Teething troubles?

An in vitro assessment of teething gels' effects on human gingival mesenchymal stem cells

BACKGROUND

The aim of this study is to examine the cytotoxic effects of dental gels with different contents, which are frequently used during teething, on gingival mesenchymal stem cells (G-MSCs).

METHOD

The teething gels used in this study were Dentinox, Gengigel, Osanite, and Jack and Jill. The human gingival mesenchimal stem cells (hG-MSCs) were incubated with these teething gel solutions (0.1%, 50% and 80% concentrations). Reproductive behavior of G-MSCs was monitored in real time for 72 h using the xCELLigence real-time cell analyzer (RTCA) system. Two-way repeated Anova test and post hoc Bonferroni test were used to evaluate the effect of concentration and dental gel on 0-hour and 72-hour viability. Significance was evaluated at p < 0.05 level.

RESULTS

Teething gels prepared at 50% concentration are added to the G-MSC culture, the "cell index" value of G-MSCs to which Dentinox brand gel is added is significantly lower than all other groups (p = 0.05). There is a statistically significant difference between the concentrations in terms of cell index values at the 72nd hour compared to the 0th hour (p = 0.001).

CONCLUSIONS

The local anesthetic dental gels used in children have a more negative effect on cell viability as concentration increases.

Knowledge and management practices of infant teething symptoms among mothers in a tertiary facility in Ghana

Introduction

teething is a natural process that all infants go through, and most toddlers obtain their first tooth around six months. However, misconceptions about teething and its remedies are still prevalent. The study assessed the knowledge and management practices of infant teething symptoms among mothers whose children were admitted to the Pediatric ward of Tamale Teaching Hospital.

Methods

the study adopted a prospective descriptive cross-sectional design with a quantitative data collection method. A total of 251 mothers were selected using a convenient sampling strategy, and a structured questionnaire was used for data collection.

Results

the study found that 79.7% and 20.3% of respondents had good and poor knowledge of teething, respectively. Also, 65.3% and 34.7% of the mothers had good and poor practices, respectively, in the management of teething symptoms. Marital status (p= 0.029) and type of ward (p= 0.020) were significantly associated with mothers' knowledge of teething. Furthermore, mothers less than 30 years of age (OR, 2.07; 95% CI: 1.19-3.57; p= 0.009) and mothers with formal education (OR, 2.22; 95% CI: 1.22-3.81; p= 0.004) were more likely to have good management practices for teething symptoms.

Conclusion

most mothers have a good understanding of child teething, but they do not think delayed eruptions indicate systemic disease. They identified taking the child to the hospital during teething symptoms and administering Paracetamol to relieve the symptoms as standard practices. However, more education is needed to differentiate between teething signs and other ailments and to prevent substandard first aid practices during teething.

Parental beliefs in and attitudes toward teething signs and symptoms: A systematic review

BACKGROUND

Parents believe that teething is associated with signs and symptoms, which may induce them to give medications that could harm their children. Some children may require alleviation of symptoms and overall attention.

AIM

To assess parents' beliefs in and attitudes toward teething.

DESIGN

Through electronic databases and gray literature, this systematic review identified cross-sectional studies reporting parents' beliefs in, knowledge about, and attitudes toward the signs and symptoms of primary tooth eruption in children aged between 0 and 36 months. Three reviewers independently selected the studies, collected the information, assessed methodological quality, and checked for accuracy with disagreements solved by a fourth reviewer. The Agency of Research and Quality in Health questionnaire for cross-sectional studies was used for quality assessment. Descriptive analysis with median and interquartile ranges was adopted.

RESULTS

Twenty-nine studies comprising 10 524 participants from all geographic regions were included. The methodological quality of the studies was moderate. Most parents have beliefs in signs and symptoms during dentition, the most reported symptom being the desire to bite. Oral rehydration was the most exposed attitude in the studies included. Only a small proportion of parents reported no attitude.

CONCLUSIONS

The majority of parents believed in at least one sign or symptom associated with teething, and only few of them would do nothing or just wait for the signs or symptoms to pass, with no difference among countries (Protocol doi: 10.17605/OSF.IO/S2KZ3).

