Teething: the movement of a tooth through the gums, whereby the root grows as the tooth moves into place.
Big picture
Baby teeth:
Whether it is baby teeth coming into the mouth, or adult teeth replacing baby teeth, the process of eruption can be very painful. Get the baby Tylenol® ready, because the screaming and crying is a response to the actual perception of tissue destruction. Before the teeth pierce the gingiva, they apply pressure to the tissue, which causes redness and soreness of the gums. The desire to chew sharp objects is your child's natural response to help "cut their teeth." What they are actually cutting is the thick inflamed gingival tissue.
Adult teeth:
Adults who start having this pain frequently come to the office for emergency visits. Wait!!! Adults have teeth coming in. Anywhere from ~18-28-yrs-old is about the time that wisdom teeth like to start coming in. This frequently causes severe pain, especially since there is frequently not enough room for them and they like to try and erupt into impossible positions putting all the adjacent teeth and tissues in pain.
More Specifically
Baby teeth:
I really feel for my baby. She is one. Last night she really let me have it because she is having severe teething pain. So, I gave her a frozen plastic ring with small poking parts on it designed for the specific purpose of helping with this discomfort. After about a half hour of chewing on this and a weight appropriate microdose of baby Advil (1 tsp), she was finally able to relax and fall back asleep.
Adult teeth:
I sometimes see adults come in with similar amounts of pain as it relates to their partially-erupted soft-tissue impacted wisdom teeth (also called: 3rd molars). What is frequently problematic about these partially-erupted wisdom teeth is that they cannot come in all the way because they are blocked out (impacted) due to their position as it relates to their 2nd molars, and a tissue flap sits over 90% of the top of the tooth and often a bit of bone as well. Why does this matter? Food packs into this uncleanseable space and then it sits their in the presence of oral bacteria and it ferments and becomes infected (fancy term: Pericoronitis). Then, the patient presents with pain, purulent drainage, and needs emergency care of their wisdom teeth.
A Diagnostic Plan
Baby teeth:
Plan on giving your baby or child appropriate medication and tools to help with normal eruption. One rule of thumb to see if things are moving in the right direction - teeth should come in sets of two, parallel as in a mirror image from the midline of the central teeth.
Adult teeth:
You may be a person who thinks, "Oh, no not me." "My wisdom teeth are not a problem." "I have lots of space for them to come in." Let me give you a dentist's perspective on this attitude. Even if you have room for them, you will not heal as easily when they have to be extracted in your old age. Let's assume you live to a ripe old age of 80 and your dexterity is still good - even these people tend to miss their wisdom teeth when brushing and flossing. Wisdom teeth are wont to get cavities and periodontal disease. Planning to have them removed before they become a serious problem is still a prudent choice, for the person who wants to avoid the pain and problems that you can expect with wisdom teeth.
