Teething: Not a source of fever and not an explanation for symptoms of illness
By- Dr. Jonathan Wood

Teething continues to be offered as an explanation for fever or as a reason for a variety of symptoms in infants and young children. An important study published in the September 2011 issue of Pediatrics elegantly dispels this misunderstanding. Researchers (pediatric dentists) visited non-daycare infants repeatedly in their homes and gathered data: symptoms reported by mothers, oral exams, and infant temperatures. This was an excellent study for a variety of reasons: the oral exams were performed by experts, the temperatures were taken by the examiner by two different methods, the exams occurred daily over a period of weeks to months and therefore generated detailed data around the eruption of multiple teeth in each child and over 230 teeth overall.

The conclusions:
· Teething does NOT cause fever (before, during, or after tooth eruption)
· Minor increases in temperature (less than 0.3 degree F) occur on the day of and the day after eruption, but it is negligible and occurs within the range of normal temperature variation
· Minor symptoms - sleep disturbance, irritability, increased saliva, rash, loss of appetite, diarrhea - can occur in the day of and day following eruption. But again, these symptoms are not of a severe nature.

Why is this important?
· Doctors and parents should not invoke teething as an explanation for fever, even low-grade fever.
· Nor should they invoke teething as an explanation for severe changes in activity or behavior.
· When teething is used as an explanation for these findings, parents and doctors alike can delay the diagnosis of a more serious illness. In young infants especially, this is important: a true fever can be the only signal that a severe illness is developing and the immature immune system of the infant makes prompt diagnosis and treatment particularly important.

What can be done about teething?
· "Teething tablets" and anesthetic gels are not recommended. Parents can inadvertently deliver toxic amounts of the active ingredients and should avoid these products. They have also never been shown to be effective.
· Teething rings have been shown to be useful and effective.
· Gently massaging an infants gums often helps and satisfies the infants urge to chew on something

For more information of teething and care for a child's early teeth, visit the American Academy of Pediatrics' "Healthy Children" website http://www.healthychildren.org/English/Pages/Register-Email.asp It requires a free registration, but is full of much useful information for parents.

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