New medical device coating mouth gel for temporary relief of teething symptoms: a pilot randomized, open-label, controlled study

BACKGROUND

This study verified the feasibility of the monthly recruitment rate, tested the Face, Legs, Activity, Cry and Consolability Pain Assessment Tool (FLACC) for pain in infants and collected preliminary efficacy and safety data of a new proprietary oral gel formulation of high-molecular-weight hyaluronan (HMWHA) for the relief of teething. Results will support the design a future main trial vs. local anesthetic, that is currently the only clinically proven pain reliever.

METHODS

This was a pilot, randomized, controlled, multicenter, open-label, and parallel-group trial. It was performed in two Romanian clinics recruiting infants from 3 to 36 months. Teething diagnosis was based on a minimum of three symptoms such as: local pain, swelling, erythema, hyper-salivation, and depth characteristics of unerupted tooth. Absence of subcutaneous mucosal laceration was also required. The children were assigned either to HMWHA (HABPX V 3.3, Bioplax Ltd, Wallington, UK), or to standard drug (Dentinox^®-Gel N; Dentinox, Berlin, Germany) and treated for 7 consecutive days. Investigators recorded the primary endpoints: swelling, redness and pain (by FLACC method), on days 0, 3 and 7. Changes in crying, mouth spasms, salivation, local pain, swelling, and redness were the secondary endpoints, recorded daily by the parents, on diary cards. Tolerability was assessed on day 14, too.

RESULTS

Twenty-seven Infants were allocated in HMWHA, and 30 in standard drug. Enrolment rate was 9 patients/month/site. A significant reduction for HMWHA group was evidenced in pain, swelling (from day 0 to 7, P=0.034 between groups), redness (from day 0 to 3, P=0.045 and from day 0 to 7, P<0.001 between groups) and confirmed by the parents' diary records. Pain measurements obtained by FLACC method are consistent with the data belonging to other parameters. Investigator's global assessment of performance was in favor of the HMWHA (P<0.005). Only two patients, both belonging to standard drug group, experienced adverse events (fever, not related to treatment) and dropped out of the study.

CONCLUSIONS

The results solve the feasibility questions and clearly evidence the performance of HABPX V 3.3 in teething symptoms, exceeding the objectives of a simple pilot trial to some extent. Coating oral gels containing HMWHA could be a therapeutic solution for both parents and physicians in managing the irritation and pain resulting from tooth eruption in children.

Levels and correlates of knowledge of teething among Saudi Arabian families

Background

Parental knowledge of teething has been repeatedly investigated; however, little emphasis has been made on the associated sociodemographic factors with good knowledge of the parents and whether or not good knowledge is translated into adopting proper pain-relieving practices. The present study aims to firstly assess the knowledge level and practices of Saudi parents regarding teething and then explore associated sociodemographic variables with good knowledge of teething to determine the relation between parents' knowledge of teething and their adoption of pain-relieving practices.

Methods

This cross-sectional study recruited parents from the social networking sites Facebook, Twitter, Instagram, and WhatsApp, and they were asked to answer a pretested three-part internationally accepted questionnaire. Data were examined using descriptive statistics, chi-square analysis, multivariate logistic regression analysis, and Spearman rank-order correlation coefficient analysis.

Results

One thousand four hundred ninety-nine parents responded and returned completed questionnaires. Of those, only 11.2% had good knowledge of teething. The majority of parents did not have basic knowledge of the teething period as well as believed that teething was associated with a runny nose (87.5%), diarrhea (77.9%), and sleep disturbance (72%). The results of multivariate logistic regression analysis indicated that parents with no primary school education (Odds Ratio: 0.29), or those who had an intermediate or secondary education level (OR: 0.55 and 0.78) were less likely to have good knowledge compared with parents who had a university degree. However, parents who earned intermediate monthly income (OR: 6.63) were more likely to have good knowledge of teething. With regards to practices used to relieve teething pain, inappropriate practices were observed regarding bottle feeding at night to soothe the child's pain (72%) and applying topical analgesics to rub the gum (72.4%). A significant positive correlation was found between the knowledge score and the practice score of both fathers and mothers (r = 0.22 and 0.13, p < 0.0001).

