The mothers’ experience of their infants’ teething at three different settings in Uganda and South Africa.

Abstract

‘Teething’ – a common subject of discussion among nursing mothers has been held responsible for a variety of childhood ailments by both health professionals and parents. It appears to be a social construct coined by society to express the experience the child goes through during the early days of childhood. Teething to the dental profession is the biological expression of tooth movement, in a predominantly axial direction, from the tooth’s developmental position within the jaws to its emergence in the oral cavity. Several studies have reported both health professionals and parents to attribute local and systemic disturbances to the eruption of the primary dentition. The mothers’ experience and understanding of teething have not been reported on. Objectives; To determine what mothers understood by the term teething. To establish the signs and symptoms mothers associate with teething. To ascertain the treatment sought by mothers for their child’s teething. To investigate how mothers in different settings (Uganda and South Africa) understand and respond to teething. Methods; Using a face-to-face approach, interviews with 375 mothers attending well-baby clinics at Mulago Hospital, Uganda, East Ridge Baby Clinic, Mitchells Plain, South Africa and Gugulethu Day Hospital, South Africa with children ages 6 -30months with atleast one primary tooth in the mouth were carried out. Following consent to take part in the study one hundred and twenty five mothers at each of the clinics at the three sites were interviewed. Information regarding the mothers’ understanding of and source of knowledge of teething, their ascribed signs and symptoms to teething, experience and response of their own child’s discomfort was gathered. All interviews were conducted by a calibrated researcher (AK). Results; The mothers’ understanding of teething differed significantly between the studied sites (p<0.0001). There was a significant difference when the two Cape Town groups were compared (p<0.0001). When responses of respondents from Kampala were compared with those of the mothers in Mitchells Plain (excluding Gugulethu) the results were not statistically significant at the 0.01 level (p=0.027), however a comparison of responses from Kampala and those from Gugulethu (excluding Mitchells Plain) produced a statistically significant value (p<0.0001). A large proportion of the interviewed mothers were affected by the eruption of own child’s primary dentition (p<0.0001). Over 66% of the respondents associated erroneous signs and symptoms to the eruption of own child’s primary dentition. A large proportion of the respondents attested to having received information about teething from relatives, friends, neighbours or from elders. Only 22 (5.9%) out of the 375 respondents claimed to have received information about teething from a health worker. None of the respondents claimed to have consulted a dentist. In response to their child’s discomfort, a higher proportion of respondents preferred seeing a health care provider than using other means. Conclusion; The findings of this study revealed an understanding of teething by mothers to be marred by several traditional beliefs and practices and to differ from that of health professionals. Mothers at the three different settings were found to associate teething with several signs and symptoms. There was a difference in associated signs and symptoms from site to site. Some of the associated signs and symptoms such as diarrhoea and chest infection were reported proportional to the burden of disease at the given sites. The fact that mothers were found to erroneously blame the erupting primary dentition for different signs and symptoms calls for efforts to educate mothers on what teething is and is not. The results point to a need for further studies targeting an in-depth knowledge of the mothers’ understanding of teething. This would stamp out harmful practices associated with the teething process in young children in some societies and cultures.