So, If you’re sure the reason for your child’s fractiousness is teething, then what can you do to help? Well, as my own children know I’m a great believer in the old fashioned rocking chair because it calms not only the infant but the mother also! It may even do this by stimulating the release of endorphins (naturally occurring painkillers) in the mother and baby.

However, since rocking chairs don’t feature much in modern households nowadays, there are other things that can be done.

NHS Choices gives some advice under the heading of teething gels, teethings rings, chewing, painkilling medicine, cool drinks, comfort, and preventing rashes.

TEETHING : TREATMENT

COUNTRY : UK

Teething rings

Teething rings give your baby something to safely chew on, which may ease their discomfort and provide a distraction from any pain.
Some teething rings can be cooled first in the fridge, which may help to soothe your baby’s gums. Follow the instructions that come with the ring so you know how long to chill it for. Never put a teething ring in the freezer as it could damage your baby’s gums if it becomes very hard or cold.
Also, never tie a teething ring around your baby’s neck, as it may be a choking hazard.
A useful alternative to a teething ring is a cold, wet flannel.

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It seems the use of amber beads as teething necklaces is becoming fashionable.

I can see absolutely no reason why they may work and indeed they could be a hazard due to strangling or choking.

A mother in New Zealand who has a scientific background has challenged their use and what she says seems very sensible.

AMBER TEETHING BEADS : A FEW POINTS TO CONSIDER

COUNTRY : NEW ZEALAND

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Always check the constituents of teething gels. They should not contain salicylates as a painkiller / anti-inflammatory agent. Aspirin is a member of the salicylate family, and neither aspirin nor any other salicylate salt should be given to children under 18. This is because it can occasionally be responsible for the development of a condition known as Reye’s Syndrome in children. This is a very serious condition, although fortunately rare.

Since April 2009, in the UK The Medicines and Healthcare products Regulatory Agency (MHRA) advised that teething preparations containing salicylates should not be used. Always discuss the suitability of teething gels with the pharmacist when you purchase them. This is particularly important when travelling outside the UK.

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Sometimes life can be very difficult for the parents of a crotchety baby. What’s wrong? Teething is one of first things that springs to mind. All sorts of people might give all sorts of advice, and that advice might turnout to be right, of course. Sometimes though it could be wrong. Very wrong.

The chances are, without examining the baby, if the advice given turns out to be correct, then it is just by chance, based on the probability that most babies, most of the time are not seriously ill. However, teething is a diagnosis of exclusion.

DOES A TEETHING CHILD NEED SERIOUS ILLNESS EXCLUDING

COUNTRY: UK

We also identified one paper highlighting the risks of attributing relevant medical symptoms to teething. This review suggests that there is no evidence that teething can be “identified” as the source of symptoms in a child. We agree with previous authors and recommend that this is a diagnosis of exclusion, to be made with caution. We acknowledge that this message may conflict with many firmly held beliefs of our patients’ parents and of other colleagues, but this review has shown that if a child is ill enough to be admitted to hospital, other organic causes need to be excluded, so that the child is managed appropriately. We also suggest that visualisation of the gums should be part of the clinical examination of the mouth and pharynx in young children to deal with the possible parental concerns, as teething has often been diagnosed on the basis of symptoms alone.

Clinical Bottom Line

No evidence is available to suggest that there are any symptoms or signs specific to teething that allow a diagnosis to be made confidently in a child without excluding other organic pathology (grade B).

It seems then, if a teething child is giving a parent or other carer (the one who knows the child best) real cause for concern, eg, inactivity, poor feeding, diarrhoea, fever, unusual cry, unusual rash, then that concern should be taken seriously. The baby should be examined by a GP or paediatrician to rule out other causes of a sick child, before the diagnosis of “teething” is made.

Remember, grannys, aunties, friends, nursery nurses, health visitors etc are not trained in the diagnosis of an ill child. Only doctors are and some of them who do not see a lot of children, are sometimes not good at it either.

Fortunately the parent who spends most time with their child usually becomes pretty good at knowing when it is appropriate to get worried, and their worries should never be dismissed as “anxiety” or “neuroticism” even if in some situations this may turn this is the case.

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Many babies are not disturbed at all by teething, or they may have problems cutting some teeth but not others. Once the tooth has penetrated through the gum, the symptoms generally disappear.

It stands to reason that some discomfort of the gums is likely and they may appear red and slightly swollen prior to a tooth erupting. The baby may put his hands in his mouth as he attempts to rub his tender gums. Alternatively he may chew anything he can find.

The gum discomfort may lead to unwillingness to feed, irritability, restlessness and disturbed sleep.

Another symptom commonly thought to indicate teething is flushing of the cheeks – often only on one side.

Excessive salivation (dribbling) is also often a sign that a tooth is on its way.

Symptoms of teething are usually mild and the baby may be cross, but active and does not look ill. You know your own baby best and if you feel she is not as active as usual, or behaving abnormally in any way, then do not assume it is teething, but seek medical advice. The baby may need a full medical examination to exclude other causes of a change in behaviour for example infection.

Although a slight elevation of temperature is thought sometimes to be associated with teething, significant elevation leading to fever should always be regarded as due to something else. Similarly, diarrhoea should not be put down to teething.

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This newborn baby looks peaceful now, but once home there will probably be occasions when he seems cross and unsettled. Questions like “could it be wind?” or “could he be teething already” may be asked.

Very occasionally, a baby is born with a tooth or two but the normal time for the cutting of the first tooth is much later than this. Below is a guideline of when to expect teeth to appear:

Bottom front teeth (incisors) – 5-7 months. Usually the first to come through

Top front teeth (incisors) – 6-8 months

Top lateral incisors (either side of the top front teeth) – 9-11 months

Bottom lateral incisors (either side of the bottom front teeth) – 10-12 months

Canines (Eye teeth – towards the back of the mouth) – 16-20 months

Molars (back teeth) – 12-16 months

Second molars – 20-30 months

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