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Personal View: It's only teething... A report of the myths and modern approaches to teething

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Abstract

Paediatric dentistry is not my usual field of work. I am now based almost entirely in restorative dentistry and it is five years since I worked in the dental department of a children's hospital. An essay on teething would appear to be an unusual choice of topic. With the current professional climate of 'general professional education' and 'lifelong learning' I can easily justify my time and effort studying a subject somewhat removed from my regular work. However, to be completely honest, I have reached that age when many of my friends, relatives and colleagues are enjoying the sleepless nights that accompany expanding families. Add to this the fact that I have recently married into a family of midwives, health visitors, nurses and new mothers. I was not sure that I was giving the best, most up to date advice when asked about teething. So some reading around was required. If only it were that simple. I now feel equipped to give a little more help than simply saying, "It's only teething..."

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... Tooth eruption time varied in age 4-10 months. The first tooth eruption occurs in 1% before the 4th month when 1% of infants do not have any teeth until the 12th months (19). In the present study, the mean time length of teething was 7.16 ± 1.60 months. ...
... Wake also reported that most child health professionals (70% -85%) believed that teething causes fever, pain, irritability, sleep disturbances, biting and putting objects to mouth, drooling and red cheeks (13). But in another investigation on 21 infants in Melbourne, Australia, no signs and symptoms were strongly correlated with teething, which was not consistent with the results of many other studies including the current one (19). ...
... In another study very small number of healthcare providers believed that teething causes eczema and rash (18). Wake and Hesketh conducted a study on pediatric nurses, pharmacists, GPs, dentists and children specialists and in each group it was thought that at least some infants or young children had symptoms of teething, although beliefs toward the prevalence of teething symp- toms were quite different in the groups (19). ...
... Widespread folklore had been built around teething so much that it earned the Latin name Dentition 2 Difcillis(difcult dentition). Hippocrates claimed that children experiencing teething suffered from itching gums, fever, convulsions and diarrhea, especially when cutting their 2 canines . In 1839, 5016 children deaths in England were attributed to teething and it was documented as the cause of 12 % of deaths of 2 children younger than 4 years of age . ...
... In 1839, 5016 children deaths in England were attributed to teething and it was documented as the cause of 12 % of deaths of 2 children younger than 4 years of age . From the th th 16 to the 19 century, 50% of infant deaths in 2 France were ascribed to teething . Globally, in more recent times, various researchers have reported an association between teething and symptoms of fever, diarrhea, sleep 3,4,5. ...
Article
Research findings in Nigeria have revealed that misconceptions about teething is common in the society, particularly among individuals from the lower social class. This prompted the development of a twenty four minute video in a local Nigerian language (Yoruba) titled “Owoero” (meaning “ease”) . The video conveys a general message on ease of eruption of teeth in children; void of the long list of perceived symptoms. Videos are powerful communication vehicles and important health education tools. They have been used in many countries and previous researches have shown that videotapes are useful aids in health education This present video is to serve as a culturally appropriate community dental health education tool, with special focus on nursing mothers and pregnant women particularly in south western Nigeria because of their essential role in oral health care of children. The video also targets people from the lower socioeconomic class due to their poor knowledge and practice of oral health .This article describes the rationale behind the choice of a culturally appropriate heath educational video and the process and steps that went into the finished work.
... The belief that teething was a deadly disease was widely accepted until the late 19 th century. Hippocrates claimed that children experiencing teething suffered from itching gums, fever, convulsions and diarrhea, especially when cutting their canines [2]. In 1839, 5016 child deaths in England and Wales were attributed to teething [3]. ...
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Introduction: Misconceptions are associated with the teething process in Nigeria and is often blamed for symptoms in infants. A horrendous incident occurred in Nigeria in 2008 which recorded 84 infant deaths due to consumption of adulterated teething syrup to prevent teething problems. In the quest to engage the populace, particularly mothers, in health education to change this erroneous mindset about teething, it will be necessary and more cost effective to involve Traditional Birth Attendants (TBA’s) who can be invaluable in assisting to dispel myths associated teething as they live and work among the local populace and many times give counsel to mothers. Aim: To assess the attitude and beliefs of TBA’s in Ibadan, to teething in infants. Methods: A cross sectional survey was conducted among TBA’s in Ibadan, Nigeria. A thirteen item interviewer administered questionnaire was distributed to all 163 TBA’s in the five urban local government areas who agreed to be part of the study. Results: Over half of the respondents (59.5%) and (55.8%) associated the teething process with fever and diarrhea respectively. Other beliefs included boils (49.1%), loss of appetite (48.5%), weight loss (44.2%), and sleeplessness (42.3%). A greater proportion of the older and less educated TBA’s associated teething with fever, diarrhea, boils, loss of appetite and weight loss. The respondents would advise analgesics (55.8%), teething powder (67.5%), antibiotics (12.3%), concoctions (4.3%) and sedatives (4.3%) as teething remedies. There was a greater tendency for less educated TBA’s to advise the use of concoctions and antibiotics. Conclusion: The study reveals grave misconceptions among TBA’s who in developing countries like Nigeria give counsel to mothers in the various communities. There is an urgent need for health education to the TBA’s particularly the older and less educated ones.
