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Teething: Problems and Solutions
Does teething cause fever, diarrhea, and illness in babies?

Actually, there is no evidence that teething causes illness in babies. Current medical and dental research shows that fever, diarrhea, and symptoms of illness, are simply coincidental findings during teething.
Babies do, however, salivate more, refuse food more often, and demonstrate increased daytime restlessness during teething.

Teething is a natural process in which primary teeth erupt into the oral cavity. This process usually begins at 6 months of age and ends at 30 months.

What can be done about the pain associated with teething?
The following steps can help:
1. Have two clean teething rings, which have been chilled or frozen, ready for baby chew on.
2. Give children's Tylenol elixer, as needed, to alleviate pain and inflammation.

Note that using benzocaine ointment on baby's gums is not a good idea because:
1. Benzocaine ointment may sensitize your baby to future benzocaine-related allergic reactions.
2. Benzocaine ointment may cause numbing of the throat and your baby may choke if too much is used.

Parents should always seek the advice of a physician when they suspect that their child has an illness. This will prevent serious medical problem from being overlooked.
Remember that infants with Herpes Simplex Virus-1 may be might be misdiagnosed as having teething problems.

For a pediatricians's point of view, click on Dr. Greene

Obstructive Sleep Apnea In Children
Obstructive sleep apnea ,OSA, is the most common type of sleep apnea, and it has been implicated in some cases of Sudden Infant Death Syndrome.

OSA occurs when the throat muscles and the tongue relax during breathing - partially blocking the opening of the airway. Airflow is absent despite beathing efforts.

Infants with obstructive sleep apnea (OSA) can be treated with a nose mask through which continuous positive airway pressure is provided. This form of treatment is called nasal continuous positive airway passage, (nCPAP), and is the most common effective treatment for sleep apnea.

For those patients who cannot tolerate nCPAP treatment, a dental device, called a prosthetic mandibular advancement appliance, PMA, can be fabricated. Mandibular repositioning devices are generally not used in children, however, because they may stimulate unwanted growth in the epiphyseal plates.

OSA should not be confused with central sleep apnea, which occurs when the respiratory centers in the brain fail to send messages to initiate breathing.

A third way to address OSA involves surgical treatment of the structure causing the obstruction - such as the tonsils, adenoids, tongue, uvula, or soft palate.

PubMed medline query provides numerous research abstracts for this important topic.
Northern Light Search gives numerous medical links for this topic as well.

For more information on sleep apnea in children, click on
MedscapeWire or
Reuter's Medical News

Could Your Toddler Develop Baby Bottle Tooth Decay?
Does your child go to sleep with a bottle or a sippy cup containing milk, juice, or soda? If so, the stage could be set for developing cavities in baby teeth. For important information on preventing cavities in your child's teeth see Baby Bottle Tooth Decay.

Can Pacifiers Prevent Crib Death?
Crib death is a colloquial term for SIDS, or sudden infant death syndrome.
SIDS is the leading cause of death among infants from one month to eleven months of age.

Pacifiers may act as a myofunctional appliance in infants, stimulating the tongue, keeping it positioned up and forward in the oropharyngeal cavity. This modified tongue posture might help to prevent blockage of the pharynx and help keep an infant's airway open.
Pacifiers may also strengthen the muscles of the upper airway.

The drawbacks of pacifier use include:
1. An increased chance of dental protrusion in the primary dentition.
2. An increased rate of pediatric ear infections, such as otitis media.

Some European studies have alluded to the beneficial effects of pacifier use. One of the first articles to research the relationship between pacifier use and SIDS was:
Arnestad M, Andersen M, Rognum T: Is the use of dummy or carry-cot of importance for sudden infant death? Eur J Pediatr 1997

You can take the following steps to lower the risk of SIDS:
1. Place your baby to sleep on its back.
2. Use tight-fitting, well-adapted bed sheets over a firm mattress.
3. Provide a smoke-free environment for your baby. Don't smoke while pregnant.
4. Be careful not to overheat your baby.

For more information on SIDS, please click on SIDS Alliance.

Can Asthma Affect Children's Teeth?
Asthma can definitely cause problems for children's teeth and gingiva (gums).
Asthma is a chronic airway disease characterized by bronchial constriction and inflammation.
Wheezing is caused by bronchial constriction, which prevents air from being exhaled.

Dental caries (the disease which results in cavities) and gingivitis are more prevalent in asthmatic children due to decreased flow of saliva.
This decreased salivary flow is caused by the action of B-2 agonists (Proventil) on salivary gland function.

Gastroesophageal reflux (GER) is the unwanted movement of stomach acid up the esophagus and into the mouth.
The prevalence of GER is increased by the use of B-2 agonists (Proventil), and by the use of bronchial smooth muscle relaxants (Slo-Bid and Theo-Dur).

A good reference article for this important topic is:
Zhu J et al: Dental management of children with asthma. Pediatric Dentistry Sept-Oct 1996;18:363-370

Parents can take these steps to decrease the oral problems associated with asthma:
1. Ensure that your child rinses with plain water at least four times per day. Rinsing dilutes the concentration of stomach acids which may reflux into the mouth.
Rinsing with water will also keep the gingival tissues moist.
2. Take you child to the dentist every six months for a check-up.

For more information on asthma see:
Asthma Information Center

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