Conclusion

A very low percentage of Saudi parents, mainly those with the highest education level and intermediate monthly income, had good knowledge of teething, which translated into appropriate practices to soothe the child's pain regardless of the parent's gender. Saudi parents should receive anticipatory guidance related to teething from all health professionals to ensure an uneventful teething period for their children.

Use of the amber teething necklace by the child population: risks versus benefits

Objective:

Based on scientific evidence, the objective of the present study is to report the possible risks and benefits of the amber teething necklace for children who use it.

Data source:

This is an integrative literature review, carried out based on the following guiding question: “Does the amber teething necklace have therapeutic properties that justify its usage during tooth eruption?”. The consulted databases were LILACS (Latin American and Caribbean Health Sciences Literature) and PubMed (National Center for Biotechnology Information), with the following descriptors: “Amber,” “Deciduous teeth,” “Strangulation,” and “Local symptoms.”

Data synthesis:

A total of five scientific articles were selected, which indicates an insufficient basis regarding the benefits associated with the use of the amber teething necklace. Conversely, there is a convergence regarding the possibility of health risks such as strangulation, asphyxiation, and swallowing of beads.

Conclusions:

Health professionals should discourage the use of the amber teething necklace by children insofar more studies on the topic are carried out.

Uso do colar de âmbar pela população infantil: riscos x benefícios

Resumo Objetivo: Com base em evidências científicas, a proposta do presente trabalho é relatar os prováveis riscos e benefícios do uso do colar de âmbar pela população infantil. Fontes de dados: Trata-se de uma revisão integrativa da literatura, realizada a partir da elaboração da questão norteadora: “O colar de âmbar apresenta propriedades que justifiquem seu uso durante a erupção dentária?’’. As bases de dados utilizadas foram LILACS (Literatura Latino-americana e do Caribe em Ciências da Saúde), PubMed (National Center for Biotechnology Information), por meio dos descritores: Âmbar; Dentes decíduos; Estrangulamento; Sintomas locais. Síntese dos dados: Após a busca dos dados, foram selecionados cinco artigos, os quais apontam insuficiente embasamento científico que comprove os benefícios relacionados ao uso do colar de âmbar. Em contrapartida, existe uma convergência quanto à possibilidade de riscos à saúde, como estrangulamento, asfixia e deglutição das pedras. Conclusões: Conclui-se que os profissionais da saúde devem desencorajar o seu uso por crianças até que pesquisas clínicas bem delineadas sejam disponibilizadas.

Retrospective analysis of the effects of a hyaluronic-based gum gel to counteract signs and symptoms of teething in infants

BACKGROUND

Teething discomfort is a widespread disorder affecting a very high percentage of infants. It creates anxiety in parents, who look for help in pediatric clinics. The use of hyaluronic acid gels has been shown in the last 20 years to be an effective tool, generally devoid of side effects, in reducing oral mucosal inflammation in adults. Recently, such results have also been confirmed in infants affected by teething.

METHODS

From our routine practice results, we have retrospectively reported the efficacy and the safety profile of Bonjela® Soothing Teething Gel (Bonkela, Reckitt Benckiser, UK), a teething gel capable of addressing in a significant way this infant complaint, which improves all the clinical outcomes used in these types of study to describe the clinical condition of infants.

RESULTS

The time×group interaction showed significant differences in unexplained cry, irritability, inappetence, salivation and gum redness (P<0.01 for all comparisons), with lower Likert scores in the treated group respect to the control one.

CONCLUSIONS

The treatment with Bonjela® Soothing Teething Gel contributed to reduce some common symptoms of teething, in comparison to the standard use of a teething ring alone.

Dog Stick Chewing: An Overlooked Instance of Tool Use?