... " In 1668, Francois Mauriceau insisted to use lancet instead of knife or coins to conduct the procedure. In 1742, Joseph Hurlock encouraged such practice to prevent child deaths caused because of teething [7] [14]. It would be ironical to understand if such a practice transformed to gouging. ...
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Cosmopolitan cities have become a pool of migrants from different parts of the world, who carry their cultural beliefs and superstitions with them around the globe. Canine gouging is a kind of infant oral mutilation (IOM) which is widely practiced among rural population of Africa where the primary tooth bud of the deciduous canine is enucleated. The belief is that the life threatening illnesses in children like vomiting, diarrhoea, and fevers are caused by worms which infest on tooth buds. This case report is of a 15-year-old Somalian born boy, who presented at the dental institute with intermittent pain in his lower right permanent canine which was associated with a discharging intra oral buccal sinus. The tooth was endodontically treated and then restored with composite. General dental practitioners need to be vigilant when encountered with tooth presenting unusual morphology, unilateral missing tooth, and shift in the midline due to early loss of deciduous/permanent canines. Identification of any such dental mutilation practice will need further counselling of the individual and family members. It is the duty of every dental professional to educate and safeguard the oral and dental health of general public.
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Many symptoms had been associated with teething in children with the possibility of overlooking potentially fatal condition. Symptoms that had been associated with teething include diarrhoea, fever, vomiting and cough. The possibility that any of these symptoms could have been due to other causes call for thorough investigation of the child before concluding that it is only "teething". The study was carried out to assess the beliefs of nursing mothers concerning symptoms that are associated with teething among children and to identify those that would seek medical treatments in case of their children having such symptoms during teething. Two hundred and ninety nursing mothers whose children had erupted at least a tooth were interviewed in the immunisation clinics of the University College Hospital and Adeoyo Maternity Teaching Hospital, both in Ibadan, Nigeria, on their beliefs and practice concerning teething in children. One hundred and eighty-eight (64.8%) of the mothers associated symptoms such as fever, cough, catarrh and diarrhoea with eruption of teeth in their children. Over half of the women agreed that a child having either fever (51.0%), ear infection (57.6%) or cough (50.3%) should be promptly taken for medical consultation and not be tagged "teething", while for other symptoms such as gum pain (74.5%), sleepless night (56.6%), vomiting (51.4%) and diarrhoea (51.7%), over half of the mothers believed that the symptoms will resolve following the eruption of the teeth. The study demonstrated that mothers in the study attributes several symptoms to teething, which could be detrimental to the survival of their children as the symptom could have been due to other causes. There is, therefore, need for public enlightenment to create awareness on the possible effect of presumptuous belief that childhood diseases are due to teething process.
Article
Historical remarks and actual views on infants teething are presented. Teething is a physiological process and a normal part of infant development, with individual variants of tooth eruption time and sequence. In 25–30% of infants, besides local gingival reaction and salivation, other systemic symptoms, such as a teething pain, anxiety and loss of appetite, may be co-incidental. The consequence of them are discomfort of an infant and distress of the parents and they are an indication to administer analgesic drugs. Prospective cohort studies show no causal association between teething and fever, infection or diarrhea. These symptoms indicate a need to exclude organic pathology.
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Throughout history, teething has been held responsible for a variety of childhood illnesses. The objective of this study was to assess parents' knowledge and beliefs about teething signs and symptoms and to investigate the practices used to alleviate teething troubles. A cross-sectional survey was conducted using a self-administered questionnaire distributed to 550 parents in Udaipur, India. The questionnaire contained three sections eliciting demographic characteristics and assessing parents' knowledge, beliefs, and practices regarding teething. Statistical analysis used descriptive statistics and the chi-squared test (p £ 0.05). Response to teething was incorrectly attributed to fever (70%), diarrhea (87.5%), and sleep disturbances (48.2%). Only 33.2% of parents allowed their children to bite on chilled objects to relieve symptoms associated with teething. A common lack of knowledge about teething among parents should encourage dental healthcare providers to educate them regarding the teething process and its management.
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Teething, especially in their first child, continues to be a daunting problem for parents. The objective of this paper was to assess the effects of providing first-time mothers with information about symptoms commonly associated with teething and ways to manage these. In a randomized controlled trial to decrease the incidence of early childhood caries, we included information on teething as another issue in a child's oral health. Mothers in the intervention group received three rounds of printed information: at enrolment during pregnancy and when the child was 6 and 12 months old. Information on teething arrived when a child reached 6 months of age. Outcome assessment was at 20 ± 2.5 months of age. Data were complemented with a systematic search for evidence on teething symptoms and how to alleviate them in other populations. Of 649 expectant mothers enrolled in the study, 441 completed the 'Child's oral health' questionnaire. There were no significant differences in teething symptoms reported by mothers in the intervention (n = 232) and control (n = 209) groups. However, mothers in the intervention group were less likely to use topical and oral medications to manage teething problems (P < 0.03) and relied more on rubbing the gums to ease discomfort (P < 0.005) than mothers in the control group. Providing mothers with information on how to address teething symptoms markedly reduced the use of medications for symptom relief. There is still need for better evidence, first, on what symptoms can or cannot be attributed to teething and, second, on what is effective in alleviating them.
