II. Physiology: Eruption of Primary Teeth

  1. One tooth erupts monthly between 6 months to 2 years
  2. Onset of Teething symptoms: 3-4 days before eruption
  3. End of Teething symptoms: 2-3 days after Tooth Eruption

III. Symptoms

  1. Irritability or restlessness
  2. Discomfort
  3. Increased night-time awakening
  4. Appetite decreased
  5. Chewing on toys or fingers
  6. Increased Drooling
    1. May be associated with rash on chin and neck
  7. Cough
  8. Low grade Temperature rise (e.g. 99.5 F) may occur
  9. Teething does not cause:
    1. High fever
    2. Rhinorrhea
    3. Diarrhea
    4. Diffuse rash

IV. Signs: Local gum inflammation at site of Tooth Eruption

  1. Sore, tender, swollen gum tissue
  2. Gum discoloration (blue or purple)

V. Management

  1. Distract with comforting (rocking or cuddling)
  2. Massage child's gums with a clean finger
  3. Ice Rings
  4. Clean frozen wash cloth
  5. Consider systemic Analgesic
    1. Tylenol
    2. Motrin
  6. Avoid fluid-filled Teething rings after Tooth Eruption
  7. Avoid Teething on potential Choke Hazards
    1. Frozen bananas
    2. Frozen Popsicles
  8. Avoid Orojel (topical anesthetic)
    1. Methemoglobinemia may occur with Overdose

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Related Studies

Ontology: Teething syndrome (C0039437)

Definition (NCI) An expected condition experienced by children during the emergence of deciduous teeth. Though a full set of 20 primary teeth takes more than two years to emerge, teething syndrome may be variably noted from the first paired eruption (usually at the sixth month) until the last. Characteristically, irritability, inflamed gingivae, drooling and chewing on solid objects may be seen several days prior to the eruption with rapid resolution. Typically, the lower central incisors appear first followed by the upper central incisors. Molars and canine teeth are the last to erupt. Anecdotal associations with fever and diarrhea are misattributed.
Concepts Finding (T033)
MSH D014078
ICD9 520.7
ICD10 K00.7
SnomedCT 67220003, 196292004, 8004003
Italian Mettere i denti, Disturbi della dentizione
Dutch tanddoorbraaksyndroom, Tanddoorbraaksyndroom, tanddoorbraak
French Syndrome de pousse des dents, Poussée des dents, Poussée dentaire
Portuguese Síndrome de erupção dos dentes, Erupção dos Dentes, Erupção dos dentes
Spanish Síndrome de dentición, Erupción de los Dientes, dentición, síndrome dental (trastorno), síndrome dental, Erupción dental
Japanese 生歯症候群, 生歯, セイシ, セイシショウコウグン
German Zahnen, Dentitionskrankheit
English teething syndrome (diagnosis), teething syndrome, Teething syndrome, teething, teeth syndrome, Teething (disorder), Teething syndrome (disorder), Teething Syndrome, Teething
Czech Prořezávání prvních zubů, Syndrom prořezávání zubů, prořezávání mléčných zubů, prořezávání zubů
Korean 생치 증후군
Hungarian Fogzás, Fogzás syndroma