Tool use is a central topic in research on cognitive evolution and behavioral ecology in non-human animals. Originally thought to be a uniquely human phenomenon, many other species have been observed making and using tools for a variety of purposes, starting with Goodall's (1964) groundbreaking work with chimpanzees in Gombe. Despite the frequent attention and great research interest in animal tool use, and ubiquity of the behavior, we argue here that chewing sticks by dogs (and other animals) should be included as a case of tool use. We discuss alternate possible explanations and then propose several testable predictions regarding this hypothesis. We suggest that tool use may be more common than is often assumed and that many cases of animal tool use may be overlooked.

Mothers' false beliefs and myths associated with teething

BACKGROUND

Teething is a physiological process experienced by all children. However, many unrelated illnesses are blamed on teething.

OBJECTIVE

The aim of this study was to assess mothers' beliefs toward teething and to investigate the practices preferred by mothers to alleviate symptoms that might accompany the teething process.

METHODS

A cross-sectional study was conducted in Basra. The study population includes mothers of young children aged (6-30) months who had at least one erupted primary tooth, and who had no history of medical or systemic disease that might affect teething. Two hundred mothers of different age groups and educational backgrounds responded to a questionnaire that included information on the child's age and birth order, mother's age, level of education, occupation, number of children, beliefs toward teething symptoms, and the practices preferred to relieve the attributed symptoms. Data has been presented in numbers and percentages, the Chi-square test was performed where appropriate, and a p value of < 0.05 was considered significant.

RESULTS

All (100%) participants attributed at least one symptom or sign to the teething process. The most common symptoms reported were fever (70%), diarrhea (68.5%), and sleep disturbance (63.5%). Sixty-eight percent of mothers believed teething remedies were effective; only 10 (5%) did not give any treatment. Over half (62%) gave medications, such as antipyretics, antibiotics, and antidiarrheal agents. Some used teething gels (29%), pacifiers (50%), gum massage (22%), and hard foods such as biscuits and carrots (43.5%). Mothers of various educational levels reported attributed symptoms, and the result was statistically significant (p < 0.05). Mothers of a firstborn child were found to have a higher tendency to attribute symptoms to teething than those who had previous experience with children (p < 0.05).

DISCUSSION AND CONCLUSIONS

Teething myths and misconceptions are common among mothers. The study identified a significant number of doctors, dentists, and pharmacists still attribute many symptoms and signs to teething despite the lack of supporting evidence. Therefore, the findings of this study highlight the need for continuous medical education and nationwide prospective studies to eradicate these false beliefs.

Are teething gels safe or even necessary for our children? A review of the safety, efficacy and use of topical lidocaine teething gels

Lidocaine-based teething gels have been widely available in Australia for decades in both commercial preparations and those compounded by pharmacies. However, many case reports have highlighted potential risks and toxicity associated with lidocaine-based teething gels when used in infants and young children, including seizures, respiratory arrest and death. The Australian and New Zealand Society of Paediatric Dentistry and the American Academy of Paediatrics do not recommend topical agents for teething, and the US Food and Drug Administration does not recommend topical lidocaine for this purpose due to concerns of toxicity. Literature supporting the efficacy of lidocaine for teething is scant and difficult to interpret due to the flawed design of the trials conducted and varied formulations used. This opinion article aims to summarise the available literature showing the limited effectiveness and associated risks of topical lidocaine gels for use in teething. In light of these findings, the authors recommend that regulatory bodies such as the Australian Therapeutic Goods Administration review the efficacy and safety of this type of medicine and consider removing the indication for teething or limiting the age of use to older children.

Exploring Parental Knowledge and Indigenous Practices for Infant Teething in Indian Population: A Cross-sectional Study

To assess the parental knowledge and practices regarding infant teething and attitude towards infant oral health among parents of infants aged 6 months to 3-years.

Digital behavior surveillance for monitoring the interests of Google users in amber necklace in different countries

AIM

To determine the interests of Google users in information about amber necklace in distinct countries over time.

DESIGN

This longitudinal retrospective study analyzed the amber necklace-related computational data generated from the activity of Google users from17 countries, by the application of Google Trends. Four search strategies were defined in English, Spanish, Portuguese, and Italian, for retrieving the monthly variation of relative search volume (RSV) between January 2004 and September 2018, including all categories and sources of search. Trends and 12-month predictive interests of users were analyzed by forecasting autoregressive integrated moving average models, while the influences of seasonality were evaluated by generalized additive models. The most popular queries employed for Google users were determined to qualitative analysis. P values < 0.05 were considered significant.

