When do babies start teething. Why is fluoride important for children’s dental health. How can fluoride prevent tooth decay. What are the recommended fluoride practices for different age groups. Is fluoridated water safe for children. How to ensure proper fluoride intake in non-fluoridated areas. What parents should know about fluoride varnish and infant formula.

The Importance of Fluoride in Children’s Dental Health

Fluoride plays a crucial role in maintaining and improving children’s oral health. This natural mineral has the remarkable ability to prevent tooth decay and strengthen tooth enamel. But how exactly does it work, and why is it so important for children?

Fluoride acts as a protective shield against cavity-causing bacteria. When these bacteria combine with sugars in the mouth, they produce acid that can erode tooth enamel. Fluoride steps in to:

• Slow down or halt cavity formation
• Protect teeth from acid damage
• Aid in rebuilding weakened enamel

Many communities have recognized the benefits of fluoride and have added it to their public water supply. This proactive measure has shown significant results, with community water fluoridation reducing tooth decay by an impressive 25%.

When Do Babies Start Teething and How Does Fluoride Come into Play?

The emergence of a baby’s first tooth is an exciting milestone for parents. But when does this typically occur? Most infants will get their first primary teeth around 6 months of age, although some may see tiny teeth emerge as early as 3 months.

It’s crucial to understand that as soon as these teeth appear, they are susceptible to cavities. This is where fluoride becomes invaluable. The American Academy of Pediatrics (AAP) recommends introducing fluoride toothpaste as soon as the first tooth emerges. But how much should you use?

• For children under 3 years: Use a “smear” of fluoride toothpaste twice daily
• For children 3 years and older: Use a pea-sized amount of fluoride toothpaste twice daily

Fluoridated Water: Safety and Benefits for Children

Parents often wonder about the safety of fluoridated water for their children. Can children safely consume fluoridated water? The answer is a resounding yes. Leading health organizations, including the American Academy of Pediatrics, the American Dental Association, and the Centers for Disease Control and Prevention, all agree that water fluoridation is both safe and effective in preventing tooth decay.

The benefits of fluoridated water extend beyond just drinking. It can also be used safely for:

• Preparing infant formula
• Cooking meals
• Brushing teeth

What if Your Community Doesn’t Have Fluoridated Water?

If you live in an area without fluoridated water or rely on well water, don’t worry. There are alternative ways to ensure your child receives adequate fluoride:

1. Consult your pediatrician or dentist to assess your child’s cavity risk
2. Consider purchasing fluoridated water
3. Ask about fluoride drops or tablets if recommended by a healthcare professional

Fluoride Varnish: A Powerful Tool in Cavity Prevention

Fluoride varnish is another effective method to prevent or slow down tooth decay in children. But what exactly is it, and how is it applied?

Fluoride varnish is a concentrated form of fluoride that is professionally applied to children’s teeth. The process is quick, painless, and highly effective:

• The varnish is painted on the top and sides of each tooth
• It hardens quickly upon application
• The varnish is brushed off after 4 to 12 hours

The AAP recommends fluoride varnish applications starting at 6 months of age during well-child visits. For optimal protection, children should receive varnish applications 2 to 4 times per year until they reach 5 years of age.

Fluoride and Infant Feeding: What Parents Need to Know

When it comes to fluoride intake for infants, there are some specific considerations for both breastfeeding mothers and those using infant formula. What should parents keep in mind?

For infants younger than 6 months:

• Breastfed babies do not need fluoride supplements
• Babies fed infant formula do not need fluoride supplements
• It’s safe to use fluoridated water to mix formula, but there’s a small risk of fluorosis

If you prefer to avoid fluoridated water when mixing formula before your baby’s first tooth appears, consider these alternatives:

• Use low-fluoride bottled water labeled as de-ionized, purified, demineralized, or distilled
• Use ready-to-feed formula, which contains minimal fluoride

Understanding Dental Fluorosis: Causes and Concerns

Dental fluorosis is a condition that can occur when developing teeth are exposed to excessive fluoride. But what does it look like, and should parents be concerned?

Characteristics of dental fluorosis:

• Appears as very faint white streaks on the teeth
• Often only noticeable by a dental expert during an exam
• Mild fluorosis is not painful and doesn’t affect tooth function or health

While using fluoridated water to prepare infant formula might slightly increase the risk of dental fluorosis, most cases are mild and do not cause any health concerns. It’s important to note that once a child’s adult teeth come in (usually around age 8), the risk of developing fluorosis is over.

Optimal Fluoride Practices for Different Age Groups

As children grow, their fluoride needs and recommended practices change. How should parents adapt their approach to fluoride use as their children age?

Infants (0-6 months)

• No need for fluoride supplements
• Can safely use fluoridated water for formula, but alternatives are available if preferred

Babies and Toddlers (6 months – 3 years)

• Start using a “smear” of fluoride toothpaste twice daily when first tooth appears
• Begin fluoride varnish applications at 6 months, continuing 2-4 times per year

Preschoolers (3-5 years)

• Increase to a pea-sized amount of fluoride toothpaste twice daily
• Continue fluoride varnish applications until age 5

School-Age Children and Beyond

• Continue using fluoride toothpaste twice daily
• Drink fluoridated water if available
• Consider additional fluoride treatments if recommended by a dentist

Debunking Common Myths About Fluoride Use in Children

Despite the proven benefits of fluoride, some misconceptions persist. Let’s address some common myths and provide accurate information:

Myth: Fluoride is not natural and is harmful to children

Truth: Fluoride is a naturally occurring mineral found in water sources. When used as recommended, it is safe and beneficial for children’s dental health.

