Spring 1998 Volume One Number Two

• Teething: The El Niño of Childhood
—teething gets blamed for a lot of things and is responsible for few.

Teething and El Niño.

What could these two topics possibly have in common?

El Niño has been blamed recently for all the adverse and unusual weather we've been seeing. Teething has been blamed for centuries for many common childhood ailments.

Back in the 4th century B.C., Hippocrates observed that teething infants could suffer from fever, con-vulsions and diarrhea. From the 16th to the 19th century, it was believed that death could occur directly from teething. At that time, the death rate among infants and small children was high. Most deaths occurred between the ages of 6 months and 2 years, the age of cutting the first teeth. It is not surprising that teething was widely believed to be a common cause of death.

Remedies for teething were violent. They included bleeding, lancing babies' gums and placing leeches on the gums.

Luckily, by the mid 19th century it was becoming clear to some that teething did not cause serious disease in infants.

So what kind of symptoms do we now believe are associated with teething? It is amazing that the medical literature recently contains very few studies on teething and its effects. One study did show that low grade fever can occur from three days prior to the eruption of a tooth until the day of eruption, although some medical experts question whether fever is really due to teething.

Observations show that children who are teething do drool a lot. This may be just a stage in the normal development of the salivary glands. Some children drool for months before any of their teeth come in. Children who are teething may chew on fingers or objects, be irritable, restless or awake at night crying. These same behaviors have been observed in animals when their teeth erupt. Whether diarrhea is caused by teething is controversial.

So, when your child is teething, you may encounter problems with your child chewing on anything in sight, being crabby, restless and awakening at night crying. Perhaps a low grade temp-erature might be present. If your child has more than a low grade temperature or has excessive diarrhea, you can't blame the teeth.

What can be done to relieve the discomfort of teething? Offer your child something clean, hard or cool to chew on—such as a teething ring, a biscuit or ice chips in a cloth. Acetaminophen or ibuprofen can be used to help the irritability and hopefully the night waking. We do not recommend gels applied to the gums, as they can have some severe side effects (such as seizures from too much anesthetic being absorbed into the bloodstream).

In our age of modern medicine, we still do not know exactly what symptoms can be attributed to teething and what symptoms cannot. Some people believe that the growing of teeth is no more painful than the growing of hair. Maybe that is the case with some children. Everyone is different and everyone has their own pain threshold.

It is the parent who knows their child best, and if something is bothering your child that has you concerned, please call for an appointment and we will check it out.

—Cindy M. Howe, MD