Teething is a significant developmental milestone that marks the emergence of your baby’s first teeth. While it is a natural process, it can often bring discomfort and distress for both the baby and parents. For most children, teething symptoms are mild and can be managed with simple home remedies. However, teething can sometimes lead to complications that require professional attention.

This article explores common teething complications, signs that indicate when it’s time to seek help from a dentist or pediatrician, and tips for managing teething issues effectively. Understanding when teething is beyond the norm can help parents make informed decisions to support their baby’s oral health and overall well-being.

Understanding Normal Teething Symptoms

Before diving into complications, it’s essential to differentiate between normal teething symptoms and those that are cause for concern. Typically, teething begins around six months of age, but it can vary significantly from child to child. Common, non-alarming teething symptoms include:

Drooling: Increased saliva production is a typical teething sign.
Gum Sensitivity and Swelling: The gums around emerging teeth may appear red, swollen, or tender.
Chewing on Objects: Babies often chew on toys, fingers, or other items to alleviate gum discomfort.
Mild Irritability: Some fussiness or irritability is expected as teeth break through the gums.
Sleep Disturbances: Teething can temporarily disrupt sleep patterns.
Mild Appetite Changes: Babies may show a decreased interest in feeding due to gum discomfort.

While these symptoms can be uncomfortable, they are generally manageable with home care and do not usually warrant medical intervention. However, when symptoms go beyond what is typical, it may be time to seek help.

Common Teething Complications and When to Seek Help

While most babies sail through teething with minor discomfort, complications can arise that require professional evaluation. Below are common teething complications and the signs that suggest it’s time to see a healthcare provider.

1. Excessive Pain and Irritability

When It’s Normal: Mild irritability and discomfort are expected during teething, and babies may cry more than usual.

When to Seek Help: If your baby’s pain seems extreme, prolonged, or unmanageable despite trying standard teething relief methods (like teething rings or gentle gum massages), it could indicate a more serious issue. Severe irritability, constant crying, or a noticeable change in behavior could signal complications like infections or other underlying conditions.

What to Do: Consult a pediatrician or dentist to rule out other causes of discomfort, such as ear infections or throat issues, which can sometimes mimic or exacerbate teething pain.

2. High Fever

When It’s Normal: A slight increase in body temperature is common during teething, but it is typically mild and not considered a true fever.

When to Seek Help: A fever above 101°F (38.3°C) is not a typical teething symptom and should be addressed promptly. High fevers could indicate an infection unrelated to teething, such as a viral or bacterial infection, which requires medical attention.

What to Do: If your baby has a high fever alongside teething symptoms, contact your pediatrician for an evaluation. It’s essential to differentiate between normal teething discomfort and an illness that could require treatment.

3. Diarrhea

When It’s Normal: Loose stools may occasionally occur during teething due to increased saliva swallowing, but it should not be persistent or severe.

When to Seek Help: Frequent, watery diarrhea is not a normal teething symptom and could indicate a gastrointestinal infection or other digestive issues. Persistent diarrhea can lead to dehydration, which is serious, especially in infants.

What to Do: Monitor your baby’s hydration by checking for wet diapers and offering fluids. If diarrhea persists for more than a day or is accompanied by other symptoms like vomiting or fever, seek medical care.

4. Rashes and Skin Irritation

When It’s Normal: Mild rashes around the mouth, chin, or chest can result from excessive drooling and are generally harmless.

When to Seek Help: If the rash becomes severe, spreads to other parts of the body, or appears infected (red, swollen, or oozing), it’s important to seek professional advice. Severe skin irritation could be due to allergic reactions, eczema, or infection.

What to Do: Keep your baby’s skin dry and clean, using bibs and frequent wiping. Apply gentle, baby-safe moisturizers or barrier creams. If the rash doesn’t improve or worsens, consult a pediatrician.

5. Refusal to Eat or Drink

When It’s Normal: Mild appetite changes are common during teething, as gum discomfort can make eating less appealing.

When to Seek Help: If your baby refuses to eat or drink for extended periods, it can lead to dehydration and weight loss. This refusal could indicate a more serious issue than teething alone, such as an oral infection or other illness.

What to Do: Offer cold, soothing foods like yogurt or chilled purees to ease gum discomfort. If the refusal persists, consult a healthcare provider to ensure there’s no underlying condition affecting their appetite.

6. Teething-Related Infections

Teething can sometimes lead to infections, particularly if the gum tissue is damaged or irritated, allowing bacteria to enter. Common infections include:

Gingivitis: Inflammation of the gums that can occur if the area around the emerging tooth is not kept clean.
Pericoronitis: Infection of the soft tissue surrounding an erupting tooth, common in older children with emerging molars.

