Tag Archives: diarhea

From the desk of Doc Smo- The latest on “Teething”

I was catching up on some of my journals the other day when I came upon an article that caught my interest.  Regular readers/listeners of my blog may remember a pedcast I did on teething last year.  In that post, I tried to get to the facts of what we know and don’t know about the effect of teething on children.  Many parents believe that tooth eruption causes high fever, diarrhea, and/or severe pain.  When I made the teething pedcast, I had concluded from my reading and my own experience that teething does not cause a lot of physical symptoms.  None of these things happen at the time of dental eruption but many parents attribute all sorts of symptoms to teething to this day.

 

So it was great interest that I read an article in the September 2011 journal Pediatrics about a study that was done in Brazil, of all places.  There, the researchers sought to determine what, if any, symptoms are attributable to the eruption of primary teeth in children between five and fifteen months of age.  They observed 231 teeth erupt in the 53 children that they observed.  To my surprise, they discovered that Grandma was right, at least partly:  teething causes fever, diarrhea, irritability, sleeplessness, and a runny nose.  The researchers found that fever .17 degrees Celsius, irritability, diarrhea and sleeplessness were more frequent on the day of a tooth eruption as well as the following day.   They did not find in any of the children they studied, however, that high fever, severe pain, or any severe symptom was associated with the teething process.  Their findings confirm my opinions expressed in last year’s pedcast; it is nice to be right on occasion.

 

The next time you hear someone talking about teething causing severe symptoms of any sort, remember the facts that this study points out:  Grandma was right to believe that a variety of physical symptoms do seem to accompany teething, but she was not correct to attribute any severe behavioral or bodily changes to teething.  Now you know.

 

Until next time.

 

Ramos-Jorge et. al. :Pediatrics Volume 128, Number 3, September 2011

Teething, Just the Facts Ma’am (Pedcast)

Transcript:

Welcome to another edition of DocSmo.com, your source for mp3s about pediatric topics.  This is your host, Dr. Paul Smolen–pediatrician by day, blogger by night–on location in the Low Country.  Yes, it’s vacation time, and me and the Mrs. are enjoying the unbelievable beauty of the South Carolina coast.  Before we get into the nitty gritty of today’s talk, let me remind my new and old listeners alike that I may or may not be your child’s doctor, and that I am not giving out medical advice specific to any one child… rather, general information about pediatrics.  For specific advice about your child, you need to visit the wonderful person you call your child’s pediatrician.

 

Today’s topic: “Teething…Just the Facts, Ma’am.  We are going to explore the essential facts about teething that new parents need to know.  So let’s get started, shall we?

 

Parents really seem to begin worrying about teething when their children come for their 4 month checkup.  I hear on a daily basis, “My infant is drooling and chewing a lot, is this teething?”  I really don’t think so.  At 4 months, babies still have very limited ability to control their muscles.  The muscles they do have the most control over are those of their mouth.  Ergo…chewing and drooling.  At this age, babies usually begin cooing and laughing as well; is this from teething as well?  I don’t think so.  The fixation that young children have with mouthing objects is their way of exploring the world, not a sign of teething in my opinion.

 

When parents bring their child for the 6-9 month checkup, parents often have infants that are still needing a lot of attention at night to sustain sleep.  I hear the same teething concerns at this visit: “This teething is terrible.  My child won’t sleep, chews on everything, and drools all the time.”  I will ask, “Does pain medicine help, Mrs. Jones?”  “No, it must be terribly painful because pain meds like acetaminophen and ibuprofen don’t help. We are up all night dealing with this severe pain.”  Then I ask, “What about during the day, is teething painful then?”  “No, it just seems to be at night.”  Hmmmmm.

My opinion again…Pain meds don’t help because these infants don’t have severe pain, but rather an overdependence on their parents at bedtime.  No daytime pain because the discomfort of teething is very mild.  No response to pain meds because, again, the discomfort is mild.  The problem is much worse at night because the main problem is that the child has not learned to become independent at night yet….For more on that subject, check out “Straight Talk About Sleep in Infancy.”

 

 

So what is the science behind teething?  Does teething cause fever?  Studies say no.  Does teething cause diarrhea?  Studies says no.  Does teething cause severe pain?  Not very often in my experience.  Is drooling a sign of teething?  Not in my opinion.

Remember, two things can happen at the same time and not be related.  Parents, are always looking to make sense of things.  I respect that, but it gets them in trouble sometimes.  A child can have a severe viral illness or another source of pain like a stomach ache at the same time that they are teething, which is affecting their behavior or sleep.  Those two things may happen at the same time but be completely unrelated.  Here is the point to remember: don’t attribute high fever or severe pain or diarrhea to teething no matter what Grandma says.  There is probably something else wrong with your child, and you need to get it checked out.

 

 

I don’t mean to minimize the whole teething process; there is something going on here.  Children get teeth all through childhood, and there is some discomfort associated with the eruption of teeth, just not severe pain unless there is a dental problem like an infected tooth.  Here is what I want you to remember about teething:

 

    • Never attribute a high fever, severe diarrhea, a major sleep problem or severe pain to teething.  Get your child checked out if they have any of these symptoms.
    • The discomfort of teething can be dealt with acetaminophen or a cool (not cold) chewing toy.  Make sure it is a safe toy!
  • My experience tells me that topical numbing drops are not very useful.
  • Remember, the eruption of teeth is not a real painful process in older children, so why should it be such a problem for younger children?  Think about it.

 

 

 

Thanks for joining me for this podcast.  If you learned something and I was able to enhance your understanding of a pediatric topic, that is great.  Feel free to check out other discussions of pediatric topics by exploring my website, DocSmo.com.  Get your free pediatric education with a simple click of your finger.  A mom told me the other day that she downloaded all of my content and made her husband listen to them on the a particularly long car ride.  Dad, I am sorry for that… 73 posts to date!  Wow.  This is Dr. Paul Smolen broadcasting from the Low Country of SC, hoping you got a little schooling on your child’s drooling.

 

Until next time.

 

 

1. http://www.webhttp://www.mayoclinic.com/health/teething/

2. http://www.mayoclinic.com/health/teething/FL00102

3. http://pediatrics.about.com/od/teething/a/0107_teething.htm

 

 

Subscribe on iTunes!

 

Subscribe on iTunes or follow us on Facebook and Twitter!

 

*By listening to this pedcast, you are agreeing to Doc Smo’s terms and conditions.

 

All Right’s Reserved.