RESULTS

In general, RSV curves were characterized by uptrends in most studied countries over the years, without the influence of monthly or quarterly seasonality. The queries were frequently associated with a desire for additional information, with respect to the definition, usability, and teething symptoms relief promoted by amber jewelries.

CONCLUSIONS

These findings indicate an increasing interest of Google users in amber necklace-related topics in different countries.

Explanation for the signs and symptoms of tooth eruption: mast cells

This study contributes to the understanding of the mechanisms associated with signs and symptoms of tooth eruption, by investigating the presence of mast cells in pericoronal tissues during the intraosseous (Group 1) and submucosal (Group 2) phases of eruption. We compared findings for these two groups with each other and with those for the oral mucosa (Group 3). In each group, 14 specimens were analyzed microscopically after hematoxylin and eosin staining and immunohistochemical analysis of c-Kit and tryptase expression. Results revealed that the number and density of mast cells is different in follicular tissues according to the eruption phase, which may mean that: 1) masticatory trauma of the oral mucosa and dental follicles in the submucosa may explain why reduced enamel epithelium exposes enamel to the cells of the connective tissue; 2) exposure of antigenic enamel proteins might correspond to the release of sequestered antigens, which may lead to the interaction of IgE and a greater number of mast cells in the region; and 3) the consequent degranulation and the local release of mediators, such as histamine, leukotrienes, prostaglandins, proteases, cytokines and growth factors, contribute to the understanding of signs and symptoms associated with tooth eruption.

Toxicological analysis of Pb and Cd by ET AAS in local anaesthetics for teething (teething gels) based on herbs available in Polish pharmacies

Studies related to the toxicological analyses of metallic impurities in pharmaceuticals (drugs) is an important issue but there is a lack of refereed literature around the safety of teething remedies from herbal origin related to toxic metals impurities. In this article, the levels of Pb and Cd were measured in samples of local anaesthetics for teething (gels) based on herbs. This article was motivated by the fact that Pb and Cd are relevant toxic metals that may cause an adverse effect in babies even at low levels. Additional justifications were (1) the insufficient control of metal impurities in teething gels, (2) the lack of sufficient validation steps and (3) the inadequate sensitivity of applied analytical techniques. The aim of this article was a qualitative and quantitative analysis of Pb and Cd in the most popular and available local anaesthetic for teething (teething gels) based on herbs (n = 5) available in Poland. Metals were determined by ET AAS (electrothermal atomization atomic absorption spectrometry), after digestion in a microwave unit using concentrated nitric acid. It was observed that all samples contained Pb and Cd. The levels of Pb and Cd as impurities (independently of the producer and declared composition) are similar. The concentrations of Pb and Cd, at ng/day levels, to which the user is exposed at daily doses meet the standards of the directive ICH Q3D.

Misconceptions and traditional practices towards infant teething symptoms among mothers in Southwest Ethiopia

Background

The assumption of a link between common symptoms such as febrile illness, diarrhea and the eruption of primary teeth has been established over many centuries. According to traditional beliefs in Ethiopia, diarrhea and fever at the time of milk teeth eruption may be due to a worm in the child’s gums. Current medical observations show little more than restlessness, drooling, and finger sucking resulting from teething. The purpose of this research was to assess mothers’ traditional beliefs and practices towards teething symptoms.

Methods

A cross-sectional descriptive study design was used with the convenience sampling technique. Mothers were approached at the pediatric Out Patient Department (OPD) of Jimma University Specialized Hospital, southwest Ethiopia. A structured questionnaire was used for data collection. The data were analyzed by SPSS (version 20).

Results

A total of 107 mothers were interviewed. Ninety-eight (91.6%) claimed that teething was associated with various symptoms. Ninety-seven (90.7%) attributed diarrhea to teething. Only one mother said she would give her child Paracetamol to relieve the teething symptoms. Five (4.7%) mothers said they would allow their children to bite on a pacifier. Ten mothers (9.3%) said that they would prefer the child’s milk tooth to be extracted. Some of the practices by mothers to relieve the symptoms include rubbing the gum of the child with garlic (12.1%) or rubbing the gum with herbs (6.5%).

