A Pediatric Dentist’s Tips
Is my child fussy because she is teething, or could it be something else?
Often caregivers believe teething is to blame for a slew of conditions, such as:
- Extended periods of fussiness
- High fevers
- Diarrhea
- Congestion
- Vomiting
Research hasn’t demonstrated that any of these are consistently associated with teething. So be sure to check with your pediatrician if they occur because they may be signs of an illness, injury, or digestive issues, rather than teething. It is especially important to seek out the advice of your pediatrician in the cases of diarrhea or vomiting in an infant, as these conditions can become serious very quickly if the child is dehydrated. True story: I once had a patient whose mom thought he was fussy from teething, but it turned out he had broken his arm falling off of the couch a few days prior!
What signs and symptoms DO we see with teething?
- Drooling, although this isn’t a symptom so much as a coincidence. The salivary glands begin to produce saliva around the same time that teeth begin to erupt.
- Fussiness in the 2-3 days immediately surrounding a tooth breaking through. Especially at night.
- Low-grade fever, if any (no higher than 100F).
- Visible discomfort that may lead to more frequent wakings from sleep (but not always). Although some schools of thought think the discomfort is more due to rapid growth generally in babies (growing pains) and not necessarily from teething.
- Increased desire to chew.
- Pain is relieved by cold, pressure, rubbing, and/or ibuprofen.
How can we support our little one through teething?
- Hydrate, hydrate, hydrate! If baby is uncomfortable and not drinking or nursing well, I deliver a little (about 1oz) water or breastmilk with a medicine syringe at mealtimes (see my TikToks about how to easily deliver liquids via oral medicine syringe – the retromolar pad area is your friend).
- Brush the gums several times a day where the tooth is erupting (this is my daughter’s favorite thing) – use a soft-bristled toothbrush or a silicone baby brush. No toothpaste is necessary yet.
- Silicone teethers – Mombella Mimi Mushroom, teether tubes (choking/gag caution if stick too far back), teething rings (firmer in texture).
- Frozen foods for chewing – large frozen fruit pieces (cantaloupe slice, banana) or vegetables (carrot, celery, green onion). *There are mesh teether rings that you can place frozen fruit into that baby can chew with less risk of choking on a loosened large piece.
- A frozen (15-30 minute) washcloth dampened with water or breastmilk for chewing.
- Pain medication (ibuprofen/Motrin works better than acetaminophen/Tylenol) if the child is over 6 months old and your pediatrician states he or she can safely be administered that medication, dosed by weight.
Cautions with teething
⛔Do NOT use over the counter teething gel that contains benzocaine. There is risk of methemoglobinemia.
⚠️Be careful with teething necklaces – never leave a child unsupervised (especially sleeping) with anything around the neck, including teething necklaces, due to strangulation risk. They’re also a choking hazard (the “individually tied” beads can be singularly lost and often go un-noticed by the parent). Children have been seriously injured and one little boy lost his life (find Dani Morin on TikTok and IG and learn about her son Deacon’s story). Research shows they’re ineffective, too (the only effect is placebo (on the parent), which is real but never worth risking your child’s life) – so save your money and try some of the above tips instead!
🌿Be certain you trust the company before you choose to use homeopathic medications. Homeopathic teething regimens are not regulated (Example: back in 2017, it was found that Hyland’s teething tablets contained inconsistent amounts of belladonna, and babies who took them had seizures, lost consciousness, and even stopped breathing! The product was recalled). I have never used any homeopathic teething medications with my children for this reason.
💊Ibuprofen/Motrin – I try to limit use to 1-2 doses over 1-2 days, as prolonged use can lead to upset tummy and constipation.
⚠️Liquid filled teethers can leak, and these liquids are often unsafe for consumption. Use with caution and supervision!
