Dentition refers to the development of teeth and their characteristic alignment in mouth. That is the number, type and morpho-physiology of the teeth.

There are four types of teeth in the oral cavity:

Incisors-There are four incisors in the upper and four in the lower jaw with a single root and sharp incisal edge. The incisors have the primary function to cut food.

Canines- There are four canines in the oral cavity with single, pointed cusp and a single root. They function to tear food and also form the corners of the mouth.

Premolars- There are eight premolars in oral cavity with 3-4cusps. There are no premolars in primary dentition. They are designed to crush food.

Molars- The most posterior teeth in mouth are called molars. There are 12 molars in the permanent dentition with three in each quadrant of the mouth. The primary dentition contains only eight molars. They are designed to grind food.

Primary Dentition and Permanent Dentition

Primary dentition or deciduous teeth are the first teeth to erupt in oral cavity. They are 20 in number. They begin to erupt at the age of six months and continue till twenty-five to thirty-three months of age. However some babies have teeth eruption when as young as three months and others not until they are a year old. These teeth then get exfoliated as the permanent teeth erupt.

Permanent dentition comprises of 32 teeth. It takes about six years for children to get their primary teeth replaced by permanent teeth between the ages of 6 and 12 years.

It is more important to have symmetry that is same teeth coming at same time on both sides than the time the teeth emerge.

Complications of Dentition

Teething can be very uncomfortable for babies and cause complications that parents might not know about. The problems during eruption of teeth are as follows:

Early dentition- Early eruption of teeth is most commonly due to hyperthyroidism i.e. overactive thyroid gland. In this the primary teeth erupt and then fall off very early and adult teeth erupt quickly.
Delayed dentition- Diseases that are genetic and affect the endocrine glands most commonly result in delayed dentition. Common conditions such as hypopituitarism, hypothyroidism, Down’s Syndrome and cerebral palsy cause delayed eruption of primary teeth.
Eruption cysts- These are fluid filled sacs that form on top of the tooth, be it primary or adult tooth, which is about to erupt. They are relatively harmless and often go away as the tooth comes through.
Neonatal and Natal teeth- Natal teeth (those that erupt around time of birth) and neonatal teeth (those which are present at time of birth) are normal teeth. At times they are actually an extra tooth that should be extracted by the dentist.

Signs and Symptoms related to teething

Studies show that teething is not associated with serious or life threatening illnesses such as high fever and convulsions, infections whether respiratory or middle ear infections, vomiting and diarrhea or strong urine. On the other hand teething is linked to the following:

Daytime restlessness
Thumb –sucking
Gum- rubbing or desire to bite on something hard
Drooling which may lead to possible rash
Loss of appetite
Swelling and tenderness of gums
Crying and irritability
Slight fever
Disruption in sleeping habits
Ear rubbing in some cases

The desire to bite on something hard, gum rubbing, crying and irritability, drooling of saliva are common symptoms that tend to appear 3-4 days before or after eruption of primary teeth and symptoms such as slight fever, decreased appetite to eat especially solids, wakefulness, facial rash and ear rubbing appear to be possible symptoms 1-2 days before or after eruption of teeth.

Flatulence During Teething

It is a problem which is very commonly linked to teething. It is seen that teething can be painful to the children and make them cry very often. When the infants cry they tend to swallow more air with each breath. This can cause excess gas in baby’s stomach leading to flatulence. Also it is seen that due to pain of dentition the children show strong tendency to take anything and everything into their mouth to bite on and ease the discomfort. If those objects are dirty and infected with bacteria they can lead to digestive issues like flatulence and even diarrhea in babies. They may even develop flatulence due to constipation. This is seen when due to pain the babies refuse to eat or drink anything leading to flatulence and constipation in turn.

General Management

Parents can observe following measures to help their child with teething troubles and flatulence during dentition.

During feeding babies’ head should be kept at a higher level than their tummy.
They should use a nipple with slower flow of milk as this can prevent air bubbles from entering the tummy as much as possible.
Give due attention and cuddling as this can help even the crankiest of babies and help them feel less irritable and happier.
Teething rings can be used to provide temporary pain relief. This is best done when the rings are chilled first. Even hard and frozen fruits and vegetables can be used for pain relief. Applying pressure to the painful area can also be achieved with a clean finger or cold spoon.
If infant is having excess saliva and drooling it should be regularly wiped off to avoid possibility of developing facial rash.
Repeated application of alcohol to the gums and mucus membrane of an infant’s mouth should be avoided as it is not only ineffective for pain relief but may lead to severe problems due to infant’s small body weight.
Application of honey, jam or sugar to feeding bottles or pacifiers should also be avoided as it is ineffective in reducing pain and instead may lead to tooth decay.

Homoeopathic Management

If the above measures don’t prove effective one must refer to a doctor for help. Homoeopathy has a valuable role to play in treating complications due to teething such as excessive flatulence and bloating without causing any side effects. It is seen that use of even painkillers and medications that are to be rubbed on the gums are not very effective over long periods of time as they wash out of infant’s mouth within few minutes. Apart from relief from various teething troubles such as excessive flatulence it is also observed that constitutional homoeopathic medicine administered at this age further help to strengthen the immune system of the infants and help them to thrive well.

Best homoeopathic medicine for flatulence is the one most similar to the disease manifestation pertaining to both mental and physical sphere.

Various homoeopathic medicines helpful during dentition for excessive flatulence are:

Aconite Napellus- It is indicated when there is a lot of pain due to bloating and the baby seems very restless and fearful in countenance. The gastro intestinal trouble is mainly causes in very hot weather. The baby may have high fever with convulsion during teething with hot and dry skin, twitching of single muscles and the baby gnaws the fist and frets and screams.

Calcarea Carbonica- In this the milestone like crawling, walking and dentition are delayed in the baby due to impaired nutrition. It is indicated in babies who take cold easily, grow fat, are large bellied, have large heads due to delayed closure of fontanelles, have swelling of glands, rachitis, pale skin and chalky look, leucophlegmatic temperament, crave eggs and eat dirt and other indigestible things making them prone to diarrhea. Calcarea baby is fat, fair, flabby, with sweat that is profuse, cold and sour smelling.

Calcarea Phosphorica- It is suited to babies with delayed milestone like late closure of fontanelles, delayed crawling and walking and tardy first and second dentition. Calcarea Phos is well indicated in anemic, scrofulous children who are peevish and always wanting to go somewhere, dark complexioned, thin and spare, weak and unable to stand up, have cold extremities and feeble digestion causing diarrhea and flatulence with aggravation of symptoms from any change of weather.

Chamomilla- This remedy is often indicated when the baby is extremely angry or irritable due to the pain such that it may feel agitated, scream and hit those around him and wants to be carried constantly to distract the baby from pain. Diarrhea during dentition that is green like chopped eggs and spinach, watery, hot, very offensive like rotten eggs well indicates Chamomilla.

Magnesia Phosphorica- It is indicated for painful dentition which gets better by drinking or applying anything warm on the affected area and by pressure as from biting on an object. Such children may also have spasms without any fever during dentition.

Pulsatilla – It is suited to babies who are weepy, gentle and mild and wants to be constantly held. There is dryness of mouth without thirst. The child frequently licks the dry lips. There is aversion to fat food, warm food and drinks. There are two or three normal stools daily and no two stools are alike. Biting on something cold may help to relieve the toothache in such children.

Flatulence during teething