Fussy and feverish, the toddler was having a really bad evening. Her mom was calling for some advice, knowing it was a long shot, but hoping to blame all of her daughter's misery on teething.
The mother explained that the child was out-of-sorts and had just spiked a 103-degree fever. Now, I'm willing to use teeth as a scapegoat when little ones are experiencing some crabbiness and teeth are erupting, but a high fever -- nope, we can't blame that one on baby teeth.
In her article in Pediatrics in Review, Dr. Lisa Markman explains that infants usually get their first tooth at about six months of age and, on average, will add one tooth per month between six and 30 months of age.
The lower central incisors (middle teeth) are usually the first to appear, and baby girls often start teething before their male counterparts.
Dr. Markham reports that, despite common perceptions, the consensus among experts is that this infant and toddler teething process does not, in fact, cause systemic changes such as decreased drinking, congestion, sleep disturbances, vomiting and diarrhea, cough, body rash or higher fevers.
The American Academy of Pediatrics notes that teething can in some cases produce mild irritability, as well as local signs of increased drooling, and pain and gum swelling at the site of tooth eruption.
The group finds that tooth eruption can be accompanied by fevers, but if teething fevers occur they are low-grade and not expected to exceed 101 degrees Fahrenheit. Higher fevers may need further investigation.
When a child is experiencing teething discomfort, AAP experts instruct parents to massage the child's sore gums with their fingers and to offer their little one a firm rubber teething ring to chew on. Frozen teethers should be avoided since they can get too hard for tender gums and can cause harm.
The U.S. Food and Drug administration generally advises against the use of benzocaine-containing topical gel and liquid teething pain relievers for children younger than 2. Topical benzocaine use has been linked to a rare but potentially fatal medical condition called methemoglobinemia, which causes a reduction in the oxygen-carrying capacity of a child's red blood cells.
Dr. Markman does suggest that the common over-the-counter pain relievers acetaminophen and ibuprofen can be used to help relieve teething pain. Their use should be "conservative," and parents must be knowledgeable about the particular form of the medication they are purchasing and the proper dosing for their own child.
•Dr. Helen Minciotti is a mother of five and a pediatrician with a practice in Schaumburg. She formerly chaired the Department of Pediatrics at Northwest Community Hospital in Arlington Heights.