Conclusions

Most of the mothers had misconceptions about the symptoms that usually appear during teething. Health education should be provided by dentists and professionals concerned with child care in correcting these misconceptions and cultural beliefs about teething symptoms.

Electronic supplementary material

The online version of this article (10.1186/s12903-018-0619-y) contains supplementary material, which is available to authorized users.

Does reduced mastication influence cognitive and systemic health during aging?

There is a growing body of literature which suggests that oral health and mastication can influence cognitive and systemic health during aging. However, it is currently unclear whether oral health, masticatory efficiency, cognitive health and systemic health merely deteriorate independently with age, or whether mechanisms exist linking mastication to cognitive and systemic health directly. The aim of this paper is to review the extent to which reduced mastication influences cognitive and systemic health during aging because this knowledge may underpin future interventions that improve quality of life. Current evidence suggests that a deterioration in mastication and oral health during aging can have: 1) direct effects on systemic health through mechanisms such as the migration of the oral microbiota into the systemic environment, and 2) indirect effects on systemic health through changes nutrient intake. A loss of teeth and reduction in masticatory efficiency during aging can have: 1) direct effects on cognitive performance and potentially impact cognitive health through mechanisms such as enhanced adult hippocampal neurogenesis, and 2) indirect effects on cognitive health through changes in nutrient intake. It is concluded that oral health and masticatory efficiency are modifiable factors which influence the risk poor cognitive and systemic health during aging, although it is currently premature to propose chewing-based interventions to slow the rate of cognitive decline and improve cognitive health during aging. Future research should include large-scale longitudinal studies which control for the types of confounding factors which concurrently influence the association between mastication and cognitive and systemic health.

Association between Fever and Primary Tooth Eruption: A Systematic Review and Meta-analysis

Aim

To perform a systematic review and meta-analysis to establish if fever is associated with primary tooth eruption.

Materials and methods

Literature searches involved Pubmed, MEDLINE, Web of Science, Scopus and Cochrane. The potentially relevant studies had the full text analyzed. Only studies concerning fever during eruption period of primary tooth in humans were included. Papers in non-English language, and papers that included syndromic patients or patients with any disease were excluded. The meta-analyses were performed with Review Manager (version 5.3). Only studies that reported the results as dichotomous data were analyzed with Cochran-Mantel-Haenszel test in meta-analysis function of Review Manager 5.3. The fixed-effects model was used to evaluate the association between tooth eruption and fever.

Results

Search identified 83 potential studies. After exclusion of the duplicated studies, or were not related to the criteria of inclusion only 6 studies were selected for the systematic review. In the overall meta-analysis, no association was found [OR = 1.32 (0.88-1.96)] between fever and primary tooth eruption. However, in the subgroup analysis, when the method used to measure fever was the rectal temperature there was an association [OR = 2.82 (1.55-5.14)] between fever and primary tooth eruption.

Conclusion

There are few suitable studies in the literature regarding the association between primary tooth eruption and fever. However, our study found an association between fever and primary tooth eruption only when rectal temperature was performed

How to cite this article

Nemezio MA, De Oliveira KMH, Romualdo PC, Queiroz AM, Paula-e-Silva FWG, Silva RAB, Kuchler EC. Association between Fever and Primary Tooth Eruption: A Systematic Review and Meta-analysis. Int J Clin Pediatr Dent 2017;10(3):293-298.

Mothers' teething beliefs and treatment practices in Mansoura, Egypt

Objectives

To reveal mothers’ beliefs about signs and symptoms associated with teething and their treatment practices.

Population and methods

A cross-sectional study done in Mansoura District on 457 mothers and their children with one or more erupted teeth. Mothers were interviewed during vaccination session at 25 chosen health facilities. Mothers were asked whether they agree or disagree about 24 signs and symptoms claimed to be associated with teething.

