Teething
by Doctor Laurence H. Miller on 06/27/11
Teething is one of the most mentioned and most misunderstood concerns of parents of young babies. Many symptoms are blamed on teething: colds, fever, cough, vomiting, hunger, diaper rash, irritability, drooling.
It is possible for an erupting tooth to cause drooling in a 6 or 7 month old infant. It's almost always the upper or lower central incisors. But drooling can even occur before any teeth, when a smart baby starts to imagine his/her next meal, and that starts the saliva flowing to get ready for feeding time.
Low grade fever is still a questionable result of teething. But certainly not HIGH FEVER. Tragedy can occur when a misled parent mistakes the high fever of serious bacterial infection, such as meningitis, for "teething fever".
Many parents believe a diaper rash is more likely to appear during teething. This actually could make sense if you consider that some people have a change in their bowel movements, with increased frequency and looseness, when they are in pain. So teething pain could cause the right circumstances for a diaper rash.
On occasion, we have seen a baby pulling at her ears and instead of an ear infection being the cause, swollen, throbbing gums are the cause of the pain. The baby has a tooth pushing out, and as it erupts, it irritates the nerve that ends inside the ear. This results in the "referred pain" which misleads the family into thinking there is an ear problem. Simply looking into the mouth and finding the brand new teeth correct the misperception.
Most parents agree that the most likely time of day for "teething" irritability is evening bedtime/cribtime. Does this make sense? It certainly does! When the baby is playing with family and receiving distracting stimulation, he may not be aware of throbbing, swollen gums. But alone, in a dark, silent crib, any sensation of pressure coming from a tooth slowly pushing its way out through the gum, will be magnified greatly! And the baby may feel panic that this pain will last forever.
It has recently been reported in the scientific literature that local pain relievers such as gels should NOT be rubbed on the infant's gum to numb it. This can cause DANGEROUS reactions. I advise wetting a baby wash cloth and putting it in a plastic bag in the freezer. Then offer the frozen cloth (without the bag!) for the baby to suck on. The cold is slightly numbing as a pain reliever and refreshing, soothing for the baby to bite into as it is firm but yielding. If crankiness persists, a dropperful of infant ibuprofen (advil or motrin) is more likely to give relief than tylenol. I am not a big fan of routine use of these medicines, but a baby suffering at night should be given comfort. As a rule I offer these drops ONLY at night for baby and parent relief. Many old time pediatricians (and grandmothers!) have recommended a drop of whiskey applied to swollen baby gums. I haven't seen this in the journals and clearly caution would be key as alcohol poisoning is unacceptable to consider. However, if the cold rag fails to give relief, and a dropperful of ibuprofen is no help, a single drop of liquor rubbed once, and once only at bedtime, directly on the swollen gum, can be of great help, to everyone.
