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Teething - Management
How should I manage an infant presenting with symptoms of teething?
- Exclude other underlying conditions which could be responsible for the symptoms, especially if the child appears unwell.
- Offer reassurance, that teething is normal and is not an illness. Symptoms are generally mild and self-limiting.
- Give advice on self-care measures to relieve teething symptoms:
- Gentle rubbing on the gum with a clean finger.
- Allow the infant to bite on a clean and cool object.
- Examples include a chilled teething ring or a cold wet flannel. For children who have been weaned, consider the supervised use of chilled fruit or vegetables (such as bananas or cucumber).
- Avoid objects that can easily be broken into hard pieces, as these are a choking risk.
- Sugar-free products are preferred as they do not promote tooth decay.
- Teething biscuits and rusks are not recommended if they contain sugar.
- Consider paracetamol or ibuprofen suspension for relieving the discomfort of teething symptoms in infants 3 months of age or older. Paracetamol is preferred for infants with asthma.
- Oral choline salicylate gels are contraindicated because of the risk of Reye's syndrome.
- Topical anaesthetics and complementary therapies (such as herbal teething powder) are not recommended.
- Explain that there is no good evidence to support their use.
- Advise parents to follow the manufacturer's dosage recommendations if they decide to use these products.
- Advise the parent to seek medical advice if the infant becomes systemically unwell (for example with a high fever) as this indicates an underlying condition unrelated to teething.
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