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From grandmothers to medical professionals, everyone seems to have a list of symptoms they believe are linked to teething. During this time period of an infant's life, passive immunity due to maternal antibodies wanes and exposure to a wide variety of childhood illnesses occurs. Parental false beliefs associated with teething may interfere with the prompt diagnosis and management of a range of serious illnesses. Strong parental beliefs which are not borne out by evidence will unlikely change until professionals (most of whom are also parents) change theirs. Therefore, there is a need to know the facts and the false beliefs attributed to teething. Medical professionals need to be educated about teething to provide reasonable explanations to concerned caregivers. This article examines the signs and symptoms frequently attributed to teething and their possible alternative causes. The contemporary principles of the management of teething are discussed, including supportive care.
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The aims of this study were to (i) investigate the parental beliefs about teething signs and symptoms, (ii) investigate the parents' practices used to alleviate teething troubles and (iii) provide an educational basis for dental healthcare providers to better educate parents on this subject. A cross-sectional survey was conducted in a random sample of 1500 parents attending Maternity and Child Health Care Centers. The self-administered questionnaire contained three sections: Section I surveyed parents' and their children's demographic characteristics, Section II aimed to assess the general knowledge and beliefs of parents regarding their children's teething. Section III aimed at investigating the practices that the parents would do to manage teething problems and relieve pain. The analysis of data was carried out using spss computer software. Descriptive statistics and Chi-squared test were utilized. Almost 75% of the participants incorrectly attributed fever, diarrhoea and sleep disturbances to teething, and more than 50% believed systemic symptoms are not related to the process. More than 50% of the participants allowed their children to bite on chilled objects, (76.1%) used systemic analgesics and (65.6%) rubbed the gums with topical analgesics to relieve the symptoms associated with teething. This study shows a common lack of knowledge about teething among parents. Parents should be better educated about the teething process and the proper management of teething troubles by the dental health care providers.
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• Historically, many of the treatments and remedies for teething have been dangerous and have contributed to the high morbidity and mortality attributed to teething. • Today, teething treatments range from teething rings and cold washcloths to homeopathic oils and topical benzocaine. Although many of these treatments are benign, others have the potential to lead to serious disease or pose a choking risk. Vigilance and caution should be used when physicians prescribe treatment and when parents choose to use nontraditional remedies. • Young children are exposed to a wide variety of situations, environments, and illnesses and virtually are guaranteed to have multiple episodes of fever, congestion, and diarrhea. Physicians and caregivers need to be aware of the temporal relationship between teething, exposure to infection, and normal childhood illnesses. This perspective will help ensure that teething is not used as a blanket diagnosis to explain both potentially serious illness and normal childhood behavior. • Parents need to be educated that local symptoms may occur, but systemic symptoms are not caused by teething. Copyright © 2009 by the American Academy of Pediatrics. All rights reserved.
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Introduction The purpose of this study was to describe and evaluate the quality of infant teething information on selected popular parenting Web sites. Methods Two checklists were used to evaluate the quality of the 16 parenting sites and infant teething-specific content included on each site. Findings Three of the 16 parenting sites did not contain teething-specific articles. Teething-specific content found on 13 of the 16 sites supported a connection between the process of teething and nonspecific symptoms with a perception that management is required. Popular management strategies included chewing on chilled objects, gingival massage, and the use of over-the-counter medications. Information about possible adverse effects of administering medications for infant teething was not found on the majority of sites. Eleven of the 16 sites advised parents to contact their primary care provider if they were uncertain about management for infant teething or whether the symptoms were related to illness. Implications Although infant teething has an evidence base from which parents and professionals can make safe decisions about symptoms and treatment, translating the evidence into professional practice and health-related information on the Internet remains a challenge. Parents and pediatric health providers would benefit greatly from the development of clinical practice guidelines summarizing our present-day understanding of teething symptoms and the limited evidence supporting the use of over-the-counter medications.
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For many clinicians and parents "teething" remains a convenient diagnosis to explain all manner of local and systemic upset in the young child. Many therapies are on the market to help alleviate the symptoms of primary tooth eruption. In this article we highlight the problems of "teething" as a diagnosis by presenting a case where an initial misdiagnosis of teething compromised a patient's life. The same patient then suffered from topical analgesic misuse during the recovery period.
