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

Your Baby & Toddler - - Contents -

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.


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.


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.


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

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