Results

Only 1.8% reported no symptoms at the time of teething. Majority had correct knowledge related to bite fingers/objects (70.5%) and drooling (60.0%). Inaccurate knowledge was reported as gum rubbing (42.0%), gum swelling (47.0%), diarrhea (51.0%), fever (83.2%) and weight loss (46.0%). Only 16.8% of mothers have good knowledge about teething problems. Logistic regression analysis revealed that the independent predictors of good knowledge are higher education (AOR = 3.7), urban residence (AOR = 2.5) and having a first-born child (AOR = 5.5). Only 13.4% of mothers did not give any treatment for teething problems. Antipyretics and antibiotics were the most frequently given treatments (71.3%, and 24.3%; respectively).

Conclusions

The majorities of mothers had low knowledge about teething problems and gave unnecessary treatments.

Signs and Symptoms of Primary Tooth Eruption: A Meta-analysis

CONTEXT

Symptoms associated with the primary tooth eruption have been extensively studied but it is still controversial.

OBJECTIVE

To assess the occurrence of local and systemic signs and symptoms during primary tooth eruption.

DATA SOURCES

Latin American and Caribbean Health Sciences, PubMed, ProQuest, Scopus, and Web of Science were searched. A partial gray literature search was taken by using Google Scholar and the reference lists of the included studies were scanned.

STUDY SELECTION

Observational studies assessing the association of eruption of primary teeth with local and systemic signs and symptoms in children aged 0 to 36 months were included.

DATA EXTRACTION

Two authors independently collected the information from the selected articles. Information was crosschecked and confirmed for its accuracy.

RESULTS

A total of 1179 articles were identified, and after a 2-phase selection, 16 studies were included. Overall prevalence of signs and symptoms occurring during primary tooth eruption in children between 0 and 36 months was 70.5% (total sample = 3506). Gingival irritation (86.81%), irritability (68.19%), and drooling (55.72%) were the most frequent ones.

LIMITATIONS

Different general symptoms were considered among studies. Some studies presented lack of confounding factors, no clear definition of the diagnostics methods, use of subjective measures and long intervals between examinations.

CONCLUSIONS

There is evidence of the occurrence of signs and symptoms during primary tooth eruption. For body temperature analyses, eruption could lead to a rise in temperature, but it was not characterized as fever.

Signs and symptoms associated with primary tooth eruption: a clinical trial of nonpharmacological remedies

Background

To evaluate disturbances in primary tooth eruption and their management with nonpharmacological remedies.

Methods

In this nonrandomized clinical trial, 270 children aged between 8 and 36 months were selected and divided into 5 groups with 54 children initially enrolled in each group. The children were seen during an 8-day period during tooth eruption. At each appointment data were recorded from oral examination, tympanic temperature measurement and a questionnaire. The five methods used as remedies to reduce teething symptoms were: 1) cuddle therapy, 2) ice, 3) rubbing the gums, 4) teething rings and 5) food for chewing. Teething symptoms, the type of erupted tooth, symptoms of recovery and the mother’s satisfaction with treatment were evaluated.

Results

Two hundred and fifty four children (mean age 16 ± 7.2 months) completed the study. The most frequent teething symptoms were drooling (92 %), sleep disturbances (82.3 %) and irritability (75.6 %). These symptoms were more pronounced in low birth weight children (p > 0.05). Canine eruption led to more loss of appetite than incisor (p = 0.033) or molars eruption (p = 0.014). Low grade increases in body temperature were observed only on the day of eruption (36.70 ± 0.39 °C), when body temperature was significantly different compared to the day before and the day after eruption (both p < 0.001). There was no significant correlation between fever as reported by mothers and temperature readings obtained by the investigators. The most favorable results for time to recovery and the mother’s satisfaction were seen when teething rings were used, followed by cuddle therapy and rubbing the gums.

Conclusions

There was no association between teething and symptoms such as fever or diarrhea. Low birth weight children may have more teething symptoms. Teething rings, cuddle therapy and rubbing the gums were the most effective methods to reduce symptoms.

