaced by a rupee the next morning.
All this is fun and the child does not get upset about the loss of his teeth and a wide-open space in his mouth.
If the teeth do not erupt in a symmetrical manner or are too crowded and the alignment is not good, or they tend to protrude, dental consultation is necessary.
Such problems may cause a lot of embarrassment to the child later on, and a good dentist can work wonders with them.


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