Deal with those teeth Everything you need to know about teething
Your mom says teething makes babies sick. Your doctor tells you it’s nonsense. Your friend raises an eyebrow because your nine-month-old doesn’t have a single tooth yet … Yes, teething is confusing, says Shanda Luyt
SOME BABIES GET their first tooth so quietly that you almost feel like you’ve missed something. Before you know it, your little one is smiling broadly with that little white pearl on display. For other babies – and their parents – the birth of a first tooth is somewhat more of a painful affair: for weeks, your baby is unhappy, drools a lot and keeps you up for countless nights before the big moment arrives.
How babies teethe is an interesting story that already starts in the womb. Prof Gert Kirsten from the department of paediatrics and child health at the Tygerberg Children’s Hospital explains that the first milk teeth, or the central incisors that can be found front and
centre, already start forming in the third or fourth month of your pregnancy.
They’re followed by the lateral incisors on either side at four-and-a-half months into your pregnancy and the canines by five-and-a-half months.
Your baby’s first little teeth will appear in the order they developed. The bottom two central incisors appear between six and seven months, then the top two central incisors (seven to eight months), followed by the lateral incisors (eight to nine months), the first molars (sixteen to twenty months) and the second molars (twenty to thirty months).
Finally your little one can boast a mouthful of twenty milk teeth in total. Sometimes a baby is born with a tooth. In such cases, a dentist should be consulted immediately to decide if the tooth needs to be removed, Prof Kirsten says. “These teeth are known as natal teeth. They often don’t have roots and are just attached to the gum,” he explains.
The same goes for teeth that erupt when baby is a month old, which are called “neonatal teeth”. “These teeth can also be quite loose, loose enough to be swallowed.”
It can also happen that teeth erupt considerably later than normal, Prof Kirsten says. “The cause can be hereditary or the result of a condition such as a thyroid gland that doesn’t produce enough thyroid hormones, rickets, syndromes and chromosome abnormalities.”
If baby’s teeth are overdue, take him to the doctor so the cause can be determined, Prof Kirsten recommends. Similarly, if the tooth has a strange shape, take your child to the dentist.
DOES TEETHING MAKE BABY ILL?
The experts differ on this one.
“Most babies will become difficult and irritable during teething,” says Teresa Hayward, a private nurse who runs a postnatal-care clinic in Port Elizabeth.
She says typical symptoms are restlessness, irritability and interrupted sleep, sore gums, red cheeks, loss of appetite, a slightly raised temperature, drooling and the urge to chew or bite.
“If a child drools a lot, you may also spot the following: a red rash around the lips and cheeks, runny tummy because of excess saliva, as well as fever and irritability because the gums are inflamed.”
But Prof Kirsten disagrees. Teething can make a baby fretful, he says, but it never causes fever, diarrhoea, interrupted sleep, drooling, red cheeks or other symptoms of illness.
There are a few things that can bedevil baby’s dental development, the prof says. These include bad oral hygiene, exposure to sugar, too much or too little fluoride and certain antibiotics, such as tetracycline. Congenital disorders also play a part.
The biggest culprit is tooth decay, which happens when the bottle is in the mouth too much – baby sleeps with it or your toddler walks around with a bottle in the mouth all day long. “Tooth decay can already destroy teeth in a ten-month-old baby,” Prof Kirsten says. “Especially the top incisors are at risk, and it’s because of fruit and other juice, flavoured milk and cola drinks that are consumed while baby’s falling asleep. It also happens with normal milk feeds.”
The bottom teeth are usually not affected because the tongue protects them. “Bacteria are usually neutralised by saliva in the mouth,” Prof Kirsten explains. “But if baby falls asleep bottle in mouth, his top teeth are bathed in milk or juice. If this is the situation, the saliva can’t get to the bacteria. The sugars in the milk or juice change into acids that dissolve the enamel and cause tooth decay.”
Tooth decay can destroy the tooth and its root and can of course be very painful. It can also mean skew and overcrowded permanent teeth, because the temporary teeth that were supposed to keep their seats warm, as it were, are no longer there.
CARE FOR LITTLE TEETH •
Don’t put your baby to sleep or allow her to sleep with a bottle in her mouth. • Replace bottle feeds with cup feeds when baby is six months old. • If your baby doesn’t want to let go of the bottle, reserve it for water. • Give fruit juice and flavoured milk only with meals. • As soon as baby has teeth, he can start visiting a dentist or oral hygienist every six months.
BRING SOME RELIEF
Teresa has the following advice: • Chewing a soft teething ring will bring baby some relief and help him “cut” his teeth. Cold objects are particularly soothing – so put the teething ring in the fridge first, but remember not to freeze it. • For quick relief, massage teething gel into the gums. • Syrups such as Panado or Calpol can help relieve pain and break fever. If the fever persists, visit your doctor. • Keep the chin dry with a bib and take wet clothes off. Use a buffer cream. • Try giving chilled (not frozen) yoghurt and baby food, as it will help soothe the mouth. You can also give boiled water that you’ve cooled, breastmilk, or formula from the fridge. YB