Is teething associated with diarrhea?

The common perception among dentists is that teething in babies and children may be accompanied by increased drooling, a slight rise in temperature, and perhaps increased irritability, but these symptoms are relatively minor. Teething and diarrhea are not usually associated. The article by Graham and colleagues reminds us that although this relatively benign view of teething-related discomfort is held by much of the western world, other cultures may hold very different views.

As the authors mention, lancing the gums overlying erupting primary teeth was a common procedure in Europe and the United States in the late 19th an dearly 20th centuries. They discuss a variation on this practice in which lancing and possible tooth extraction are limited to the area of the primary canines. Perhaps some cultures perceive the eruption of the canines to cause more symptoms than the eruption of other teeth. The practice of lancing thegums overlying the primary canines or extracting the unerupted teeth is certainly of concern. These practices can lead to altered esthetics and spacing in the permanent dentition, as well as trauma to the infant. As the authors indicate, the use of nonsterile techniques may cause increased morbidity and even mortality.

The fact that some women believe that their child's diarrhea is due to tooth eruption is of concern to primary care professionals. In studies conducted inFlorida¹ and in western Africa,²parents tended to view the diarrhea as less serious when they thought it was due to teething. But children with “teething diarrhea” are just as likely to develop dehydration as children with nonteething diarrhea. Primary care providers should be aware of these various beliefs regarding the relationship between infant diarrhea and teething. They should educate parents to recognize early signs of dehydration and should discourage the belief thatteething causes diarrhea.