When to Seek Help: If you notice swelling, redness, pus, or a foul odor around the gums, these could be signs of an infection requiring professional treatment.

What to Do: Maintain good oral hygiene by gently cleaning your baby’s gums and emerging teeth. If signs of infection appear, see a pediatric dentist or healthcare provider for evaluation and potential treatment, such as antibiotics.

7. Delayed Teething

When It’s Normal: The timing of teething varies widely. Some babies get their first tooth as early as three months, while others may not see their first tooth until after their first birthday.

When to Seek Help: If no teeth have emerged by 18 months, it’s advisable to consult a pediatric dentist. Delayed teething can sometimes indicate underlying issues, such as nutritional deficiencies, genetic factors, or medical conditions.

What to Do: A dentist will perform an examination and may suggest X-rays to determine if teeth are developing properly beneath the gums.

8. Misaligned or Impacted Teeth

Occasionally, teeth may emerge crooked, crowded, or not at all due to impaction (when teeth are blocked by other teeth or bone). This can occur with primary teeth but is more common with permanent teeth.

When to Seek Help: If you notice significant misalignment or teeth that seem stuck beneath the gums, consult a pediatric dentist. Early intervention can often prevent more complex orthodontic issues later on.

What to Do: Regular dental check-ups allow for monitoring of tooth development. The dentist may recommend treatments such as spacers, orthodontic appliances, or in some cases, surgery to correct severe impactions.

Managing Teething Complications: Tips for Parents

Navigating teething complications can be challenging, but there are several strategies parents can use to manage symptoms and reduce the risk of issues:

1. Maintain Oral Hygiene

Even before teeth emerge, clean your baby’s gums with a soft, damp cloth after feedings to reduce bacteria buildup. Once teeth appear, use a soft-bristled baby toothbrush and a tiny smear of fluoride toothpaste to brush twice a day.

2. Offer Safe Teething Relief

Provide cold, safe items for your baby to chew on, such as teething rings or chilled (not frozen) washcloths. Avoid using teething gels containing benzocaine or lidocaine, as these can be harmful to infants.

3. Monitor Feeding Habits

Pay attention to changes in your baby’s feeding patterns. If they seem uncomfortable with certain foods, offer softer, cooler options that may be less irritating to their gums. Keep an eye on their overall fluid intake to prevent dehydration, especially if they are experiencing diarrhea.

4. Keep the Area Dry

To manage drooling, use bibs, and keep your baby’s face dry to prevent skin irritation. Applying a gentle barrier cream can also help protect the skin around the mouth from rashes caused by constant moisture.

5. Regular Dental Check-Ups

Start dental visits by your baby’s first birthday or within six months of their first tooth appearing. Regular check-ups help monitor dental development and catch potential issues early.

6. Recognize When Symptoms Are Unusual

Stay vigilant for symptoms that deviate from normal teething patterns, such as high fever, persistent diarrhea, severe rashes, or extreme irritability. Trust your instincts as a parent; if something doesn’t seem right, don’t hesitate to seek medical advice.

7. Avoid Harmful Teething Remedies

Be cautious with teething necklaces, which pose choking and strangulation risks, and avoid using homeopathic teething tablets or gels that may contain unsafe ingredients. Stick to dentist-recommended teething remedies.

The Role of the Pediatric Dentist in Teething Complications

Pediatric dentists play a crucial role in managing teething complications and ensuring your child’s oral health is on track. They provide guidance on:

Teething Relief: Offering safe and effective ways to manage teething pain.
Oral Hygiene: Teaching parents and children how to care for emerging teeth.
Monitoring Development: Keeping an eye on the alignment and health of both primary and permanent teeth as they emerge.
Early Intervention: Addressing issues like cavities, misalignment, or delayed teething early to prevent long-term complications.

Conclusion

Teething is a natural but often challenging phase of infancy. While most teething symptoms are manageable with home care, complications can sometimes arise that warrant professional intervention. Recognizing when symptoms go beyond the norm is crucial in ensuring your baby’s health and comfort.

If you’re ever in doubt about your baby’s teething symptoms, don’t hesitate to reach out to a pediatrician or pediatric dentist. Early detection and treatment of teething complications can prevent more serious issues down the line and help your baby navigate teething with as little discomfort as possible. Remember, you are your baby’s best advocate, and seeking help when needed is a crucial part of their health journey.

By staying informed and proactive, you can ensure your baby’s teething process is as smooth and pain-free as possible, setting the foundation for a lifetime of healthy smiles.