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Teething - filling in the gaps…

British Dental Journal volume 237, pages 262–266 (2024)Cite this article

Abstract

Dentists and dental care professionals may be faced with concerns from parents and carers regarding teething in infants and young children. Teething is a normal physiological and self-limiting process; however, the diverse signs and symptoms that have, over time, been attributed to teething, can make diagnosis challenging. Appropriate diagnosis is crucial in preventing the potentially life-threatening sequalae of dismissing symptoms as teething and delaying appropriate treatment of a systemically unwell child. Management of teething can be approached in a five-step process based on the National Institute for Health and Care Excellence clinical knowledge summary on teething. These include: 1) history-taking, clinical examination, diagnosis and referral of systemically unwell or severely distressed children for urgent medical review; 2) providing parental/carer reassurance, information and preventative advice; 3) simple, non-pharmacological management strategies; 4) pharmacological intervention; 5) safety-netting advice in case the child becomes systemically unwell, has prolonged symptoms, or is in severe distress. The purpose of this article is to bridge knowledge gaps regarding teething to enable appropriate diagnosis and encourage dissemination of preliminary information and ensure appropriate referral by frontline dental professionals.

Key points

  • This paper provides a review of the literature regarding teething in infants and young children, including signs and symptoms, diagnosis and management.

  • This article outlines the typical process of primary tooth eruption and possible causes for deviations from the norm.

  • This article summarises a five-step management approach based on the National Institute for Health and Care Excellence clinical knowledge summary on teething.

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Author information

Authors and Affiliations

  1. Specialty Registrar in Paediatric Dentistry, The Royal London Dental Hospital, Barts Health NHS Trust, E1 1FR, UK

    Sajida Mamdani

  2. Consultant in Paediatric Dentistry, The Rotherham NHS Foundation Trust, Rotherham, S60 2UD, UK

    Sadna Rajan

  3. Honorary Clinical Senior Lecturer, Faculty of Dentistry, Oral and Craniofacial Sciences, King´s College London, UK; Consultant in Paediatric Dentistry, Evelina London Cleft Service and Dental Directorate, Guy´s and St Thomas´ NHS Foundation Trust, SE1 7EH, UK

    Nabina Bhujel

Authors
  1. Sajida Mamdani
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  2. Sadna Rajan
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  3. Nabina Bhujel
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Contributions

The review article was designed by Nabina Bhujel and Sajida Mamdani. Sajida Mamdani was involved in the literature search and drafting of the article. Sajida Mamdani, Sadna Rajan and Nabina Bhujel contributed to the write-up and approved the final manuscript.

Corresponding author

Correspondence to Sajida Mamdani.

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The authors declare no conflicts of interest.

Written parental consent was gained for publication of clinical photographs included in the manuscript.

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Mamdani, S., Rajan, S. & Bhujel, N. Teething - filling in the gaps…. Br Dent J 237, 262–266 (2024). https://doi.org/10.1038/s41415-024-7722-z

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