Teething – physiological process of an exit of a koronkovy part of tooth to a surface of an alveolar shoot of a jaw and gum. Eruption of milk teeth is followed by local signs (reddening, hypostasis and "itch" of a gum, a plentiful salivation) and the general symptoms (concern, a loss of appetite, a sleep disorder). For simplification of process of a teething it is possible to give to the child special "teethers", to carry out massage of gums, to use the anesthetizing gels, to do applications with officinal herbs. At deterioration in the general health it is expedient to consult with the pediatrician or the children's stomatologist.
Teething – the stage of development of zubochelyustny system which is characterized by emergence of milk or second teeth in the child. Eruption and change of teeth are natural processes which, on the one hand, are caused by development and growth of an organism of the child, and with another - reflect the level of his somatic health, passport and biological age. The teething occurs in certain terms; at the same time, in course of this process even at healthy children individual deviations can be observed. At the person during life the full cycle of a teething occurs twice: milk (temporary) teeth appear in 6 months – 24-30 months; at the age of 5-14 years they are replaced with second teeth.
Now in children's stomatology the tendency to reduction of terms of development and earlier teething which contacts the general acceleration is observed. An assessment of correctness of course of a teething at the child can be given by children's experts – pediatricians and stomatologists.
Criteria of a physiological teething are certain terms, a certain order and paired relationship (odnovreyomenny emergence of odnoimenyony teeth in the right and left half of a jaw).
At newborns in an oral cavity teeth are absent; the mucous membrane covers edge of an alveolar shoot, the dense roller. Nevertheless, process of laying of teeth begins on the 6-8th week of an embryogenesis. By the time of the birth in each jaw of the child about 10 temporary and 8 constant follicles (rudiments of teeth) which are at a different stage of development and a mineralization already lie. Other rudiments of second teeth are formed in jaws after the birth.
Eruption of milk teeth at children on average begins in a vozrayosta of 6-7 months when formation of a crown of tooth comes to an end and its root begins to develop. The first in an oral cavity the lower central cutters, then (in 8-9 months) – the top central cutters appear. Eruption of the top side cutters happens at the child in 9-11 months; the lower side – in 11-13 months. Further approximately in 1-1,5 years the first top painters (molars), after it - the first lower painters appear. Then canines on the top and lower jaw are consistently cut through (at 16-20 and 17-22 months according to). Eruption of milk teeth comes to the end at the age of 2-2,5 years with appearance of the second lower and top painters.
Thus, the dairy bite at children contains 20 teeth; premolyara in it is mute otsutstyovut. In pediatrics for approximate assessment of number of teeth at the child about one year the formula is used: N - 4, where N – age in months. Teething schedules at normally developing children can be moved up in this or that party: so, at one milk teeth appear at the age of 4 one or 2nd months of years; at others - from 8-10 months to 3,5 years.
Right after eruption milk teeth have porous and rough enamel which contains few minerals. Therefore at non-compliance with due hygienic care of teeth, a diet, dental prevention (sealing of fissures, application of fluorinated medicines, deep fluoration) there is a high risk of development of caries of milk teeth. The enamel hypoplasia can serve as the investigation of a pre-natal underdevelopment of tissues of tooth.
Terms of eruption of second teeth usually coincide with terms of loss of dairy. As a rule, already after loss of temporary tooth in a hole hillocks or a part of a cutting edge of a second tooth are visible. Proreyozyvaniye of second teeth nachinayotsya from the first painters at the age of 5-6 years. Constant central cutters (lower, then top) appear in 6-8 years; behind them, in 8-10 years, there is a change of side cutters. Eruption of canines, the first and second premolyar (small molars) is the share of age of 10-12 years. The last by 13-14 years cut through the second painters. By 17-25 years there are wisdom teeth (sometimes they are not cut through absolutely).
Children's second teeth considerably differ from the adult's teeth on the anatomic features. In particular, in second teeth at children the volume of a cavity of tooth and a pulp much more, and solid fabrics - is less therefore various exogenous factors can easily cause caries and a pulpitis. Therefore it is so important to provide from the very beginning the correct leaving, to regularly pass professional hygiene, processing of teeth fluoric medicines.
The factors influencing teething terms
Terms and features of eruption of zuyob are influenced by hereditary and environmental factors. Among the last the leading role is assigned to the burdened perinatal anamnesis: to beyoremennost toxicoses, Rhesus factor conflict, intra cranial patrimonial trauma, prematurity, infectious diseases of the period of a neonatality, etc.
At such children terms of a teething can be late approximately twice. Later teething is noted also at the children born from mothers with heart diseases who had a herpetic infection, toxoplasmosis, etc. diseases.
The correct formation of zubochelyustny system in many respects depends on development of the child in the first year of life. So, it is noticed that deadlines of eruption of milk teeth are skirted at a congenital hypothyroidism, and time and an order – at rickets. Violations of processes a prorezyvayoniya and changes of teeth can be noted at hypophysis pathology, full refusal of breastfeeding, sepsis of the newborn, frequent ORZ, the postponed pneumonia and so forth. In turn, violation of a teething can lead to formation of the wrong bite at children.
