Prospective Longitudinal Study of Signs and Symptoms Associated With Primary Tooth Eruption

Abstract

WHAT'S KNOWN ON THIS SUBJECT:Currently, there is not enough scientific evidence to indicate that the eruption of primary teeth causes systemic manifestations in infants. Signs and symptoms such as fever, diarrhea, irritability, and sleep disturbance may indicate more serious conditions. WHAT THIS STUDY ADDS:Results of this study contribute toward supporting the concept that teething is not associated with severe signs and symptoms. Thus, health professionals involved in the care of infants should seek other causes before attributing severe signs and symptoms to teething. abstract OBJECTIVE: To assess the association between primary tooth eruption and the manifestation of signs and symptoms of teething in infants. METHODS:An 8-month, longitudinal study was conducted with 47 noninstitutionalized infants (ie, receiving care at home) between 5 and 15 months of age in the city of Diamantina, Brazil. The nonrandomized convenience sample was based on the registry of infants in this age range provided by the Diamantina Secretary of Health. Eligible participants were infants with up to 7 erupted incisors and no history of chronic disease or disorders that could cause an increase in the signs and symptoms assessed in the study. Tympanic and axillary temperature readings and clinical oral examinations were performed daily. A daily interview with the mothers was conducted to investigate the occurrence of 13 signs and symptoms associated with teething presented by the infants in the previous 24 hours. RESULTS:Teething was associated with a rise in tympanic temperature on the day of the eruption (P ϭ .004) and with the occurrence of other signs and symptoms. Readings of maximal tympanic and axillary temperatures were 36.8°C and 36.6°C, respectively. The most frequent signs and symptoms associated with teething were irritability (median: 0.60; P Ͻ .001), increased salivation (median: 0.50; P Ͻ .001), runny nose (median: 0.50; P Ͻ .001), and loss of appetite (median: 0.50; P Ͻ .001).CONCLUSIONS: Irritability, increased salivation, runny nose, loss of appetite, diarrhea, rash, and sleep disturbance were associated with primary tooth eruption. Results of this study support the concept that the occurrence of severe signs and symptoms, such as fever, could not be attributed to teething. Pediatrics 2011;128:471-476

Prevalence of Teething Symptoms in Primary Teeth and Associated Factors: Cross-Sectional Study in Children aged 12-23 months in Pelotas, Brazil

“…Excess salivation was the most reported symptom (67.7%), followed by irritability (65.22%) and fever symptoms (44.1%), which were also frequently reported in other studies [8,10,12].…”

“…Thus, fever conditions are usually related to a viral origin and not to tooth eruption [7], since tooth eruption is insufficient to determine these symptoms, although these symptoms may occur concomitantly to the eruptive process. Thus, even though parents and some health professionals associate tooth eruption to the onset of some symptoms, other organic causes should be excluded in order to avoid more serious health complications [8].…”

Assessment of Gingival Mucosa of Infant Rats during Teething

“…1,4,[10][11][12] The fever response is considered an integral part of the acute inflammatory reaction and is produced by interleukin-1 (IL-1), which is an endogenous pyrogen that activates specialized receptors located in the hypothalamus. 13 IL-1 is produced by different cells, including macrophages, monocytes, osteoclasts, A cells, neutrophils, fibroblasts and epithelial cells [14][15][16][17] and is secreted in the extracellular fluid in two molecular forms, alpha and beta, both of which have proinflammatory effects.…”

Can the physiological process of teething in babies be abnormal?

“…Аналогичное проспективное исследование было проведено бразильскими авторами [11]. Под наблюде-ние были взяты 47 детей в возрасте от 5 до 15 мес.…”

“…В период исследования детям проводилось ежедневное измерение тимпанической и аксиллярной температуры, осмотр ротовой полости и регистрация возможных сим-птомов дентации. По результатам анализа полученных данных было установлено, что процесс прорезывания зубов достоверно ассоциировался с повышением тим-панической температуры в день появления зуба, а также наличием таких симптомов, как раздражительность (р < 0,001), повышенное слюнотечение (р < 0,001), ринорея (р < 0,001) и снижение аппетита (р < 0,001) [11].…”