Trial registration

Iranian Registry of Clinical Trials: code IRCT201211127402N3

Infant dental enucleation: A literature review on a traditional remedial practice in East Africa

OBJECTIVE

To summarize and review the literature on infant dental enucleation, a traditional remedial procedure prevalent mainly in East Africa.

MATERIALS AND METHODS

Literature searches were made electronically using general and specialized search engines. The main search was performed through a systematic strategy in PubMed, comprising tabulated keywords, search codes, and translated and transliterated terms. Criteria for the selection of studies were designed to provide a general understanding of the procedure. The findings were synthesized into two sections: a summary of the population prevalence studies, and a thematic literature review.

RESULTS

An overview of the known prevalence and clinical specifications was established. Insight was gained into the purpose of the procedure and the factors influencing its performance. Diverging suggestions were seen with regard to the rationale for use of infant dental enucleation between different populations. Moreover, reports of complications and consequences involving the general health and the dentoalveolar structures of patients were examined.

CONCLUSIONS

Prevalence, clinical features and risks of infant dental enucleation point to a need for greater awareness of the procedure. Further, there is a need for specific guidelines regarding management of suspected cases within dental and healthcare communities.

Teething myths among nursing mothers in a Nigerian community

Background:

Many symptoms had been associated with teething in children with the possibility of overlooking potentially fatal condition. Symptoms that had been associated with teething include diarrhoea, fever, vomiting and cough. The possibility that any of these symptoms could have been due to other causes call for thorough investigation of the child before concluding that it is only “teething”.

Objectives:

The study was carried out to assess the beliefs of nursing mothers concerning symptoms that are associated with teething among children and to identify those that would seek medical treatments in case of their children having such symptoms during teething.

Materials and Methods:

Two hundred and ninety nursing mothers whose children had erupted at least a tooth were interviewed in the immunisation clinics of the University College Hospital and Adeoyo Maternity Teaching Hospital, both in Ibadan, Nigeria, on their beliefs and practice concerning teething in children.

Results:

One hundred and eighty-eight (64.8%) of the mothers associated symptoms such as fever, cough, catarrh and diarrhoea with eruption of teeth in their children. Over half of the women agreed that a child having either fever (51.0%), ear infection (57.6%) or cough (50.3%) should be promptly taken for medical consultation and not be tagged “teething”, while for other symptoms such as gum pain (74.5%), sleepless night (56.6%), vomiting (51.4%) and diarrhoea (51.7%), over half of the mothers believed that the symptoms will resolve following the eruption of the teeth.

Conclusion:

The study demonstrated that mothers in the study attributes several symptoms to teething, which could be detrimental to the survival of their children as the symptom could have been due to other causes. There is, therefore, need for public enlightenment to create awareness on the possible effect of presumptuous belief that childhood diseases are due to teething process.

How first-time mothers perceive and deal with teething symptoms: a randomized controlled trial

BACKGROUND

Teething, especially in their first child, continues to be a daunting problem for parents.

OBJECTIVE

The objective of this paper was to assess the effects of providing first-time mothers with information about symptoms commonly associated with teething and ways to manage these.

METHODS

In a randomized controlled trial to decrease the incidence of early childhood caries, we included information on teething as another issue in a child's oral health. Mothers in the intervention group received three rounds of printed information: at enrolment during pregnancy and when the child was 6 and 12 months old. Information on teething arrived when a child reached 6 months of age. Outcome assessment was at 20 ± 2.5 months of age. Data were complemented with a systematic search for evidence on teething symptoms and how to alleviate them in other populations.

RESULTS

Of 649 expectant mothers enrolled in the study, 441 completed the 'Child's oral health' questionnaire. There were no significant differences in teething symptoms reported by mothers in the intervention (n = 232) and control (n = 209) groups. However, mothers in the intervention group were less likely to use topical and oral medications to manage teething problems (P < 0.03) and relied more on rubbing the gums to ease discomfort (P < 0.005) than mothers in the control group.

CONCLUSIONS

Providing mothers with information on how to address teething symptoms markedly reduced the use of medications for symptom relief. There is still need for better evidence, first, on what symptoms can or cannot be attributed to teething and, second, on what is effective in alleviating them.