The onset of teething precedes the eruption of a tooth by several days. The first tooth usually erupts by six months but this may vary between four and 10 months. Teething has also been called “cutting of the teeth” and the medical term for teething is odontiasis.
Treatment with pain relievers such as acetaminophen or ibuprofen can keep a baby comfortable. However, under the age of six months, some experts feel that ibuprofen should be avoided because of potential side effects. Ibuprofen, unlike acetaminophen, has anti-inflammatory effects, but it may also be harsher on the baby’s gastrointestinal tract.
Medications which contain a local anesthetic called benzocaine, should be avoided. These are medications which typically are placed on the baby’s inflamed and tender gums. In November, 2006, Health Canada issued a warning about the use of benzocaine in infants as well as certain adults. It may be associated with an increased risk of methemoglobinemia, a rare, but serious condition in which the amount of oxygen carried through the blood stream is greatly reduced. And in May of last year, the U.S. Food and Drug Administration urged the avoidance of all forms of this produce – sprays, lozenges and gels – in children less than two years of age except under the advice and supervision of a health-care professional.
Applying gentle pressure on the gums may help ease the discomfort. Rubbing the gums with a clean finger or using a cool object such as a teething ring can be tried. Biting down on a clean facecloth may work. Objects in the child’s mouth which may cause choking should never be used. And alcohol should never be used to numb the gums.
Homeopathic drops have helped a number of babies deal with the discomfort. It is generally regarded as safe, but more studies are required before it can be suggested as standard of care.
Send pediatrician Peter Nieman your questions at pediatrician@globeandmail.com. He will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.