Doctor in the House: Is your infant drooling excessively? She may be teething - The Indian Express

Odontiasis also known as teething in babies, occurs where the teeth cut through the gums in an infant. It is a fascinating process that most parents eagerly wait for. In most children, this process usually starts between four to seven months, but this is not a rule of thumb. It is merely an estimation, so don't worry if
your baby's teeth came in early or even later. Each baby is different.

Signs that your baby maybe teething

A lot of babies don't really show major symptoms and you may suddenly discover a tooth has sprouted in the lower jaw when you are breastfeeding. Others may show one or more of the following symptoms or even most of them:

— swollen and painful gums,
— being more fussy than usual
— mild fever
— wanting to chew on anything and everything
— putting fingers or even the whole hand in the mouth
— drooling excessively to the point that the baby develops a rash
— tugging at the ear
— unwilling to eat or feed

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As mentioned above, most children sprout teeth and have no real problem. But if your baby develops high fever, vomiting and diarrhoea, cough and cold you need to speak to your paediatrician as these are not symptoms of teething.

How to soothe your baby's teething discomfort

When your baby is uncomfortable there are few things that can be done to soothe your baby. What worked for your friends with their baby may not work for yours. You can try putting something cold in the baby's mouth like a cold spoon or a wet, clean wash cloth, or even a cold pacifier. A solid cold teething toy may work but many paediatricians advise against this as it can hurt the baby's gum. I don't advise those fluid-filled teething gels as there is a chance that your baby may bite it and it may tear spilling all the liquid in
her mouth. An older child, say around nine months old, can sip some cool water.

Another option is to wash your hands and gently massage the gum or even let your little one gnaw at your finger, as long as they have not sprouted a tooth, then of course it could get very painful you.

Avoid products that are not approved as treatment for teething. These can include:
— liquid teething gel toys that can break
— plastic toys that can break in the baby's mouth
— teethers that are frozen solid, which can hurt the baby

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Instead use toys made of rubber and substances that are not harmful such as lead. I see many children wearing teething necklaces. These are dangerous, as it can form a tight noose around the baby's neck. Also babies can choke on the beads if they put it in the mouth and the the necklace breaks.

If you still want your baby to wear one of these, then its better if it goes around the waist or even around the ankle. As you cannot be around the baby all the time, it is better that it is not around the neck.

Teething Medicines

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There are many dental gels available in the market and other baby teething gels that promise to help with the pain. It really does not help as it gets washed away. It may even cause swallowing problems as it may numb the throat. Benzocaine is a local anaesthetic that is present in most of teething gels and is not recommended for children under two years. It can cause rare but very serious side effects. You can always use paracetamol as a pain killer. I don't recommend ibuprofen as it should not be given ideally to children under six months.

Order Of Tooth Eruption

When and how teeth come in can be different for every baby, but in most cases, the front lower two teeth come in first, followed by the opposite top two teeth and then the ones on the side in the top row. This is followed by two on either side of the lower two teeth and the the molars. The teeth in front of the molars are next and then the back molars which are the last to come. By the time your baby is three years old, she would be having 20 teeth.

Caring for your baby's teeth

Ideally, good oral hygiene should start before your baby develops her first tooth. You can gently clean her gums with a wet clean muslin cloth or gauze once a day. Be very gentle and make sure you don't hurt their
mouth. Even when your baby develops teeth, continue cleaning with just water
and a cloth at least two times a day.

Once your baby is a year old, use a brush with bristles and put a small amount of fluoride-free toothpaste to clean the teeth. Your paediatrician will monitor your child's teeth and check that there are no caries and if there is, they will refer you to a dentist. Till three years of age, your paediatrician will keep an eye on your baby's teeth. Thereafter your child's teeth will need to be looked after by a paediatric dentist!

Dr Saroja Balan is consultant neonatologist and paediatrician at Indraprastha Apollo Hospital. Her column appears every fortnight.

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