Teething is the process in which an infant’s teeth sequentially appear by breaking through the gums. Even through teething is a normal part of an infant’s development, surprisingly little is known about the causes and management of teething signs and symptoms. Teething pain is the commonest symptom associated with the eruption of the primary dentition. The eruption of primary teeth usually begins around 4-8 months of age with the eruption of lower incisors and is complete at around 30 -36 months of age when second primary molars erupt.
Teething pain sometimes is referred to as ‘Dentitio Difficilis and it is the commonest symptom associated with the eruption of primary dentition. Adults assume an infant is experiencing pain because they appear distressed, or because they believe the incisal edges of teeth cut through the alveolar bone and gingival during eruption. Pain may result from elevation of inflammatory mediators in the crevicular fluid and in tissue surrounding the erupting teeth, which stimulate nociceptive receptors. Local pain may be further exacerbated by rubbing or scratching the gingival tissues, by biting in to hard objects or by presence of pathology such as eruption cysts.
Signs and Symptoms associated with Teething:
Local teething symptoms are : Gingival swelling, irritation, redness of gums,thumb sucking and gum rubbing.
The systemic disturbances that are associated with teething include : Loss of appetite, crying, increased salivation, drooling, diarrhea, boils general irritability and fever, runny nose, conjunctivitis, some day time restlessness.
Moreover, increased biting, wakefulness, ear rubbing and facial rashes have also been reported to be associated with teething.
Generally the eruption of primary teeth begins when other changes in the infant’s immune system, growth and development are also occurring, that is around 6 months of age. This predisposes an infant to a variety of infections like respiratory tract infections,UTI, middle ear infections, etc.
The teething period has been described as an 8 day window, including the 4 days before tooth eruption and 3 days following.