Teething vs. Illness: How to Tell the Difference
April 10, 2000 (Atlanta) -- Pediatricians and parents have long disagreed on which of a child's symptoms are caused by teething and which symptoms could indicate a serious illness.
A new study helps confirm what the American Academy of Pediatric Dentistry has said, that fevers greater than 102°F should not be attributed to any tooth problem, including teething. It also helps dispel worldwide folk beliefs that diarrhea is associated with teething.
"Before caregivers attribute any infants' signs or symptoms of a potentially serious illness to teething, other possible causes must be ruled out," says lead author Michael L. Macknin, MD, of the department of pediatrics and adolescent medicine at the Cleveland Clinic in Ohio. His paper appears in the April issue of the journal Pediatrics.
Macknin and colleagues followed 125 babies ages 3 to 6 months for eight months. During the period, parents kept a daily log that included their child's temperatures, tooth eruptions, and a checklist of 18 symptoms. All illnesses, medications, and immunizations were also recorded.
The teething period was defined as the eight-day period beginning four days before a tooth comes through the gum and extending three days afterward.
Of the infants who completed the study, more than 35% had no symptoms during their eight-day teething periods, says Macknin. Others had decreased appetite for solid foods, biting, drooling, ear rubbing, gum rubbing, irritability, rash on face, sucking, and abnormal temperature and wakefulness. Biting, drooling, gum rubbing, irritability, and sucking occurred with greater frequency during teething.
Elevated temperature -- but less than 102°F -- was an indicator of teething, but only the day before and the day that the tooth actually came through the gum.
Noting that many people believe teething can cause diarrhea, Macknin says his group found only a weak association between the two.
After reviewing the study, Zuhair Sayany, DMD, assistant professor of pediatric dentistry at the University of Pennsylvania School of Dental Medicine in Philadelphia, tells WebMD the study shows that many symptoms thought to be caused by teething may actually instead be caused by a serious illness. Sayany is also on staff at Children's Hospital of Philadelphia.