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Teething

Infant and Children, Pregnancy | September 30, 2019 | Author: Naturopath

Children, pregnancy, infants

Teething

Teething in babies can be a major concern for parents and carers with many symptoms being attributed to the much waited for appearance of a tooth.

The teeth of baby are formed during foetal development with the journey through the gum to eruption usually takes place around the ages of 6 – 9 months. Once the first tooth appears the next ones keep coming at a pace of about one a month, resulting in a full complement of 20 teeth at between 2-3 years. Permanent teeth start to make their arrival from approximately 6 years of age.

Tooth eruption can take around 8 days from first signs and is often proceeded by a small lump, red, swollen gums and sometimes a cyst or blister may appear.

Teeth do not “cut” their way through the gum. The tooth emerges through a pathway remodelled by tissue.

Tooth Anatomy

Foetal teeth development begins at about 28 days of development and mineralization at about 14 weeks in the uterus. Teeth erupt when the crown mineralization is almost complete, but roots are still forming.

Tooth AnatomyThe crown is made of enamel and sits above the gum line and covers the sensitive root below the gum line, which attaches in a socket in the alveolar bone of the jaw. The root makes up two third of the total length of the tooth.

The tooth is made up of 4 types of tissue.

  • Enamel – the outer most material covering the tooth
  • Dentin – soft bone-like material for support and carries some nerve fibres
  • Pulp – the centre of the tooth containing blood vessels, lymph vessels and nerve fibres
  • Cementum – covering the root

Symptoms

Some symptoms have been identified as being temporally related to teething. These, although minor, can still be distressing for both parents and child. They may include:

  • General irritability
  • Disturbed sleep
  • Gum inflammation
  • Drooling
  • Loss of appetite
  • Diarrhea
  • Facial rash
  • Mouth ulcers
  • Increase in body temperature
  • Increased biting, gum-rubbing and sucking,
  • Wakefulness
  • Ear-rubbing/pulling

Misconceptions

Often there are symptoms attributed to teething which are unrelated to the eruption of teeth. Symptoms accredited to teething may actually be the result of other illnesses. If there is fever, diarrhoea, irritability or a significant change in behaviour, consult the doctor before blaming these symptoms on teething.

Most experts agree there may be some discomfort during the teething process

What Can Help 

Supporting Healthy Tooth DevelopmentTender Loving Care (TLC). Sometimes offering cuddles and gentle, soothing communication is all that is needed. The housework just has to wait.....

Chilled teething rings. Cold causes localized vasoconstriction which decreases the inflammation, and biting on an object gives further relief by applying pressure to the gums.

Analgesics – Check with the pharmasist and always check the dose.

Homeopathy. The use of homeopathy medications is popular and for some result are noted on their application. Homeopathy has no scientific evidence on its benefit.

Amber necklaces. Some people have found the use of amber has reduced some symptoms of teething. Scientific research has not been able to qualify how amber helps and caution is advised for the use of amber necklaces as a choking risk.

Caution

Caution is advised on the use of some over-the-counter teething medications.

Analgesics

  • Benzocaine. Topical applications of an analgesic containing benzocaine. Children under the age of 2 are at risk of a potentially deadly condition called Methemoglobinemia from absorption of benzocaine through the oral mucosa. This condition interferes with oxygen transportation through the blood and can occur within minutes - to - hours even after only one use. 
     
  • Acetaminophen (paracetamol). Over-dose can cause severe liver injury.
     
  • Ibuprofen. Regular use is associated with bleeding in the stomach and injury to kidneys, although not common, is still a concern.

Supporting Healthy Tooth Development

Some nutrients are needed to support the development and health of teeth. Vitamin D, calcium and phosphorus play a role in the development and maintenance of healthy teeth and gums.

Adequate Vitamin D in pregnancy and infancy

Vitamin D influences the formation and mineralization of teeth. Vitamin D function as a regulator of calcium and phosphate metabolism. A sufficient supply is necessary during pregnancy, along with calcium, to ensure healthy bone development of the foetus, and has a direct effect on tooth mineralization. Studies have shown the lower the level of vitamin D of the pregnant mother, the higher the age of the child before the eruption of teeth. Vitamin D has also been found to benefit oral health by exerting and effect on inflammatory functions and to stimulate the production of anti-microbial peptides.

Calcium and phosphorus are needed for bone strength. For healthy strong structures of the body including the jaw in which teeth reside.

Supporting Healthy Tooth DevelopmentHealthy diet for healthy teeth

Include foods:

Calcium - Dairy foods such as cheese and yoghurt, brown rice, oranges, cabbage, beans, broccoli, peas and salmon.

Phosphorus - Cereals, wheat germ, soya beans, almonds and other nuts, meat, poultry, fish, eggs, grapes, citrus fruit, cucumbers and tomatoes.

Vitamin D - Natural sunlight, dairy products, eggs, some cereals and oily fish such as tuna and sardines.

Follow age-appropriate guideline when introducing foods to infants. 

Breastfeeding is best.  If using a bottle for feeding, don’t leave baby unsupervised and remove bottle once feeding is finished. Don’t put baby to bed with a bottle. Only use breastmilk or formula for baby.

Drink water or plain milk. Water does not need any additives. For babies under 1 year, boil water and use breastmilk or formula. For children over 1 year full fat milk is suggested. Low fat milk can be used for babies over 2 years of age.

Drink from a cup. Once baby is over 6 months of age they can drink from a cup.

What to Avoid

Avoid giving babies and children fruit juices, sweet drinks, soft drinks or cordials especially under 12 months of age.

Simple sugars. Adults love giving children lollies – usually because they enjoy the sweetness themselves. Once a child experiences the taste of sweet – there is usually no going back. Avoid the temptation of introducing empty, detrimental substances (let’s not call them food) to children and instead provide healthy, wholesome foods to support growth and development.

Eating foods with high levels of sugar causes tooth decay and decayed baby teeth can damage the permanent teeth underneath.

  • Resist introducing sweets or lollies to babies and children
  • Do not offer sweets and lollies as a reward
  • Do not offer babies and children soft drinks or lolly water

Dental Hygiene

Once teeth have appeared gentle brushing, using a soft cloth or brush, is recommended twice daily. This helps to remove plaque build-up.

Children up to the age of 7 or 8 will need help with teeth cleaning.

The bottom line

Teething is not an illness. It is a natural process in the journey of growth and development. 

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References

https://www.pediatriconcall.com/pediatric-journal/view/fulltext-articles/297/J/0/0/374/0

https://sciencebasedmedicine.org/separating-fact-from-fiction-in-pediatric-medicine-infant-teething/

https://www.tga.gov.au/alert/paracetamol-practitioner-fact-sheet

Impact of vitamin D on pregnancy-related disorders and on offspring outcome. https://www.ncbi.nlm.nih.gov/pubmed/29169993

The Associations of Maternal and Neonatal Vitamin D with Dental Development in Childhood https://academic.oup.com/cdn/article/3/4/nzy100/5371118

https://www.dhsv.org.au/dental-advice/general-dental-advice/babies

https://www.dhsv.org.au/dental-advice/teeth-tips-and-facts/calcium-vitamin-d-and-phosphorus

https://www.healthline.com/nutrition/15-calcium-rich-foods

https://www.healthline.com/nutrition/foods-high-in-phosphorus#section1

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