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The aim of this study was to investigate whether there are increased levels of the inflammatory cytokines IL-1beta, IL-8, and TNFalpha in the gingival crevicular fluid (GCF) of erupting primary teeth. This increase could explain such clinical manifestations as fever, diarrhea, increased crying, and sleeping and eating disturbances that occur at this time. Sixteen healthy children aged 5 to 14 months (mean=9.8 months) were examined twice a week over 5 months. Gingival crevicular fluid samples were taken from erupting teeth. As a control, GCF was collected from the same teeth 1 month later. Cytokine production was measured by ELISA. Signs and clinical symptoms were listed. Pearson correlation coefficients were used in the comparisons described below. A paired t test was used to analyze the same variable at different times. Fifty teeth of the 16 children were studied. GCF samples were collected from 21 of these teeth. Statistically significant differences (P<.05) were found with regard to the occurrence of fever, behavioral problems, and coughing during the teething period and the control period. During the control period, 72% of the children did not exhibit any clinical manifestations, whereas during the teething period only 22% of the children did not exhibit any clinical manifestations. The study revealed high levels of inflammatory cytokines during the teething period, with a statistically significant difference in TNFalpha levels (P<.05) between the teething period and the control period. Correlations were found between cytokine levels and some of the clinical symptoms of teething: IL-1beta and TNFalpha were correlated with fever and sleep disturbances; IL-beta and IL-8 were correlated with gastrointestinal disturbances; IL-1beta was correlated with appetite disturbances. Cytonkines appear in the GCF of erupting prmary teeth. The cytokine levels are correlated to some symptoms of teething.
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To evaluate Turkish parents' experience about their infants' teething; which symptoms they have seen and attributed to teething and how they have acted to manage these symptoms. A questionnaire form was applied by face-to-face interview to 335 families who have children less than 18 months of age and have at least one tooth. They were asked questions to clarify the eruption time and sequence of primary teeth of their infants and whether their infants had some symptoms they attributed to teething. The mean eruption time of the primary teeth was 7.4 +/- 2.0 months, with a range of 3-17 months. Teeth eruption time was found similar in both genders. Teeth eruption time of the term and preterm infants was similar. (P > 0.05). The first tooth erupted was the lower central incisor in the 288 infants (86.0%) and upper central incisor in 44 infants (13.1%). Most of the families (98.8%) reported that their children had suffered from at least one of the symptoms that were mentioned in the questionnaire. The most commonly reported symptom was increase in biting, followed by irritability and fever. Of the children who were taken to a health care centre, in 78.8% the symptoms were attributed to teething and in 7.1% a bacterial infection was found and antibiotics were prescribed. When an infant at teething age has some symptoms, they may be attributed to teething but other possible causes must be ruled out first.
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Teething is a developmental process and occurs over a broad chronological age range. The objective of this study was to evaluate the effects of feeding pattern and growth parameters on teething time of healthy infants. A total of 1200 term newborn infants followed up in Gazi University well-child clinic infants were evaluated, and their growth parameters, feeding patterns, and timing of the eruption of the first tooth were noted. The routine visit times of the clinic were chosen as the cut-off values for teeth eruption for logistic regression analysis for investigating factors that determine the timing of teeth eruption. Timing of the eruption of the first tooth ranged from 4 to 13 months. On the sixth month visit, 24.3%, and on the ninth month visit 84.5% of all infants had at least one tooth. Height-adjusted weight and height percentiles being less than 50, being fed by cow's milk or by formula in the first year, were independent factors negatively influencing teeth eruption by the sixth month, while all but height-adjusted weight percentiles being less than 50 had negative impact on tooth eruption by the ninth month. Growth parameters and feeding pattern may be determinants of the timing of teeth eruption in healthy infants.
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Objective: To summarize and review the literature on infant dental enucleation, a traditional remedial procedure prevalent mainly in East Africa. Materials and methods: Literature searches were made electronically using general and specialized search engines. The main search was performed through a systematic strategy in PubMed, comprising tabulated keywords, search codes, and translated and transliterated terms. Criteria for the selection of studies were designed to provide a general understanding of the procedure. The findings were synthesized into two sections: a summary of the population prevalence studies, and a thematic literature review. Results: An overview of the known prevalence and clinical specifications was established. Insight was gained into the purpose of the procedure and the factors influencing its performance. Diverging suggestions were seen with regard to the rationale for use of infant dental enucleation between different populations. Moreover, reports of complications and consequences involving the general health and the dentoalveolar structures of patients were examined. Conclusions: Prevalence, clinical features and risks of infant dental enucleation point to a need for greater awareness of the procedure. Further, there is a need for specific guidelines regarding management of suspected cases within dental and healthcare communities.
