Dr Nnaemeka Omeje is a Consultant Paediatrician, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State. He speaks with ALEXANDER OKERE on teething, a natural occurrence in babies that could lead to problems if not well-managed

What is teething?

Teething is a process by which teeth erupt or break through the gum and appear on the surface. While the baby is still in the uterus, you will find that the teeth develop within the mandible (lower jaw bone) and the maxillae (upper jaw bone). But over time, between the ages of six months and 12 months, the teeth come to the surface and break through the gum. It is that process of eruption that is called teething.

Are there stages when this process occurs in babies?

There are two sets of teeth in children. The first is the milk teeth that appear within six months and 12 months. But from five and a half years to six years or so, the milk teeth will gradually be replaced by the permanent set of teeth that the child will have. So, the process of teething can actually be in two stages. There is the primary one – the one in which there are many misconceptions and assumptions such that many mothers tend to do some things that may be harmful to the baby because there may be some symptoms associated with primary teeth eruption. But the permanent teeth eruption does not cause symptoms that anybody should be worried about.

How long does it take for the primary teeth to erupt?

Actually, no one knows exactly how long. But the teeth erupt around six months of life. Usually, an observant mother may notice some symptoms three to five days before the teeth eventually break through the surface of the gum and are visible when the child opens the mouth.

What are the signs and symptoms that an observant mother should notice?

While a tooth is moving underneath the gum tissue and just before it erupts, there may be some soreness or swelling. So, the child may become irritable and there may be loss of appetite because the mouth is sore; the child doesn’t want anything worsening the pain. The child may once in a while bring the hand to the mouth or introduce objects to the mouth in an attempt to reduce that discomfort. Also, there may be some mild rash because there is excessive drooling which can cause skin irritation. The mother may notice the child rubbing the affected jaw because of the pain from the tooth that is about to erupt. Those are some of the symptoms.

But there are other symptoms that are not usually associated with eruption. For instance, teething is not known to cause fever, diarrhoea, vomiting or serious illness. The problem is that many mothers may attribute such symptoms to teething and in doing so; diagnosis of a more serious illness may be missed because they may think it’s just teething.

Are there complications when teething occurs?

No. Teething is a normal physiological occurrence. It is not associated with any serious illness, not to speak of complications. However, the complication may be from wrong interventions, when you give things that you shouldn’t have given (to the child) just because you suspect teething or you neglect other illnesses and think it’s because of teething. Sometime in 2008 or 2009, over 84 babies died as result of the administration of a particular brand of teething powder that was contaminated by a very toxic chemical which led to kidney injuries. Those may be some of the complications that may arise from teething.