Teething Flashcards
What is teething? what do teeth come in/ lost
- Eruption of deciduous (milk) teeth thoruhg gingival tissues
- occues at different times for every child
average: 4-12 months
Full set of primary teeth by 3 years
start losing primary teeth by 5-6 years
What are the features of our dentition?
- 20 teeth total (in adult 30 teeth)
- susceptible to dental caries (cavities)
- give shape to face
- crucial for learning to eat and speak
- role in proper alignment, spacing and occlusion of permanent teeth
*priamry teeth have thinnger enamel than permanent teeth
describe the development of teeth
Children’s teeth begin developing in the womb
Pregnancy nutrition vital for development of child’s teeth
*calcium,phosphorus, vitamin C, vitamin D
Avoidance of certain medications while pregnant: ex tetracycline
*tetracycline during pregancy can cuase issues with teeth development in womb
Normal tooth eruption timeline (children)
- 1st tooth erupts at 6-7 months
- erruption is symmetrical: Upper teeth usually erupt 1-2 months after the same tooth on lower teeth
~ 1 tooth/month
*central incisor on bottom usually 1st, then central incisor on top
Normal tooth erruption timeline for adult teeth?
- 1st permanent dentition erupts at 6-7 years of age
- process continues for 6 years
- symmetrical eruption
Describe delayed tooth erruption
- in otherwise healthy child, aa delay in up to 6 months is no clinical significance
*as long as at 12 months ahve some teeth, if not RED FLAG
- delayed tooth erruption DTE occurs:
- premature and low birth weight babies
*racial, ethnic, sexual and individual factors can have influencer
tooth erruption timeline
7+4
7 months: first teeth
11 months: 4 teeth
15 months: 8 teeth
19 months: 12 teeth
23 months: 16 teeth
27 months: 20 teeth
* 4 months between each
ex: Healthy 10 month old infant bron @ 40 weeks, no significant past medial history
- freq drooling and more iritable and has rectal temp of 37.7 for past 22 hours
- she can been drinking less formula -> wonders if teething
- has lower central incisors at 7 months: asking when will she get her two front teeth?
* teo teeth should come in upper jaw in next few months
What signs and symptoms are associated with teething?
Gum redness, swelling +/- tenderness
Gum rubbing, biting or chewing on hard objects
Drooling -> facial irritation
Irritabilit, restlessness, crying, insomnia
Decrease inappetite, increased thirst
*symptoms peak in incidence and severity on day of or before eruption, generally resolve within 3 days
What signs and symptoms are not associated with teething?
Vomiting • Diarrhea • Malaise • Fever • Rashes
Does Teething cause fever?
- most studies done are poor quality, found some suggestion of association between:
inc temp and the day of tooth erruption +/- 1day
*caregivers inaccurately report slight inc in body temp as fever
*Infants with T>38.5C, or 38-38.5C on days other than the day of tooth eruption +/- 1 day should be evaluated for other sources of fever
- those presenting with low grade fever during the window may be monitored conservatively if well appearing
What are eruption cysts
- localized dome shapred soft bluish swollen area filled w/ tissue fluid and blood
*forms over emerging incizers and molars
May be surrounded by inflammation
Localized to the gum overlying the crown of an erupting tooth
Not associated with infection
Usually disappear if left alone
*DO NOT BREAK -> see dentist if does not go away with tooth errupting
what signs and symptoms require a dental consult when possible
Pericoronitis (gums surrouning wisome teeth become infected_
Delays of >6 mo in a primary tooth eruption (1 year of age, 6 mo before/after)
Delays of >12 mo in a permanent tooth eruption (if 7 and no permanent teeth)
Eruption cysts: If causing discomfort +/- interfering with feeding OR If they do not drain
what signs/symptoms would require an urgent dental consult?
- pericoronal abscess
(caused by acute pericoronitis)
*abscess accumulation of puss that can spread to cheek)
* if there is a suspensed systemic illness in young child (diarrhea, fiver, potential 2nf underlying cause refer for medical consult)
what are the goals of therapy for teething?
- Minimize/ relieve gum pain and irritation: reduce child irritability, minimize sleep disturbances
- Prevent complications: involve medical or dental professionals when indicated
signs of methemoglobinemia
- weakness, confusion, headache, difficulty breathing and or pale, fray or blue coloured skin, lips and nail beds
*as % methhemolgobin increases effects more severe
