Fever from Primary Tooth Eruption – What is the evidence?

  • Sara Matos General and Family Practice, Unidade de Saúde Familiar Navegantes, Agrupamento de Centros de Saúde Grande Porto IV
  • Patrícia Silva General and Family Practice, Unidade de Saúde Familiar Navegantes, Agrupamento de Centros de Saúde Grande Porto IV
Keywords: Dental eruption, Fever, Infant

Abstract

Introduction: There is no consensus on the causal relationship between primary dental eruption and both systemic and local signs and symptoms. Fever, an important sign, is often reported. Such lack of evidence hampers clinical reasoning and may contribute to delayed diagnosis of important conditions.
Objective: To review existing evidence underlying the association between primary tooth eruption and fever.
Methods: A review of the evidence on English, Portuguese and Spanish scientific publications over the last ten years was performed in the main international databases using the query “tooth eruption” and “fever” [MeSH], and in the index of Portuguese medical journals using the query “erupção dentária” and “febre” [DeCS]. SORT system of the American Family Physician was used for rating the strength of evidence.
Results: A total of 53 articles were retrieved, from which two meta-analyses and two original studies were selected, comprising a total of 5317 children. Massignan et al. (2016) meta-analysis and Memarpour et al. (2015) clinical trial found a slight temperature increase on the day of primary tooth eruption, but no fever. In Nemezio et al. (2017) meta-analysis, this association was observed in the subgroup that used the rectal method for temperature assessment. Un Lam et al. (2016) observational study reported a fever prevalence of 49.9%.
Discussion and conclusions: The present analysis had several limitations, including a significant heterogeneity amongst studies in the definition of fever, interpersonal variability during fever measurements, different fever assessment methods or absence of that information, and no exclusion of confounding factors. Given available evidence, it is not possible to establish a clear association between primary dental eruption and the occurrence of fever. A higher number of robust studies is required to confirm this hypothesis (SORT B).

References

Olabu BO, Okoro DO, Thigiti JM, Oramisi VA. Impact of socio-cultural practice of infant/young child gum lancing during teething. J Clin Pediatr Dent [Internet]. 2013 [cited 2018 Feb 10];37(4):355–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24046981

Memarpour M, Soltanimehr E, Eskandarian T. Signs and symptoms associated with primary tooth eruption: a clinical trial of nonpharmacological remedies. BMC Oral Health [Internet]. 2015 Dec 28 [cited 2018 Feb 10];15(1):88. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26215351

Haznedaroglu E, Mentes A. The Internet versus pediatricians as a source of infant teething information for parents in Turkey. Clinics. 2016. p. 430–4.

Massignan C, Cardoso M, Porporatti AL, Aydinoz S, Canto GDL, Mezzomo LAM, et al. Signs and Symptoms of Primary Tooth Eruption: A Meta-analysis. Pediatrics [Internet]. 2016 Mar 1 [cited 2018 Feb 10];137(3):e20153501–e20153501. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26908659

Kiran K, Swati T, Kamala BK, Jaiswal D. Prevalence of systemic and local disturbances in infants during primary teeth eruption: a clinical study. Eur J Paediatr Dent [Internet]. 2011 Dec [cited 2018 Feb 10];12(4):249–52. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22185250

Un Lam C, Hsu C-YS, Yee R, Koh D, Lee YS, Chong MF-F, et al. Early-life factors affect risk of pain and fever in infants during teething periods. Clin Oral Investig [Internet]. 2016 Nov 23 [cited 2018 Feb 10];20(8):1861–70. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26592811

Ramos-Jorge J, Pordeus IA, Ramos-Jorge ML, Paiva SM. Prospective Longitudinal Study of Signs and Symptoms Associated With Primary Tooth Eruption. Pediatrics [Internet]. 2011 Aug 8 [cited 2018 Feb 10];128(3):471–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21824888

Feldens CA, Faraco IMJ, Ottoni AB, Feldens EG, Vítolo MR. Teething symptoms in the first year of life and associated factors: a cohort study. J Clin Pediatr Dent [Internet]. 2010 [cited 2018 Feb 10];34(3):201–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20578655

Nemezio MA, Oliveira KM De, Romualdo PC, Queiroz AM, Paula-e-Silva FW, Silva RA, et al. Association between Fever and Primary Tooth Eruption: A Systematic Review and Meta-analysis. Marwah N, editor. Int J Clin Pediatr Dent [Internet]. 2017 [cited 2018 Feb 10];10(3):293–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/29104392

Zhen C, Xia Z, Ya Jun Z, Long L, Jian S, Gui Ju C, et al. Accuracy of Infrared Tympanic Thermometry Used in the Diagnosis of Fever in Children. Clin Pediatr (Phila) [Internet]. SAGE PublicationsSage CA: Los Angeles, CA; 2015 Feb 6 [cited 2018 Feb 10];54(2):114–26. Available from: http://journals.sagepub.com/doi/10.1177/0009922814545492

Published
2018-12-28
Section
Review Articles