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Background Parental knowledge of teething has been repeatedly investigated; however, little emphasis has been made on the associated sociodemographic factors with good knowledge of the parents and whether or not good knowledge is translated into adopting proper pain-relieving practices. The present study aims to firstly assess the knowledge level and practices of Saudi parents regarding teething and then explore associated sociodemographic variables with good knowledge of teething to determine the relation between parents’ knowledge of teething and their adoption of pain-relieving practices. Methods This cross-sectional study recruited parents from the social networking sites Facebook, Twitter, Instagram, and WhatsApp, and they were asked to answer a pretested three-part internationally accepted questionnaire. Data were examined using descriptive statistics, chi-square analysis, multivariate logistic regression analysis, and Spearman rank-order correlation coefficient analysis. Results One thousand four hundred ninety-nine parents responded and returned completed questionnaires. Of those, only 11.2% had good knowledge of teething. The majority of parents did not have basic knowledge of the teething period as well as believed that teething was associated with a runny nose (87.5%), diarrhea (77.9%), and sleep disturbance (72%). The results of multivariate logistic regression analysis indicated that parents with no primary school education (Odds Ratio: 0.29), or those who had an intermediate or secondary education level (OR: 0.55 and 0.78) were less likely to have good knowledge compared with parents who had a university degree. However, parents who earned intermediate monthly income (OR: 6.63) were more likely to have good knowledge of teething. With regards to practices used to relieve teething pain, inappropriate practices were observed regarding bottle feeding at night to soothe the child’s pain (72%) and applying topical analgesics to rub the gum (72.4%). A significant positive correlation was found between the knowledge score and the practice score of both fathers and mothers ( r = 0.22 and 0.13, p < 0.0001). Conclusion A very low percentage of Saudi parents, mainly those with the highest education level and intermediate monthly income, had good knowledge of teething, which translated into appropriate practices to soothe the child’s pain regardless of the parent’s gender. Saudi parents should receive anticipatory guidance related to teething from all health professionals to ensure an uneventful teething period for their children.
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Objective: The relationship of the first deciduous tooth eruption and the general health of an infant has always been a subject of curiosity. The enigma of teething although historical, continues to pervade contemporary child health care due to many unexplained teething myths. The treatment modalities used in teething have been diverse. The objective of this study was to evaluate the awareness, beliefs and knowledge of parents towards teething symptoms. Materials and method: Hundred parents were randomly selected from two kindergarten schools and were interviewed according to a structured questionnaire. Collected data was analyzed by a statistical software known as SPSS. Results: Results revealed that though parents knew about teething but there was lack of awareness regarding diverse treatment modalities and the teething myths and realities. Conclusions: More educative programs should be initiated to make parents aware of teething myths and realities.
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Misconceptions about the teething process has led to high infant morbidity and mortality, which was recently experienced in Nigeria due to consumption of an adulterated drug used in the prevention and treatment of teething-related illnesses in infants. It is however, unknown if these misconceptions still persist in a rural town in Nigeria despite oral health awareness campaigns targeted at this. The aim of this study is to assess the beliefs and practices of residents in Igbo Ora, a rural township in Nigeria, regarding the teething process. A descriptive cross-sectional study was conducted among 393 adults in Igbo Ora using a 33-item, semistructured questionnaire. Symptoms such as diarrhea (80.7%), fever (69.2%), and boils (64.4%) were still considered as a must to accompany teething. Teething powder, teething syrup, and traditional concoctions were commonly recommended by (42.0%), (31.6%), and (48.1%) of the respondents, respectively, to treat and prevent teething symptoms. This study revealed that misconceptions about teething are still highly prevalent among the populace in Igbo Ora, and a structured oral health education intervention at the community level is urgently needed.
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Background: Most parents believe that teething is associated with some symptoms and commonly use Internet to gain more information about the health of their children. Pediatricians can also serve as a source of information for health-related requirements of parents. This study aimed to compare the information provided by pediatricians regarding tooth eruption and the information available in Persian-language websites. Materials and Methods: This descriptive, analytical, cross-sectional study was performed in two phases. In the first phase, the questionnaire was designed by 85 pediatric pediatricians in Isfahan about children's dental eruption and internet resources. The second phase was the study of 22 Persian websites about children's tooth eruption using Google search engine and the keywords “tooth eruption,” “tooth eruption symptoms.” Then a checklist was prepared to evaluate the quality and completeness of the content. Data were analyzed by the Chi-square test and Fisher's exact test using SPSS (P < 0.05). Results: None of the retrieved websites had the health on the net code of conduct. The most common symptoms of teething reported by both pediatricians and websites included irritability, drooling, gingival tenderness, chewing tendency, decreased appetite and sleep disturbances. In non-pharmacological methods to control the symptoms related to tooth eruption in both groups, embracing the baby (P < 0.001), using soft tooth ring (P = 0.049) and chewing hard foods (0.016 P = significant. Use of oral pain medication (P = 0.01) and sedatives and medications (P = 0.04) were significant in the medication method. Conclusion: None of the websites reviewed had a valid source code and author. Although websites cannot replace the instructions of pediatricians regarding growth and development of children and their teething, supplementary information can be acquired from high-quality websites because there seems to be no significant difference between these two information sources regarding tooth eruption symptoms and their management.
