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
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
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.
Rachel Berger, MD, associate professor of pediatrics at Children's Hospital
in Pittsburgh, tells WebMD she was glad to see a teething study of a large
group of infants. "It's an important study. This study showed that there is
no association [between teething and diarrhea and fevers]."
Her advice: "Parents should pay attention to any serious symptoms, any
temperature greater than 102°F, especially in a little baby, and other symptoms
such as cough, runny nose, decreased urine output, vomiting, [because] those
are not associated with teething," she says. "If kids are not acting
themselves, are really acting sick, parents need to bring kids to the doctor.
Severe diarrhea [and] temps greater than 102°F are not caused by teething and
they should give their doctor a call."
- Researchers have completed a new study to determine exactly which symptoms
can be attributed to teething, and which may have a more serious cause.
- Elevated temperature (up to 102°F), biting, drooling, gum rubbing,
irritability, and sucking all were more common among babies who were
- Temperatures above 102°F and diarrhea were not associated with teething,
and caregivers should not dismiss these symptoms.