Some scientists note that at firstborns teeth are cut through earlier, than at the subsequent children; at boys is later, than at girls, and at children of young parents – later, than at children pozdnorodyashchy. Cases of the birth of children meet already cut through teeth (more often the central lower cutters). The reasons of a pre-natal teething are unknown, however it is absolutely definitely possible to tell that prematurely appeared teeth are defective on the structure and have the roots which are not created up to the end. Such teeth are subject to removal soon after eruption. Otherwise when sucking they will constantly injure mother's nipple that can lead to development of mastitis. Vnutriutrobno the cut-through teeth are dairy therefore second teeth after their removal will appear only in 6-7 years.
Despite steady opinion that the teething at babies inevitably is followed by "tooth fever" (temperature increase, vomiting, a diarrhea, skin rashes, episodes of spasms), children's stomatologists insist on falsehood of similar representations. Being physiological process, lasting for 2,5 years, the teething cannot and should not be followed by any pathological manifestations.
The most part of the symptoms which are noted during this period is not connected directly with a proyorezyvaniye of teeth, and serves as display of the general infection or violations of food. It is connected with introduction of feedings up, an exception protective a vliyayoniya of maternal milk, deficiency of vitamins and other factors which increase the child's susceptibility to various infections. Often the teething period chronologically coincides with a SARS, sharp intestinal infection, viral stomatitis, quinsy, rhinitis, tonsillitis, otitis, reaction to vaccination or with the advent of a new product in the child's diet.
At the same time, the teething at most of children of chest age is followed by the same manifestations that allows to consider them as symptoms of this state, but not background diseases. Usually harbingers of a teething appear in 3-5 days prior to a tooth top exit from a mucous membrane of a gum and right after it abate. Swelling and reddening of a gum are local signs of fast eruption of tooth. Sometimes in 2-3 weeks prior to eruption of tooth on a gum the hematoma in the form of a small tumor of cyanotic color develops. Usually existence of a hematoma does not demand intervention, however at its increase in sizes the cut mucous and evacuation of contents is carried out. Sometimes eruption of tooth is followed by insignificant bleeding from a gum.
As the investigation of mekhayonichesky irritation of chuvstviyotelny nerves of a gum as the cutting-through teeth serves the so-called "itch" of gums which is expressed that the child begins to pull various objects in a mouth to gnaw and bite them desenny rollers. For the same reason at a teething the strengthened salivation is noted. The plentiful salivation partly is explained by a sitting position, and also insignificant depth of a poyolost of a mouth and inability, new to the child, in time to swallow saliva, that regulating its quantity. Owing to a salivation there can be an irritation and pour to areas of a mouth, chin, cheeks, breasts.
The increase in body temperatures over 37,5 °C which is not connected with other reasons can serve as the general symptoms of a teething; the vomiting caused by swallowing saliva; the cough caused by hit of saliva in airways. At children the sleep can be interrupted, decrease appetite (up to refusal of food), to appear irritability and tearfulness.
The help at a teething
At considerable deviations in teething terms (if by a year the child has no tooth) it is necessary to consult with the children's stomatologist. In this case implementation of the orthopan-tomogram for assessment of a condition of rudiments of teeth and an exception of an edentia will be required.
It is possible to facilitate a condition of the child at a teething, having surrounded the kid with parental care and caress and regularly carrying out simple procedures. For removal of an itch and pain special gels with locally anesthetizing effect which can be rubbed in gums several times in days are used. It is possible to process gums soda solution, broth of a sage, a camomile or bark of an oak. At the expressed pain syndrome use of the anesthetizing medicines is admissible (an ibuprofen, paracetamol, etc.). If the child badly transfers a teething, it is possible to visit in advance the children's homeopathist who will recommend individual homeopathic medicines.
In the period of a teething it is expedient to use so-called teethers for teeth – special toys from soft plastic which the child can gnaw without risk to injure gums. Special massage of a gum the finger which is wrapped up by the gauze moistened in cold water can help the kid.
Care of teeth after eruption
The preventive visit of the child to the stomatologist has to take place soon after eruption of the first teeth or in 1 year during consultation the expert will estimate a structure of the maxillofacial device, a condition of bridles of language and lips, will recommend the correct care of teeth. Further visits of the children's stomatologist have to become regular – 2 times a year for prevention of caries.
It is necessary to clean the first milk teeth 2 times a day by means of a piece of a gauze or a silicone brush on a finger without toothpaste use. Since 1 it is possible to clean a dry toothbrush, and since 2 years – to use children's toothpaste.
Health of second teeth in many respects depends on a condition of dairy. Various damages of temporary teeth can damage rudiments of constants therefore treatment of caries of milk teeth is obligatory. The correct course of process of a mineralization of enamel requires enrichment of a diet products, rich phosphorus, calcium, vitamin C; restriction of the use of sweet.