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Tool use is a central topic in research on cognitive evolution and behavioral ecology in non-human animals. Originally thought to be a uniquely human phenomenon, many other species have been observed making and using tools for a variety of purposes, starting with Goodall’s (1964) groundbreaking work with chimpanzees in Gombe. Despite the frequent attention and great research interest in animal tool use, and ubiquity of the behavior, we argue here that chewing sticks by dogs (and other animals) should be included as a case of tool use. We discuss alternate possible explanations and then propose several testable predictions regarding this hypothesis. We suggest that tool use may be more common than is often assumed and that many cases of animal tool use may be overlooked.
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Background: The assumption of a link between common symptoms such as febrile illness, diarrhea and the eruption of primary teeth has been established over many centuries. According to traditional beliefs in Ethiopia, diarrhea and fever at the time of milk teeth eruption may be due to a worm in the child's gums. Current medical observations show little more than restlessness, drooling, and finger sucking resulting from teething. The purpose of this research was to assess mothers' traditional beliefs and practices towards teething symptoms. Methods: A cross-sectional descriptive study design was used with the convenience sampling technique. Mothers were approached at the pediatric Out Patient Department (OPD) of Jimma University Specialized Hospital, southwest Ethiopia. A structured questionnaire was used for data collection. The data were analyzed by SPSS (version 20). Results: A total of 107 mothers were interviewed. Ninety-eight (91.6%) claimed that teething was associated with various symptoms. Ninety-seven (90.7%) attributed diarrhea to teething. Only one mother said she would give her child Paracetamol to relieve the teething symptoms. Five (4.7%) mothers said they would allow their children to bite on a pacifier. Ten mothers (9.3%) said that they would prefer the child's milk tooth to be extracted. Some of the practices by mothers to relieve the symptoms include rubbing the gum of the child with garlic (12.1%) or rubbing the gum with herbs (6.5%). Conclusions: Most of the mothers had misconceptions about the symptoms that usually appear during teething. Health education should be provided by dentists and professionals concerned with child care in correcting these misconceptions and cultural beliefs about teething symptoms.
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Aim To perform a systematic review and meta-analysis to establish if fever is associated with primary tooth eruption. Materials and methods Literature searches involved Pubmed, MEDLINE, Web of Science, Scopus and Cochrane. The potentially relevant studies had the full text analyzed. Only studies concerning fever during eruption period of primary tooth in humans were included. Papers in non-English language, and papers that included syndromic patients or patients with any disease were excluded. The meta-analyses were performed with Review Manager (version 5.3). Only studies that reported the results as dichotomous data were analyzed with Cochran-Mantel-Haenszel test in meta-analysis function of Review Manager 5.3. The fixed-effects model was used to evaluate the association between tooth eruption and fever. Results Search identified 83 potential studies. After exclusion of the duplicated studies, or were not related to the criteria of inclusion only 6 studies were selected for the systematic review. In the overall meta-analysis, no association was found [OR = 1.32 (0.88-1.96)] between fever and primary tooth eruption. However, in the subgroup analysis, when the method used to measure fever was the rectal temperature there was an association [OR = 2.82 (1.55-5.14)] between fever and primary tooth eruption. Conclusion There are few suitable studies in the literature regarding the association between primary tooth eruption and fever. However, our study found an association between fever and primary tooth eruption only when rectal temperature was performed How to cite this article Nemezio MA, De Oliveira KMH, Romualdo PC, Queiroz AM, Paula-e-Silva FWG, Silva RAB, Kuchler EC. Association between Fever and Primary Tooth Eruption: A Systematic Review and Meta-analysis. Int J Clin Pediatr Dent 2017;10(3):293-298.
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Background: Teething is an important developmental milestone in young children. Mothers attribute several symptoms to teething and their beliefs in turn affect their behavior towards the healthcare of children during the period of tooth eruption. This study assessed maternal beliefs and behaviors towards teething in young children in Benin City, Nigeria. Methods: A descriptive cross-sectional study was carried out among mothers who brought their babies to Well Baby Clinics in three health facilities in Benin City, Nigeria. The tool for data collection was a structured researcher-administered questionnaire. Data were analyzed using SPSS version 16.0. Results: Mothers of 420 children (mean age 16.2 ± 8.6 months) participated in the study. Over two-third 302 (71.7%) believed that infant teething is associated with various symptoms. The commonest symptoms reported were fever 258 (85.7%) and diarrhea 241 (80.0%) while the least was redness of the gums, 2 (0.7%). A greater proportion of respondents, 224 (74.4%), 186 (61.8%) and 184 (61.1%) managed teething discomfort with teething syrups, tepid sponging and teething toys respectively. More than half of the respondents 263 (54.3%) and 162 (56.3%) gave analgesics to relieve fever and oral rehydration solution (ORS) for diarrhea attributed to the teething process respectively. Conclusion: Mothers’ beliefs encourage the use of “teething” as a ready explanation for childhood diseases. They utilize analgesics, ORS, teething syrup and herbal medications to relieve perceived teething symptoms. The misconception about teething can be corrected through health education of mothers when they access health facilities. The mass media may also be employed to reach a larger audience. Key words: Teething, Maternal behaviors
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The spiritual development of the child must occupy a main place among the interests of the practicing dentist, the physiological premonitions related to the child oral health being often connected in this age period with spirituality and faith. In this way, the child patients are continuously facing a straight association between their own growth and development, doctor and spirituality. This article aims to study the relationship between subjectivism, spirituality or religion and paediatric oral health, thus delimitating the possible ethical dilemmas which the paediatric dentist would encounter in his practice, together with his deontologically required constant concerning about the spiritual values of the patient and his family. Despite the fact that the therapeutic option or following a certain treatment are subordinated to the autonomy of the patient or his legal representatives, in many cases this autonomy can be affected by variable degrees of religious devotion, an aspect hard to quantify in scientific studies. Various aspects like the substances used in the dental practice, the recommended dietetic hygienic- alimentary regime, establishing the visit to the dentist or its duration can be therefore decisively influenced by patient religion and culture. The paediatric dentist must be always ready to meet subjective customs, practices, beliefs or superstitions and to consider them seriously as an integrant part of his professional relation. Through the multitude of the existing professional relationships, their frequency and the special quality of the involved parts, the doctor-patient relationship in the dental area, mostly in the paediatric field should be of more concern for the bioethical research community.
