Attributing a pediatric fever to teething

In this column, Cecil discusses teething-associated fever in response to a parent apparently told the only cause found for a temp of 103.4F was “teething.”

Since it’s unlikely a competent ED physician would attribute a fever to this, it’s more likely the patient was told the only abnormality found was teething–not that teething was the cause. It is common for babies to have high fevers without an immediately apparent cause. When they do the presumptive cause is an unidentified infection.

I’ve known MDs, especially both the newbie and ol’-fashion kind, and I’m going with Cecil on this one. The “competent ED physician” you describe has, over the past few decades, been in the minority. Especially in the early years, and you are free to note how this reflects on the SDMB old farts like the ones I know, as we have already. :frowning:

I heard a house-call (remember them? no?) MD making that call. In another thread on another board, back in the day not nearly long ago enough, [del]engineering[/del] MD training was as much an apprenticeship as a formal education. Even see the show, “Scrubs.” Apparently there is still a lot to it. :rolleyes:

Is this belief that teeting causes a fever common in the english-speaking world, or did Cecil not want to cite foreign-language sources? Because his quotes are UK, US and Australia.

I’m not a parent, but I’ve never heard this belief (myth?) in parenting tips or anecdotes in Germany. Only that babies can have very high fevers very quickly, so parents shouldn’t totally panic, only worry a lot. :slight_smile: (It’s still not very healthy for the brain if the temp. goes over 41 C).

I’m a little unclear on the summary opinion you are expressing here.

If it’s that medical training can be a bit lacking, you’ll get no argument from me, but one of the difficult issues has been trying to open up the medical profession to a selection of candidates beyond those simply able to score well on tests. Unfortunately, popular opinion on this board to the contrary, those tests do correlate with the ability to assimilate and evaluate actual facts relevant to practice as opposed to a pure apprentice-ship type model.

The Pedant is double-boarded in Internal Medicine and Emergency Medicine, scoring 95% on his most recent Emergency Medicine Re-Certification last year. This is actually a pretty damn high score considering there is at least 5% of the test material with which I genuinely disagree. So I am assuming you are not painting all elderly ED physicians with the same “ol’ fart” brush. A few of us have a brain left, and to the point of the topic at hand, my experience tells me in this situation a patient insisting on an explanation when the correct explanation is “fever, cause unknown; probably benign infection of undetermined etiology” is likely to over-hear what the doctor said.

But hey, maybe the patient really did run into a stupid and lazy physician who got into a crummy medical school on some sort of alternative track.

Yeah, I was debating starting a thread to say the same thing when I saw someone already had.

My pediatrician has told me that 103.4 isn’t really a big deal in young kids. We took our girl to the doctor with that, and had her tested for infection. Nothing was found. She said there really isn’t a problem with high fevers in children. Give some Tylenol if it makes them feel better, but otherwise don’t worry.

I agree with the OP. Cecil’s take on his correspondent is not near sceptical enough. Read the first two sentences. This isn’t someone asking if babies get fevers from teething. This is someone who “knows” they do, and is asking Cecil why the medical profession is lying to cover it up.

We are talking about someone who verges on anti-vax style “conspiracy theory” BS thinking.

Given that background, I’d say it is not only possible but positively likely that the doctor in question merely said yes the baby was teething and no they didn’t know why the baby had a fever. The parent has then quite likely put two and two together and made about twenty. And/or the parent has then pressed the MD to confirm the former must be causing the latter and the MD has seen the futility of arguing with a True Believer and given some non-committal answer which the parent (in True Believer style) has taken as a considered opinion. Wouldn’t be hard to imagine that happening in an ER context where the Dr just wants to get onto the next patient.

I wish your pediatrician would say something to my day care center then as any fever over 99.5 is out for the next 24 hours.

As for the subject, I’ve always thought, for the last 4 years, that teething did cause a fever. For both kids it seemed that when the tooth had broken through they had a high temp. I’ll have to look in the books we have and see if they actually say it or not.

That’s just to prevent spreading infection. It’s a bit overzealous since 99.5 is such a mild fever, but it’s understandable. My pediatrician didn’t say that 103.4 happened without an infection. She just said it wasn’t ER time. In fact, we didn’t absolutely have to see a doctor at all.

As was said in the column, though not directly, the fever reading on the oral thermometer is due to gum inflammation, which can raise the mouth’s temperature. The mouth was the most common orifice in which to take the temperature. Also, many parents do not know that a temperature taken rectally will normally be about 1 degree higher than one taken orally. This is the second most common orifice for taking infant temperatures, particularly if they are fussy. With the appearance of reliable and accurate home ear thermometers, this myth may finally start losing credibility.

Hmmm. I’ve been told by midwives, and have very recently read in childcare books, that (mild) fever and diarrhea are common side effects of teething (the latter being caused by swallowing excessive saliva which is itself caused by the irritated gums). I feel so used.

The littl’un (still popping out teeth at 19 months) did have a few more serious fever spikes but this was separate from the teething issues and was generally described as “just a baby thing”, treated with children’s paracetamol or ibuprofen.

nitpick: it’s only one data point.

103.4 swillin’ gatorade and playing nintendo doesn’t get my attention.

100.3 floppy with dry mucus membranes and hasn’t peed in 12 hours, does.

I agree ... but this is a slight overgeneralization, fevers in young children are more case specific. Are there other symptoms? What is their medical history? How long has the fever endured?

There are some risks to not seeking medical attention for high fever or a sudden spike in body temperature such as incontinence/loss of bowel control, vomitting, dehydration, loss of consciousness, or even febrile seizures.
There’s no need to rush to the ER for every fever but you should consider all the facts and that you may have to go in some circumstances.

Exactly!

ETA: The doctors here recommend Advil for children’s fever, presumably because it lasts longer.