Teething

• What is teething?

  It is the emergence of deciduous teeth.
• At what age do most infants start teething?

  Around 6 months of age
• What are deciduous teeth also known as?

  Milk teeth or baby teeth
• Which teeth usually erupt first during teething?

  Central incisors
• When does a full set of milk teeth usually emerge?

  By 2–3 years of age
• What happens to deciduous teeth by about 6 years of age?

  They start to fall out
• How long before tooth eruption do signs and symptoms of teething generally start?

  3–5 days
• What are common symptoms associated with teething?

  Pain, drooling, irritability, and wakefulness
• What is a possible mild symptom of teething?

  Mild pyrexia (temperature < 38°C)
• What may happen to the gums just before tooth eruption?

  They may swell, appear red, and become tender
• What are the management strategies for teething symptoms?

  • Gentle gum rubbing
  • Allowing biting on cool objects
  • Supervised use of chilled fruits/vegetables
  • Avoid choking hazards
  • Prefer sugar-free products
  • Cuddling and reassurance
  • Regularly wiping excess saliva
  • Brushing teeth twice daily after eruption
  • Dentist visit by 6 months of age
• What should be done for infants three months or older if self-care measures fail?

  Consider paracetamol and/or ibuprofen
• What are topical oral lidocaine-containing products recommended for?

  For teething pain if practical measures fail
• What is the age restriction for Bonjela® use?

  Not licensed for children under 5 months
• Why are topical oral lidocaine products not very useful for teething pain?

  They wash out of the baby’s mouth quickly
• What is the risk associated with excessive lidocaine ingestion in children?

  It can be possibly fatal
• What should not be recommended for children under 16 years of age?

  Topical oral salicylate gels
• What is the risk of using topical oral salicylate gels in children?

  Risk of Reye’s syndrome
• What is the stance on homeopathic and herbal teething products?

  • Do not recommend homeopathic teething tablets or gels
  • Herbal products lack good-quality evidence
  • Follow manufacturers' dosage instructions if used
  • Avoid unlicensed products
• What is an example of a herbal teething product?

  Ashton and Parsons® teething powders
• What is an example of a homeopathic teething product?

  Nelson’s Teetha® teething granules
• What is the minimum age for using Ashton and Parsons® teething powders?

  From 3 months
• What is the minimum age for using Nelson’s Teetha® teething granules?

  From 3 months
• What is the evidence supporting the use of homeopathic and herbal teething products?

  There is no good-quality evidence