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Objectives: To assess the knowledge about teething, to evaluate the experiences of the mothers' during the teething of their youngest child and practices undertaken by them to relieve teething symptoms. Study design: A stratified cluster sampling technique was used to collect representative sample of school children of Jazan province (Saudi Arabia), who were provided with a questionnaire kit to be filled by their mothers. Results: A total of 159 mothers participated in this study More than four-fifths and three-fourths of the study population knew that the first primary teeth erupt at 6-7 months of age and lower central incisors are the first teeth to erupt respectively. The most prevalent signs and symptoms associated with teething as reported by the mothers were desire to bite (97.5%), fever (93%), diarrhoea (91.1%), increased salivation (79.9%), loss of appetite (77.4%) and gum irritation (71.7%). A little more than half (55.7%) of the mothers' gave their child a chilled object to bite and 42.1% bottle fed their baby at night to relieve teething pain. Conclusions: Many mothers had poor knowledge and misbeliefs about teething. There is a need to educate the mothers of Jazan province on the facts related to teething, specifically those related to teething pain relieving practices.
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Parent education about oral hygiene, feeding practices, and diet is a major goal of early dental visit before the age of I year. This is particularly important for early start of preventive measures in infant. First dental visit should be scheduled during first year of life. The goals of infant oral health care are to prevent acquisition of harmful microflora and early childhood caries, establish proper feeding habit, start with early prevention programme, and child's proper oral hygiene. Maternal xylitol use during perinatal period and up to the end of child's first year of life could be beneficial to delay MS colonization. If natal teeth cause oral ulcerations (Riga-Fede disease) the sharp incisai edges of the tooth should be smoothening. Where the ulceration is large and interfering with feeding, the natal tooth should be removed. Regarding teething parents should be advised that it is physiological process in infants which can not cause any kind of serious symptoms. Paediatricians and paediatric dentists should be involved in oral hygiene education and family counselling regarding diet and feeding practice. Information about developmental abnormalities, caries and injuries prevention to the parents can be valuable for infant oral health.
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Aim This longitudinal study aimed to investigate the prevalence of teething-related pain and fever and the early-life factors that may affect the risk of experiencing these disturbances within the first 1.5 years of life. Materials and methods Participants were recruited (n = 1033) through the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort (n = 1237). Interviews were performed tri-monthly regarding the prevalence of teething pain and fever in children from 6 to 18 months of age. Crude and multivariable analyses were conducted using Poisson-log regression models. Results Prevalence rates for teething pain and fever were 35.5 and 49.9 % respectively. Multivariable Poisson regression analysis showed maternal second-hand tobacco smoke (SHS) exposure to increase the risk of both pain (mean ratio = 1.35; p = 0.006) and fever (mean ratio = 1.22; p = 0.025), whereas SHS exposure plus active smoking further increased risk of teething pain in the children (mean ratio = 1.89; p = 0.029). Delivery via Caesarean section increased risk of teething pain (mean ratio = 1.27; p = 0.033), while prenatal plasma vitamin D insufficiency lowered such a risk (mean ratio = 0.62; p = 0.012). Compared to Chinese infants, Indian babies exhibited lower risk of teething pain and fever (both p ≤ 0.001). Conclusions Early-life factors such as tobacco smoke exposure and vitamin insufficiency during pregnancy, ethnicity and childbirth via Caesarean section may significantly affect the child’s susceptibility to teething-related pain and fever. Clinical relevance Knowledge of prevalence and risk factors of teething disturbances may better equip primary caregivers and healthcare professionals to accurately detect teething-related local and/or systemic signs/symptoms and effectively facilitate tobacco cessation among pregnant women.
