Tag Archives: pain

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

 

 

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From the desk of Doc Smo: Swimmer’s Ear Prevention 101 (Article)

If you have ever had it, you know Swimmer’s Ear hurts like crazy. However, most people have no idea what Swimmer’s Ear is and what causes it. Well, lets fix that right now. To understand the cause, we need to start by gaining an understanding of the architecture of the ear and how it is different than other places in the body. The ear canal is a dark tunnel lined with skin that is often very damp, especially in warmer weather. Water frequently gets in but gets trapped by the shape of the ear canal. Well, what happens to water anywhere it sits around without movement, especially when it’s at body temperature? You know it, yuk grows in it! This is especially true in your ear canal when you are in and out of water all day. Once the water enables fungus and bacteria to grow in the ear canal, it is easy to see how these microbes can infect the surrounding skin. Swelling occurs to the point that the ear canal can literally be shut, making things much worse. Oh man, that can hurt!
All of this leads to a tender ear, aching down the side of the neck, and a very miserable child. The children most prone to having bouts of Swimmer’s Ear are: those with eczema (lots of cracks in their skin), those who frequently use Q-tips, those who are in and out of water frequently (especially lake or ocean water), and those who go to bed with wet hair (yes, your mother was right on that one).

Once an outer ear infection gets started, it can be very difficult to control; prevention is the only game in town. Here is a simple way to prevent Swimmer’s Ear in your child, especially as they go off to camp and swim in lakes and rivers. First, buy a bottle of rubbing alcohol and pour half of it out. Fill the bottle back up with either white vinegar or apple vinegar. If you can get a bottle with a dropper on it, great. At the end of EVERY summer day, when no more water is going to get into your child’s ear (usually bedtime), put a few drops of the alcohol/vinegar mixture in their ears and rub it around. Dry the excess with a towel. The combination of the alcohol and acidic vinegar make a very hostile place for germs, and they simply don’t grow. Without the bacteria and fungus in abundance, the cracks don’t get infected. Make sure their hair is dry, and put those little puppies to bed. If you are religious about this, most children won’t be suffering from Swimmer’s Ear this summer. Miss a day or two and all bets are off. If they go to camp, figure out how to make this happen there. It is worth the effort.