Teething

Teething is the process by which a baby’s teeth erupt. Infants show symptoms many days before actual tooth erupts. The first tooth usually erupts by 4 – 10 months (average 6 months).

Symptoms of teething

These symptoms are present before and during the process of teething.

• Irritability and increased fussiness.
• Decreased feeding due to gum soreness.
• Increased drooling.
• Rash on face due to excessive drool.
• Decreased sleeping and frequent awakening due to discomfort.
• Increased sucking and mouthing of fingers and objects.

Many parents think diarrhea, fever and running nose are symptoms of teething. But this is not true. These symptoms occur at the time of teething but are not due to it. There can be increased risk of diarrhea as there is increased mouthing through which baby can acquire infection.

Duration of teething 

• Variable discomfort for few days before tooth eruption.
• Some babies have more discomfort and longer duration during teething.

Order of tooth eruption

• Central incisors – 4 – 12 months
• Lateral incisors – 9 – 16 months
• Canine teeth – 16 – 23 months
• First molars – 13 – 19 months
• Second molars – 22 – 24 months

Soothing sore gums

• Rubbing baby’s gums with cold wash cloth
• Offer a chilled teething ring
• Give something for gnawing like a cucumber or carrot
• Keep baby’s face clean by drying with a clean cloth
• Over the counter pain medicines like acetaminophen (paracetamol) or ibuprofen can be given
• Homeopathy pills may be helpful during teething. But their role is doubtful and should be used with caution.

Secondary dentition 

• By 2 – 3 years of age all the primary or milk teeth have erupted.
• After 6 years of age the teeth gradually start falling and are replaced by permanent teeth (secondary dentition).
• By the time the child is 12 years old he/she have 28 permanent teeth.
• The four molar teeth erupt later after 16 years of age.

Dental Care

Good oral habits

• Do not share utensils like spoons, glasses etc with your child.
• Remove bottle from baby’s mouth as soon as the feeding is over.
• Do not bottle feed your baby to sleep. If child is not giving up night time feed, give only water in bottle.
• Try switching over to cup from bottle once the child is 6 months old.
• Try to discontinue habit of thumb sucking or pacifier.
• Keep sugary snacks between meals to a minimum

 Cleaning teeth 

• Initially when the teeth erupt clean with a soft cloth
• Once more teeth erupt start cleaning with toothbrush and water.
• Toothbrush should be soft and short headed.
• Change the toothbrush when bristles start spreading or after 3 months.
• Brush twice a day.
• Start using a pea sized toothpaste with toothbrush once child is 2 – 3 years old.
• Toothpaste should be containing fluoride but make sure that your child rinses and spits out the toothpaste.

How to teach brushing

• Start teaching how to brush once child is 2 -3 years old.
• Try brushing your child’s teeth first, and then have her repeat what you did.
• Use a soft bristles child sized toothbrush. Let you child choose her/his own dental supplies like toothbrush and toothpaste.
• Use a pea sized amount of fluoride toothpaste.
• While performing each step, talk to your child about what you are doing and what the next step will be.
• First, brush the inside surfaces of all teeth, angling the bristles at 45 degrees toward the gumline. Brush one to two teeth at a time using a gentle, circular motion.
• Next, clean the outside surfaces of all teeth. Be sure to angle the bristles toward the gumline, and brush each tooth with short, gentle circular motions.
• Finally, brush the chewing surface of the teeth, and for added good hygiene points, don’t forget to brush the surface of the tongue.
• Brush together as a family twice a day, especially before bed, for two to three minutes each time.
• Let the child watch you brushing and then copy the same.
• Praise your child for successful attempts at brushing.
• Even when your child learns how to brush his/her teeth, continue supervising till the child is 6-7 years old.

Dentist visits

• Your child should see a paediatric dentist when the first tooth appears, or no later than his/her first birthday.
• A check-up every six months is recommended in order prevent cavities and other dental problems. However, your dentist can tell you when and how often your child should visit based on their personal oral health.
• A dentist should also be visited in case of caries, toothache, milk teeth start falling before 4 years of age, loose milk tooth, overlapping of teeth when permanent teeth are erupting.

Dental caries 

• Caries can begin as early as the teeth begin to emerge, often progress rapidly, and can cause great pain to the child.
• Children who are frequently exposed to sugary liquids such as milk, breast

milk, formula, fruit juice, and other sweet liquids for long periods of time

especially during sleep/ bedtime run a great risk of suffering from caries.

• Brushing twice a day and following good oral habits as outlined above greatly reduce risk of caries.
• Consult a dentist as soon as you notice dental caries.