If you imagine a child who is teething, what do you see? An irritable child suffering from fever, pain and usually indisposed?
Teething is a normal development process that people have long associated with the disease. However, the evidence says the opposite.
What is the strength of this proof? Can you do something to help a child who is teething? What about teething gels and teething necklaces?
Medical myth of Monday: infant dentition causes fever
Teething begins when new teeth come out of the gums and usually begin around the age of six months.
A review of 16 studies found that, although teething was related to signs and symptoms, these were generally mild, resulting in gum irritation, irritability, and salivation.
Although body temperature may rise slightly, the review found weak evidence suggesting a fever spurt. Many symptoms of dental flare, such as irritability, sleep disturbances and salivation, are difficult to measure objectively and are based on what parents report, which is subjective and may be inaccurate.
And, as teething progresses and its timing is relatively unpredictable, it is virtually impossible to record even measurable symptoms, such as temperature changes, reliably and reproducibly.
Thus, start-up problems seem to be overestimated in the types of studies that are based on remembering what happened.
What else could cause the symptoms?
Other biological triggers might actually explain the symptoms traditionally associated with dental flare. Dental flares coincide with normal changes in children's immunity; the mother's antibodies are transferred to babies during pregnancy and help protect the baby in the first 6 to 12 months of life, but begin to decrease at about the same time as the dental flare.
This, coupled with behavioral changes as infants begin to explore their environment, increases the chances of catching viral infections with symptoms similar to those reported for dental flares.
Separation anxiety and normal changes in sleep patterns can also explain irritability and sleep disturbances, which can be mistakenly attributed to dental flare.
Since teething symptoms are usually mild and concentrated on the mouth, parents are cautioned not to assume that signs of disease from other parts of the body are due to dental flare. This is because it could delay the detection of potentially serious infections that require medical attention. This can also delay getting help from parents to help their child fall asleep.
How about teething gels?
Finding solutions to the perceived problem of dentition can lead parents to base their hopes on gels, toys and other products, none of which have been scientifically evaluated to relieve the symptoms of teething.
Nevertheless, teething gels usually contain a variety of ingredients that help relieve the symptoms supposedly related to teething. Some, such as the teething gel from Adelaide's Women & # 39; s and Children's Hospital, recently discontinued, contain lidocaine, an anesthetic.
Very little lidocaine is absorbed into the body when it is applied to the gums and only minor complications such as vomiting have been reported in Australia. However, accidental ingestion and excessive application can lead to intoxication resulting in seizures, brain damage and heart problems.
The decision to discontinue the freeze follows a 2014 warning from the US Food and Drug Administration against the use of teething gels with topical anesthetics, after reports of hospitalizations and deaths infants and children.
We asked five experts: Is it possible to give pain killers to children?
There have also been warnings about teething gels containing benzocaine. This is another anesthetic applied to the gums that can lead to a dangerous and fatal blood disease called methemoglobinemia, which affects the blood's ability to carry oxygen.
Another common ingredient in popular teething gels is choline salicylate, an anti-inflammatory similar to aspirin. This increases the risk of liver disease and brain injury if the child eats too much. It can also lead to the risk of Reye's syndrome, a rare but serious condition that can lead to seizures, loss of consciousness, and death. Reye's syndrome has been associated with the use of aspirin in children, especially during viral infections.
A suspected case of Reye syndrome caused by a teething gel in 2008 led to a contraindication (warning) of the products in children in the United Kingdom.
A number of young Australian children who have used too much teething gel containing salicylate have also been hospitalized with side effects.
But the products are still available in Australia.
What about "natural" products?
Although a range of "natural" and homeopathic teething solutions are widely marketed to parents of young children, they also present risks.
A manufacturer recently recalled a range of natural teething gels after reported poisoning cases. And US regulatory authorities have found that the same range contained levels of belladonna greater than those reported, a toxic plant that, despite its dangers, is used as a homeopathic painkiller and sedative.
In search of "natural" therapies, parents are also turning to amber teething necklaces to relieve their symptoms. Amber is a fossilized tree resin that, in the past, has anti-inflammatory properties.
However, several throttling cases widely reported
have resulted in warnings from US and Australian regulatory authorities. There is currently no scientific evidence that these collars work.
The Australian Commission for Competition and Consumer Affairs (ACCC) reports that amber and other "serrated" necklaces, even when mothers wear them, are:
… Colorful and playful in design, and can be confused with toys.
All toys for children aged 36 months and under, including teething toys, are strictly regulated by Australian standards. As ACCC warns, teething collars are unlikely to meet this requirement.
What to do?
So, what are the best options for relieving startup symptoms? In the absence of good-quality evidence recommending a specific treatment, experts suggest that the best cure is affection and attention.
Rubbing the gum with a clean finger or applying gentle, firm pressure with a cold (but not frozen) washcloth or teething ring can provide some relief. Although it is difficult to know exactly how it works, it is unlikely that they will cause serious problems.
Teething can be a difficult time, but it will eventually pass. In the meantime, it is important that parents avoid falling into the trap of supposedly not only unproven, but also potentially dangerous healings.
How to (gently) bring your child to brush your teeth