Monday, April 26, 2010

The Truth about Teething Part I: Is it Teething or Something Else?

Most parents dread their infants' teething. They anticipate sleepless nights and inconsolable crying. Parents have attributed dozens of symptoms to teething including drooling, biting, fever, runny nose, congestion, ear problems, diarrhea, skin rash, and vomiting. But what if some or all of those symptoms are not part of teething? In this post, we'll take a closer look at what parents believe about teething versus what the research tells us.

Teething Basics

Teething is more formally called "tooth eruption" and occurs as infant teeth move from the jaw through the gums and become visible in the baby's mouth. While all babies are different (as we always say), babies teeth typically start showing up when the baby is about 6 or 7 months old. Most often, the first teeth to appear are in the lower front of the mouth and a full set of baby teeth may take two years to emerge. Teething, therefore, goes on for many months. Of course, those of you who are already parents know that!

The Teething Experience

While researchers associated biting, thumb sucking, and drooling with teething 30 or 40 years ago, today's parents have expanded their ideas about teething to include a wide range of concerns. In an interesting study published in Pediatrics in 2000, researchers followed a group of children aged 6 to 24 months that attended childcare settings. Each weekday, they asked parents and childcare providers about symptoms commonly believed to be associated with teething. The children's mouths were examined daily by a professional to see if any teeth had appeared. The concept was to identify which symptoms were associated with teething and which were not. What did they find? Virtually none of the common symptoms assumed by parents to be related to teething was statistically associated with tooth eruption. Interestingly, when the parents who participated in the study were asked about their children's teething symptoms, they reported many of the common symptoms even though their own records didn't support the connection. Other studies also support the view that parents are likely to assume that many symptoms of illnesses (like colds and ear infections) are related to teething.

Why Study Teething?

Clinicians and researchers are concerned that some parents might dismiss symptoms of more serious conditions (like ear infections) as teething and delay taking their babies to the doctor. Other parents might give medications to babies unnecessarily either for a few days or a few weeks. Another interesting finding is that parents in the studies often "diagnosed" teething by the symptoms rather than by tooth appearance. Young babies' behavior can be very confusing. Babies also end up catching many minor illnesses during the months in which teeth typically appear. Parents, struggling to understand what is happening with their babies may decide that "teething" must be the reason for their babies' runny noses, skin rashes, and fevers but they are likely to be wrong. Each baby will experience teething in his or her own way but the research indicates that most of the symptoms related to tooth eruption are mild and short-term. We'll talk more next time about what parents might do to "treat" their babies' teething and whether or not these "treatments" work.

Next time: The Truth about Teething Part II: Can Parents Make Teething Easier for Babies?


  1. Thanks so much for you fantastic blog - it is the voice of reason amongst so much conflicting information which deals with 'the average baby' - who has one of those?? I would love to hear your thoughts on daytime sleep as everything I come across about infant sleep is about nighttime. My 15wk old daughter sleeps well at night (sleeps 7 - 7, waking up for 3 feeds from midnight but going straight back down), so anyone I ask about daytime naps says 'think yourself lucky'. She is a catnapper during the day and really inconsistent, hates feeling drowsy and can shout about being tired for an hour or more before finally dropping off for 10 mins then wide awake again. Very occasionally she falls asleep in the early afternoon and will only wake briefly for feeds and sleep right through until 6am. She is so unpredictable it makes going out and sorting out a daytime routine really hard as she is cranky (and incredibly loud!) when tired. Sorry for the length of this comment, but I haven't been able to find any info about this kind of issue anywhere... Many thanks again, and best wishes! Josiejo

  2. Wow. I just read the above comment (Joseiejo) and it basically says everything I wanted to say! My daughter (five months)sleeps like a champ at night, waking up only once or twice to feed then right back to bed no bouncing-- 9pm to 8:30am. During the day her naps are 30 minutes to the minute. She used to have naps of all lengths but not anymore! She hates feeling drowsy too but when I bounce her a bit she falls asleep quickly. I tried the "wake to sleep" method today and it worked (kind-of) in the morning and bombed this afternoon (30 min became 15). I'd love some info on naps so I can help my little day-time cranky baby and take her out more.
    Lastly, your blog is so positive and makes me feel normal and that I'm not doing something wrong because my baby cries... This is important as I am surrounded by a lot of "my baby never cries" mothers...
    Thanks for all your time and information. KAP(Greece)

  3. People told me my son was "teething" starting at 4 months old. Someone even suggested letting him chew on a chicken bone. I'm glad I didn't listen... the boy didn't actually pop a tooth until the week before his first birthday!

    I think a lot of baby fusses are chocked up to teething, but parents need to realize that it's just normal and natural for babies to fuss sometimes, or a lot of the time, depending on the baby!

  4. Hi, my DD, 9 mo, has no tooth my now, and I suspect, like the ladies in that group, that she has has symptoms of teething from 4mo, but nothing appeared. We had her ears checked - nothing there, even if she's grabbing her ears and her hair a lot, and becomes cranky. Orajel helps her calm down. So, is it teething?

    Then, smb. suggested that she may lack Calcium, that's the reason the teeth do not appear, what do you think about that? (she's BF, never given formula)
    Thx a lot.

    P.S. She also has those sleeep problems mentioned above, a cat napper since she was little. And she also wakes up at night several times, looking for the breast and then falls asleep again.

  5. i'm not sure i agree with the definition of "teething", maybe it's just symantics. I think 'teething' starts long before tooth eruption happens. i have 3 children, all of whom started drooling excessively and chewing on everything around 4 months of age, but no teeth showing until 8 or 9 months. i consider this whole process teething, as the tooth must work its way up from the jaw thru the gum.
    if the purpose of the article is to say that not every diaper rash or ear infection, etc is related to teething, then yes, i agree.
    to the moms above asking about nap issues, try elizabeth pantley's no-cry nap solution. it specifically talks about nap time vs. overnight sleep. one suggestion to try would be white noise.

  6. Interesting blog. To the ladies who are having napping issues. My daughter is now 5 months and has gone through the mill of various sleep habits. In the beginning she slept great at night and would nap, then between 3 and 5 months (what I termed "The transition") she didn't nap well at all sometimes going 7 hours without sleep, but night times weren't bad. Now, she naps just great during the day, but gets up more frequently at night. We also dealt with colic and I think we may be dealing with some teething at this point. I don't know what to tell you helped other than trying to be consistent, but sometimes that didn't work. I think babies just grow and change and sometimes we need to grow and change with them and know that eventually this too shall pass.

  7. The research seems crazy as the discomfort starts long before any tooth breaks the surface. In fact, that's when the discomfort eases!