SYSTEMIC MANIFESTATIONS OF TEETHING SYNDROME IN INFANTS AND TODDLERS: DIAGNOSTIC CHALLENGES AND MANAGEMENT TACTICS

Teething is a normal developmental process in infancy, yet parents and clinicians frequently attribute a wide range of systemic symptoms to it, including fever, diarrhea, irritability, sleep disturbance and poor feeding. This article reviews the current evidence on the systemic manifestations of tooth eruption in infants and toddlers and examines the diagnostic difficulties that arise when a febrile or systemically unwell child is assumed to be teething. The review shows that local signs of eruption, such as gum swelling, drooling and biting, are common, while the evidence for a true fever or gastrointestinal illness caused by teething is weak. Attributing a significant illness to teething can delay the diagnosis of infection. The article also considers management, including non-pharmacological measures and the safety concerns raised about benzocaine-containing oral products. On this basis, a practical diagnostic approach is proposed: teething is considered a diagnosis of exclusion when fever or systemic symptoms are present, and the clinician should look for another cause before accepting teething as the explanation.