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To evaluate disturbances in primary tooth eruption and their management with nonpharmacological remedies. In this nonrandomized clinical trial, 270 children aged between 8 and 36 months were selected and divided into 5 groups with 54 children initially enrolled in each group. The children were seen during an 8-day period during tooth eruption. At each appointment data were recorded from oral examination, tympanic temperature measurement and a questionnaire. The five methods used as remedies to reduce teething symptoms were: 1) cuddle therapy, 2) ice, 3) rubbing the gums, 4) teething rings and 5) food for chewing. Teething symptoms, the type of erupted tooth, symptoms of recovery and the mother's satisfaction with treatment were evaluated. Two hundred and fifty four children (mean age 16 ± 7.2 months) completed the study. The most frequent teething symptoms were drooling (92 %), sleep disturbances (82.3 %) and irritability (75.6 %). These symptoms were more pronounced in low birth weight children (p > 0.05). Canine eruption led to more loss of appetite than incisor (p = 0.033) or molars eruption (p = 0.014). Low grade increases in body temperature were observed only on the day of eruption (36.70 ± 0.39 °C), when body temperature was significantly different compared to the day before and the day after eruption (both p < 0.001). There was no significant correlation between fever as reported by mothers and temperature readings obtained by the investigators. The most favorable results for time to recovery and the mother's satisfaction were seen when teething rings were used, followed by cuddle therapy and rubbing the gums. There was no association between teething and symptoms such as fever or diarrhea. Low birth weight children may have more teething symptoms. Teething rings, cuddle therapy and rubbing the gums were the most effective methods to reduce symptoms. Iranian Registry of Clinical Trials: code IRCT201211127402N3.
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Abstract Aim: The purpose of this study was to ascertain mothers’ awareness of the teething process in children, their associated symptoms, adopted cultural practices, and medicines given to relieve these symptoms. Materials and methods: A total of 115 mothers participated in this study that was conducted in the Dental Outpatient Department (OPD) of Dow University of Health Sciences from July 2021 to September 2021. The pre-validated adapted questionnaire consisting of 20 items which included mothers’ sociodemographic details, mothers’ awareness regarding the teething process, and cultural practices to relieve these symptoms was administered. Chi-square tests of significance (Fisher\'s exact test) were used with a 95% confidence interval while the p-value was set at less than 0.05 for statistical significance. Results: Out of 115, half of the mothers knew the completion dates of deciduous dentition, that is, approximately 3 years that was statistically significant with education. Fifty-two percent of the mothers expressed their concern when their children started teething which was correlated with education. Ninety percent of the mothers reported that teething was associated with different symptoms. Fever was the most reported symptom during teething followed by diarrhea and poor appetite. On worsening of teething symptoms, 61 (53%) mothers took their children to the hospital. Paracetamol was the most common medicament given by 59 (51.3%) mothers which was associated with their education and occupation. The majority of mothers did not associate teething symptoms with their older children and siblings and this was correlated with mothers’ education. Conclusion: In this study, awareness of teething symptoms was directly correlated with mothers’ educational levels. Misbeliefs of teething such as the association of diarrhea and fever with teething and the use of medicines for teething was prevalent in mothers having no professional education. Half of the mothers gave paracetamol during the teething period but some from the other half were dependent on harmful unregulated homeopathic drugs. Clinical significance: Mothers have wrongful beliefs regarding infant teething in Pakistan which endangers children\'s well-being. Harmful homeopathic drugs are being given for symptoms which have no relation to the teething process. Moreover, these misconceptions might delay accurate diagnosis of other ongoing diseases.
Article
The purpose of this study is the evaluation of the tooth eruption ages in a sample of children aged between 6 and 24 months. The sample consists of 204 children aged between six and twenty-four months, followed up for a period of one year in collaboration with seven pediatricians in the province of Sassari (Italy). The visits were carried out at the paediatricians' practice in order to receive immediate feedback about the clinical conditions of children. Regarding the ages of eruption of all elements it was observed a shift more or less important, depending on the tooth considered.
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This investigation was conducted to determine whether primary herpetic gingivostomatitis may be responsible for those signs and symptoms commonly attributed to teething in infants. Twenty infants presenting with a parental diagnosis which indicated teething difficulty were included in this study (Group A). Twenty infants who were in no distress served as controls (Group B). Oral swab samples were obtained from each infant and then processed to ascertain the presence of herpes simplex virus (HSV). Each infant's temperature and oral status also were recorded. Nine subjects in Group A (45%) were positive for HSV. Of these nine, seven had elevated temperatures (less than 100 degrees F) and all had signs of oral infection of varying severity. Of the 11 subjects in Group A who were negative for HSV, five had elevated temperatures, but none showed evidence of oral infection. Subjects in Group B were all negative for HSV, elevated temperature, and signs of oral infection. Results of this study suggest that oral HSV infection should be included in the differential diagnosis of infants presenting with a parental diagnosis of teething difficulty.
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