Teething or "dentition difficilis,"derived from Latin for pathologic dentition or difficult dentition, was considered a deadly disease until the late 19th century. Hippocrates, Homer, Celsus and Aristotle are known to have associated teething with significant morbidity.(1) Hippocrates claimed that children experiencing teething suffered from itching gums, fever, convulsions, diarrhea, vomiting, cholera, tetanus and meningitis. Dr Thrasher, a well known dentist, wrote in Dental Cosmos, "So deadly has teething become that one third of the human family die before 20 deciduous teeth have fully appeared." (2) Infant mortality was extremely high in previous centuries, typically at 6 months to 4 years of age, a time period temporally corresponding to tooth eruption. Thus, it is not surprising that teething was also believed to be the cause of death.

Systemic medicaments have through the ages been used for managing teething, many containing opiates, lead acetate, mercurial and bromide. Ironically, most of these compounds were poisonous and contributed directly to the high morbidity and mortality of teething infants and children. (Table 2) In the 18th and 19th centuries, treatments for teething included purgatives and emetics even if the child presented with vomiting and diarrhea. Topical medicaments included animal milk, butter and a honey/salt mixture. Treatment also involved removal of teeth, hot nails pressed into the gums, and lancing of the gum tissue. Lancing consisted of two incisions given crossing at 90⁰ overlying the 'difficult' tooth and it was supposed to relieve the pressure in ischemic mucous membrane overlying an incipiently erupting tooth in the absence of any anesthesia. (3)

Such remedies are no longer recommended. The complications are disfiguring and deadly. Traditional healers or village elders often use unsterilized equipment, leading to localized and systemic infections. Lancing or tooth removal can cause enamel defects, malformed teeth, and altered mandible size.

But many of these historical misconceptions about teething and the related dangerous remedies persist. In some rural areas, the belief that teething causes diarrhea is common and the gum swelling that precedes tooth eruption is believed to be the cause. These remedies are believed to relieve the pathologic tension on the gums, thereby alleviating diarrhea and vomiting.

Table 2. Historical Teething Remedies no longer used now