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Teething

teeth, child, set, jaw, gum, milk, cut and permanent

TEETHING.

The first set of teeth are called the milk teeth. They have usually all appeared above the gum by the end of the second year of life, or from that to the thirtieth month. The full set consists of twenty teeth, ten in each jaw. The ten are formed of four central incisors, or cutting teeth, one canine or eye tooth at each side of these four, and two molar or grinding teeth at the back on each side. They appear on an average at the following periods:— The first teeth of the lower jaw appear earlier than those of the upper jaw. While the above table gives the average dates, the period varies greatly. Thus the central teeth of the lower jaw may appear as early as the third month, and an interval of some months may then elapse before others are cut. There are cases on re cord of children being born with some teeth, already cut. Ou the other hand, in some cases the teeth are unusually late of appearing, some remarkable cases being on record of children who cut no teeth till some years after birth. As a rule, if the cutting of the teeth is long delayed, it is an indication of some backward ness of development. It may be due to the child not getting food of a proper quality to supply the needed material for tooth forma tion, and the slowness of the growth of the teeth may coincide with slowness and softness of bone formation. Parents in such cases should, consider whether the child is receiving a sufficiently nourishing diet, and especially should be assured that the diet is not too ex clusively of a starchy kind, too much corn-flour, rite, arrow-root, or kindred food, and too little milk, and whether some addition of oat flour, broth, meat, eggs, &c., should not be made to its diet.

The teeth are already in their sockets in the jaw when the child is born. It is their continuing growth that causes them to press upwards on the gum till they cut through it. While the milk-teeth are pushing their way upwards the foundations of the permanent set are already being laid in the jaws, and when, at the age of two years or two and a half years, all the milk-teeth are visible, considerable ad vances have been made in the development of the second set. It is the continued upward growth of the teeth of the permanent set which causes them to press on the roots of those of the milk set. This pressure gradually causes wasting of the roots of the milk-teeth, till, at six years of age, when the first of the per niamcnt set appears above the gum (see pp. 195

and 0.96), little of some of the milk-teeth is left but the crown attached to the gum, and it usu ally drops out as the permanent one pushes up to take its place. But at this time, six years of age, the child has not only the twenty milk teeth, but more deeply in the jaw it has also, already well-developed, twenty -eight of the thirty-two that form the permanent set. At this time, therefore, the child has no less than forty-eight teeth in its jaws.

The period of teething is the time when the advancing teeth are pushing up vigorously under the gum, and when the gum is rendered sensitive and painful by the pressure. The pressure is also irritating to oilier parts, and the excitement carried to the salivary glands (p. 196) by nervous communication causes the constant flow of saliva. The period of teething is, consequently, a time when the child is more than usually irritable and excitable, and more than usually liable to disturbance of various kinds. While this is so, it is too common to blame teething for all sorts of ailments that have little connection with it, and consequently to neglect attending to some of them, or seek ing advice for them, in the hope that when the teeth are cut the ailment will pass away. It is the writer's constant experience that, if the mother or nurse will give a little more than ordinary care to the tending and management of the child, and will watch the condition of the bowels, giving, when it seems necessary, a Mall amount of gently opening medicine, castor oil or magnesia, and plenty of careful exercise and fresh air, the troubles of teething will cease to alarm and annoy. The various ailments apt to arise during teething, and the method of dealing with them, are considered further on in the next section. During the period, the child is much comforted, and the process of cutting aided, by having a clean india-rubber ring to press and chew with its gums. As a rule lancing the gums is to be avoided.

For the preservation of the permanent teeth children should be trained to use a tooth-brush with warm water daily, using also, if need be, a tooth-powder of a fine kind. In order to get the child trained to this habit, it is well to teach it to use a brush, even for the milk teeth. A child of two years and a half is quite capable of being trained to a cleanly habit of this sort, and looks upon it as an amusement rather than as an irksome task.