Our 8-month old keeps having fevers, and we’re wondering if that could be from his being on the verge of cutting new teeth. His gums are swollen on his lower front. A friend told us that we need to make an incision in his gums to fix this, but I’m skeptical of that. Can you help?
Michelle from Colorado
(See Dr. Hall’s answer below.)
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Let me say right off that I don’t recommend cutting your baby’s gums. I paid close attention in my pediatric dentistry courses in dental school and I have never heard of that before. Mother nature has a way to make sure those teeth come in normally, and you don’t need to help her any. The pressure causing eruption of the teeth comes from the growth of the root—as it gets longer, the tooth is pushed up and out through the gum. I would worry, if you try to accelerate that process, that the root may not be formed enough to fully support the tooth.
About fevers and cutting teeth. Yes, children can get a mild fever from erupting baby teeth. Other symptoms associated with teething are fussiness, drooling, restless sleep, and lack of appetite. I would give them a little Tylenol for this—no surgery.
And while we’re on the subject of tooth eruption, let me say one thing about the eruption of permanent teeth, because in some circumstances, those teeth may need some help. If the permanent tooth has appeared in your child’s mouth but the baby tooth is still there, you probably want to have the baby tooth extracted. Otherwise, it could cause deflection of that permanent tooth. This can occur most often for the erupting premolars that are replacing the baby molars. Erupting permanent teeth will dissolve away the roots of baby teeth as they come to the surface. The baby molars have multiple roots, and if only some of those roots have dissolved away, the baby tooth will hang on by maybe a couple of the undissolved roots. That can cause the permanent premolar to be deflected to the side instead of its normal position.
Or, in the front, when the baby teeth have no spaces between them, the larger permanent incisors may come in deflected from their normal path without dissolving the entire root of the baby teeth. With consultation from an orthodontist, I would extract enough baby teeth to get those front teeth to come in their normal position. True, that will make it so there isn’t enough space for back teeth, but in my view it is better to deal with the crowding back there and help your child at least have straight front teeth until they get their braces.
So get a little help for these situations.
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.