Teething: Facts and Fiction

Abstract

1. Lisa Markman, MD* 1. *Assistant Professor of Pediatrics, Associate Director, Child Protection Team, University of Michigan, Ann Arbor, Mich After completing this article, readers should be able to: 1. Understand normal tooth anatomy and the physiology of tooth eruption as well as causes of delayed eruption. 2. Be aware of the historic beliefs about the effects of teething and therapies that have been used in the past. 3. Recognize the manifestations ascribed to teething today by parents and health professionals. 4. Describe the effects of teething. 5. Discuss the acceptable therapies for relief of the symptoms of teething. Teething is a process that all children experience. Most children get their first tooth around 6 months of age and have a complete set of 20 deciduous teeth by 30 months of age. Parental perceptions and beliefs about teething often influence the symptomatology a child experiences with tooth eruption. From medical professionals to grandmothers, everyone seems to have a list of symptoms they believe are linked to teething. “Teething, like colic, is an ill-defined nonevidence-based entity for which parents receive much advice.” (1) It is important to remember that during this same time period of an infant's life, passive immunity due to maternal antibodies wanes and exposure to a wide variety of childhood illnesses occurs. Due to this temporal relationship, teething often is blamed for symptoms such as changes in sleep and eating patterns, rhinorrhea, drooling, rash, fussiness, and diarrhea. Medical professionals need to be educated about teething to provide reasonable explanations to concerned caregivers. Teeth have two distinct parts, the crown and the root, and are composed of four different tissues (Fig. 1). The crown, which is made of enamel, lies above the gum line and covers the sensitive root, which lies below the gum line. The root makes up two thirds of the tooth's total length, goes through the periodontal ligament, and attaches into a socket in the alveolar bone of the jaw. Figure 1. Tooth …