The Mother's Manual of Children's Diseases

by Charles West

We must not, however, picture to ourselves this process as going on uninterruptedly until completed—a mistake into which parents often fall, whose anxiety respecting their children is excited by observing that after several teeth have appeared in rapid succession, the process appears to come to a standstill. Nature has so ordered it that teething which begins at the seventh or eighth month, shall not be completed until the twenty-fourth or thirtieth; and has doubtless done so in some measure with the view of diminishing the risk of constitutional disturbance that might be incurred if the evolution of the teeth went on without a pause. As a rule the two lower central incisors or cutting teeth make their appearance in the course of a week; six weeks or two months often intervene before the central upper incisors pierce the gum, but they are in general quickly followed by the lateral incisors. A pause of three or four months most frequently occurs before we see the first grinding teeth, another of equal length previous to the appearance of the eye teeth, and then another still longer before the last grinding teeth are cut.

Though a perfectly natural process, teething is almost always attended with some degree of suffering. This, however, is not always the case, for sometimes we discover that an infant has cut a tooth, who yet had shown no signs of discomfort, nor any indication that teething was commencing, with the exception of an increased flow of saliva. More frequently indeed, the mouth becomes hot, and the gums look tumid, tense, and shining, while the exact position of each tooth is marked, for some time before its appearance, by the prominence of the gum; or the eruption of the teeth is preceded by much redness, and great heat of the mouth with profuse flow of saliva, and even with little painful ulcers of the edge of the tongue, or of the inner surface of either lip. With either of these conditions the child is feverish, fretful, and cries from time to time with pain, while at the same time the bowels often are relaxed, or the child coughs and wheezes as if it had caught cold.

Symptoms such as these make up what nurses mean when they say that the child is suffering from its teeth, and this opinion is constantly followed by a request to the doctor to lance the baby's gums. Now this little operation when really called for often gives great relief, both to the local discomfort, and also to the general ailment from which the infant suffers, but it is often done when there is no occasion for it, and when consequently it causes needless pain, and does no good.

There are four different conditions in which it may be right to have the child's gums lanced:

First. When a tooth is very near the surface, and by cutting through the thin gum the child may be spared some needless suffering.

Second. When the gums are very red and hot and swollen; only in this case the gum is scratched or cut, to bleed it, not with the idea of letting out the imprisoned tooth.

Third. When the child has for some week or two been feverish and suffering; while, though the gum is tense and swollen, the tooth does not seem to advance.

Fourth. As an experiment, when during the progress of teething a child is suddenly seized with convulsions for which there is no obvious cause. The irritation of the teeth may have to do with their occurrence; and the chance of relieving it by so simple a means is not to be thrown away.

If the process of teething is going on quite naturally, no interference, medical or other, is either necessary or proper. The special liability of children to illness at this time must indeed be borne in mind, and care must be taken not to make any alteration in the infant's food while it is actually cutting its teeth, but rather to choose the opportunity of some one of those pauses to which reference has been made, as occurring between the dates of appearance of the successive teeth, for making any such change. If the child is feverish, a little soda or seltzer water sweetened and given after the effervescence has subsided will be taken eagerly, and avoid the risk of putting the child too often to the breast, or giving it food too frequently. It seeks the one or the other because it is thirsty, and craves for moisture to relieve its hot mouth; not because it is hungry and needs nourishment. If the child has been weaned, still greater care will be required, for it will often be found that it is no longer able to digest its ordinary food, which either is at once rejected by the stomach, or else passes through the intestines undigested. Very thin arrowroot made with water, with the addition of one third of milk, will suit in many cases, or equal parts of milk and water with isinglass, or equal parts of milk and the white decoction. The bowels of course must be kept open with very simple and mild aperients, but the bowels are in general more inclined to diarrhœa than to constipation, and the diarrhœa of teething children is often troublesome and requires good medical advice.

The ulcerated state of the mouth is usually connected with special disorder of the digestive organs, and that condition of acidity for which I have already recommended soda, magnesia, and similar remedies, while locally the mouth needs just that local care which is applicable in cases of thrush. Now and then, severe inflammation of the gums occurs, in which they become extremely swollen; and ulceration takes place of the gum just above where the tooth should come through, and even around some of those which have already appeared. These are cases in which lancing the gums would do nothing but mischief. They require the local care already insisted on, a mild plan of diet, and treatment to reduce any feverishness; and above all one medicine, the chlorate of potass, which in doses of four grains every four hours for a child a year old, is almost a specific.