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July 5, 2016

Opinion is divided as to the impact of teething on the wellbeing of wee ones. Tamara McLean looks at the different viewpoints and where that leaves us in taking care of our babies.

When Emma Dower’s baby son Theo gets fevered and fussy, the Auckland mum knows instinctively what’s to blame. Like so many mothers, Emma is certain it points to signs of teething and braces herself for days of grizzles, high temperatures and unsettled sleeps.

Doctors, however, disagree. The medical fraternity is convinced there is no link between the arrival of a baby’s first set of teeth and the raft of symptoms parents commonly report: from fever and runny noses through to nappy rash and diarrhoea.

The Doctor’s Take

Dr Nina Vasan, a specialist paediatric dentist at Auckland’s Kidz-Teeth, explains the facts as the medical world sees them.

Teething usually begins around six months of age, when the lower front teeth arrive, followed one to two months later by the top front teeth. Over the following 24 months baby will get a further four incisors, four canines and eight molars, giving them 20 baby teeth in all. Teething describes not just the tooth cutting through the gum but the whole process of pearly whites pushing from the jaw through the mucous membrane, cutting through nerve fibres as they go.

“Understandably, this process can be uncomfortable, maybe even a little painful for kids,” says Nina, who warns parents to expect grizzles and maybe a little blood on the gums. The dentist says other health concerns that crop up at this time are likely to be unrelated.

Dr John Cameron, a GP at Auckland’s Westmere Medical Centre, backs this view, saying fever, loose stools and runny noses for instance, have no proven link with teething, and are likely caused by the multitude of other bugs your baby is being exposed to between four and six months of age.

“Right at this age the protective antibodies that babies get through the placenta are wearing off and children become much more at risk of multiple illnesses developing at once,” John says. “With all these other things going on it can be very difficult to tell what the problem is.”

He says this message can be very confusing and frustrating for parents who come to the doctor to get peace of mind.

His busy clinic sees a constant stream of young children with various symptoms. When finding the cause, John says teething is often at the top of a mother’s list but it’s the last thing a doctor considers.

“We’re careful not to use teething as a catch-all. To say ‘Oh, it’s probably just due to teething’ can close both the doctor’s mind and the parent’s mind to other possible causes. If you do that you might miss something.”

The Midwife’s Take

Many midwives and baby experts disagree with doctors on this, tending to embrace a wider range of symptoms than those accepted by mainstream medicine.

Midwife and educator Kathy Fray lists 12 symptoms of teething in her best-selling parenting book Oh Baby!. They include mild fever, nappy rash, reduced appetite and tugging at the ears. She says teething babies can also have trouble sleeping, produce more saliva, get red cheeks and the occasional spot on their face.

Caring for hundreds of mums and their bubs over the years has the well-known author convinced the symptoms and the appearance of teeth are causally linked.

Kathy is frustrated by what she sees as doctor dismissiveness and their description of mums as being ‘confused’.

“To this,” she says, “my only reply is ‘poppycock’. When you are living 24-7 with your infant it can become black and white when they are teething again, because it so recurrently goes hand-in-hand with them becoming grizzly and fretful, waking up crying, dribbling continuously, one or both cheeks bright red, having a low fever, their stools becoming looser than normal, and a bit of nappy rash appearing out of the blue.We know exactly what is going on: they’re teething again.”

Treatment time

Thankfully there are a few points that experts on both side of the divide do agree on when advising mums on how to tackle the teething issue. They encourage parents to try not to worry too much when teething sets in. "Parents who can relax about it and see it as a brief niggle that will pass tend to have an easier time coping and so do their children," Nina says.

They also advise parents to treat the symptoms. There's widespread agreement that infant paracetamol, ibuprofen and topical teething gels like Bonjela are very helpful for pain. "When it comes to teething this is something we know is guaranteed to help make bubs feel better," John says. Our experts also recommend all manner of cold, hard objects for your baby to suck and chew on when in discomfort. A frozen banana, a chilled wash cloth, a cold spoon, a cool cucumber, a teething toy or even a clean finger to bite down on will offer relief. Breast or bottle feeding will also give comfort to a teething baby.

When it comes to more alternative therapies, opinions are split. Doctors are doubtful of the benefits of homeopathic teething powders and gels which they say contain such low concentrations of active ingredients that they're not going to work. "There's no scientific evidence at all to support their use," John says.

John and Nina take an even dimmer view on the benefits of popular amber teething necklaces. Advocates of the bead strands claim succinic acid found in the baltic amber stones acts as a natural pain reliever, anti-inflammatory and a central nervous system calmer. "Where is the proof?" asks John, who says many doctors have concerns that the necklaces could act as a choking hazard if they break and the beads are swallowed. Babies who wear them are also more likely to get gooey neck rashes. "Besides that there's no real danger, but whether they do any good is still yet to be proven."

Skepticism aside, he's sympathetic to parents who reach for these remedies when their child is in need. "Mums use them for absolutely the right reasons. They want to do everything they can to help their child. What we see is everyone wanting to do something active. Our advice with teething is sometimes it's better go against this instinct and do less, especially if your child is relatively okay."

Treat It

◦   Infant paracetamol or ibuprofen can help, especially at night

◦   Topical teething gels like Bonjela soothe gums (but can cause pain when applied)

◦   Cold or frozen fruit, cucumber pieces, a face cloth or spoon to chew on bring relief

◦   Rusks and teething toys help

◦   Breastfeeding can relax baby

◦   Homeopathic gels and powders have little scientific backing but many mums use them and believe they help. They won’t harm baby

Amber teething necklaces are regarded with scepticism by doctors who say they’re ineffective and a mild choking hazard. Some midwives say many mums swear by them and they’re worth a go.


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