If you were a baby in 19th Century England you may have been better off without teeth.
That's because according to government records, it turns out that 5% of kids died as a result of teething. While that's not an public health crisis, it's not trivial either.
Now consider that for the past, say, 110 years, zero children have died from teething.
Teething. Cured. How? Are Oragel and teething rings the great public health breakthrough ever?The unsung saviors of infants everywhere?
How many of you have taken your child to the doctor with some vague symptoms--fussiness, drooling, rashes, diarrhea, sleep disturbances etc, etc, etc, and told it was teething by your mother-in-law, crazy uncle, or worse, your...doctor.
Indeed, studies have shown that parents, dentists and doctors are all quick to believe in teething. So ingrained are doctor's notions of teething we even have an official, billable, diagnosis for it: "Teething Syndrome" (icd-9 code 520.7 for you Jeopardy fans).
Let's back up a second: What's the evidence for a "teething syndrome?" Over the years, studies have been done trying to sort this out. One study from 2000 looked at a little over 400 kids and whether they had teething symptoms. No of the observed symptoms reliably predicted teething, and the researchers wisely concluded: "Before caregivers attribute any infants' signs or symptoms of a potentially serious illness to teething, other possible causes must be ruled out."
That' s been the overall trend with teething studies--fact and fiction are very different, yet we continue to believe in it. Why?
Well, if you're someone like me (a health professional), it's an out when you have no idea about what's going on with a kid, or you're patient's parents are "worried well" meaning they come in for minor, insignificant symptoms a lot, and need reassurance that their child is healthy.
I'll venture a guess at some of the things that we attribute to teething, but are really due to something entirely different:
1) Sleep disturbances: according to sleep experts, kids don't wake up in the middle of the night from teeth coming in--no, they wake up from spontaneously awakening as they shift from one stage of sleep to the next (ie, REM to non-REM sleep).
2) Drooling: one reason I've observed kids seem to drool is that around 4 to 6 months, they get better control of their neck muscles, which allows them to hold their head up better. On the other hand, they don't get the same control over their salivary secretions--hence, it comes out front instead of heading down the back of their throats.
3) Rashes around the mouth: Saliva, described above, hits the skin and irriatates it a little.
4) Fussiness: If you're kid isn't fussy, then call Yoda, because he or she must be a future Jedi Knight.
Ok, then so what's the big deal? Most of the time, the symptoms we attribute to teething are pretty harmless. The solutions--whether it be teething rings, oragel, cold soda cans, teething tablets or other the "prescriptions" for teething, are also generally harmless (who knows how much money makers of these remedies make per year on these solutions).
(On the other hand, some choices for teething are probably best avoided: take in point the recent deaths of 84 children in Nigeria from contaminated teething medicine.)
I hate teething as a diagnosis or an excuse. I don't use it. The biggest deal for me, and I tell this to parents in my own practice, is when they're told that teething causes fever. No, I don't mean a slight, normal elevation in a baby's temperature to say, 99 degrees. I mean a fever that's over 100.4 degrees (that's the definition of a "true fever" among physicians). Fever of any kind is generally due an infection, and needs to be approached by you, your mother-in-law, your crazy uncle and most importantly, your doctor, as such. While in most healthy, vaccinated kids, fever is usually due to a temporary viral infection, it could be a harbinger of something more serious.
That's not meant to scare you, just to inform you that you ought to fire your mother-in-law, crazy uncle, or doctor if they blow your baby's temperature off due to teething.
And that's the Truthiness about Teething.