Myth: Fluoride only benefits children while their teeth are developing

Truth: While fluoride is crucial during tooth development, it continues to protect teeth against decay throughout life.

Myth: Using fluoride toothpaste is enough; fluoridated water is unnecessary

Truth: Both fluoride toothpaste and fluoridated water play important roles in cavity prevention. The combination of both provides optimal protection.

Myth: Fluoride treatments are painful for children

Truth: Fluoride treatments, including varnish applications, are quick and painless. They can easily be incorporated into routine dental check-ups.

By understanding the facts about fluoride use, parents can make informed decisions to protect their children’s oral health.

The Role of Diet and Hygiene in Complementing Fluoride Benefits

While fluoride is a powerful tool in preventing tooth decay, it works best when combined with good oral hygiene practices and a healthy diet. How can parents optimize their children’s dental health beyond fluoride use?

Dietary Considerations

• Limit sugary snacks and drinks
• Encourage consumption of calcium-rich foods for strong teeth
• Promote water as the primary beverage
• Avoid putting babies to bed with bottles containing anything other than water

Oral Hygiene Practices

• Start cleaning gums before teeth emerge
• Teach proper brushing techniques as soon as teeth appear
• Introduce flossing when two teeth touch
• Schedule regular dental check-ups starting at age 1 or within 6 months of the first tooth’s appearance

By combining these practices with appropriate fluoride use, parents can significantly reduce their children’s risk of tooth decay and promote lifelong oral health.

The Future of Fluoride Research and Children’s Dental Health

As dental health research continues to evolve, what new developments might we see in fluoride use and cavity prevention for children? While current recommendations are based on extensive research and proven benefits, ongoing studies are exploring potential advancements:

Personalized Fluoride Treatments

Future research may lead to more tailored fluoride recommendations based on individual risk factors, genetic predisposition to cavities, and local water fluoride levels.

Alternative Delivery Methods

Scientists are exploring new ways to deliver fluoride, such as slow-release devices or combination treatments with other beneficial minerals.

Long-term Health Impact Studies

Continued research will provide even more data on the long-term effects of fluoride use, further informing public health policies and individual recommendations.

Integration with Overall Health Monitoring

Future approaches may more closely link dental health monitoring, including fluoride intake, with overall health assessments to provide comprehensive care from infancy through adulthood.

As research progresses, parents can expect even more refined and effective strategies to protect their children’s teeth using fluoride and other innovative approaches.

Fluoride for Children: FAQs – HealthyChildren.org

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​Fluoride from drinking
water and other sources like toothpaste and mouth rinse can help prevent
tooth decay (dental caries for cavities) and make your child’s teeth stronger.

Here are some common questions parents ask about how fluoride helps protect children’s oral health.

Q: Why do children need fluoride?​

A: Fluoride is a natural mineral that can slow or stop cavities from forming. Bacteria in the mouth combine with sugars and make acid that can harm the outer layer of the tooth (enamel). Fluoride protects teeth from damage and helps rebuild the enamel. Many communities have added fluoride to the tap water to help fight cavities. Children should drink plenty of water and brush with toothpaste that has fluoride in it.

Q: Is fluoridated water safe for my children?

A: Yes. The American Academy of Pediatrics (AAP), the American Dental Association, and the Centers for Disease Control and Prevention agree that
water fluoridation is safe and works to
prevent tooth decay. Community water fluoridation has been shown to reduce tooth decay by 25%.

Q: When should my child start using fluoride toothpaste?

A: The AAP recommends using a “smear” of fluoride toothpaste twice a day when the first tooth appears and until age 3. Once your child has turned 3, a pea-sized amount of fluoride toothpaste can be used.

Q: What if we live in a community where the water is not fluoridated? What can we do?

A: Check with your local water utility agency to
find out if your water has fluoride in it. If it doesn’t or you have well water, ask your pediatrician or dentist if your child is at high risk for cavities. The doctor may recommend you buy fluoridated water or give you a prescription for fluoride drops or tablets for your child.

Q: Should my child get fluoride varnish?

A: Yes.
Fluoride varnish is used to help prevent or slow down tooth decay. Your pediatrician will apply the varnish starting when your baby is 6 months old at
well-child visits. It is painted on the top and sides of each tooth and hardens quickly. Then, it is brushed off after 4 to 12 hours. It is recommended that children have varnish applied 2 to 4 times per year until they are 5 years old.

Q: What should I know about fluoride if I am breastfeeding or using infant formula?

A: When they are younger than 6 months old,
breastfed babies and babies fed infant formula do not need fluoride supplements or formula mixed with water than is fluoridated. It is safe to use fluoridated water to
mix the formula if your baby is younger than 6 months old, but there is a small risk of “fluorosis.” (See more details, below.) Ask your pediatrician or
dentist if you need more advice.

If you prefer not to use fluoridated water with formula before your baby’s first tooth emerges, you can:

Q: What is dental fluorosis, and will fluoridated water mixed with infant formula increase the risk?

A: Fluorosis usually appears as very faint white streaks on the teeth. Often it is only noticeable by a dental expert during an exam. Mild fluorosis is not painful and does not affect the function or health of the teeth.

Although using fluoridated water to prepare infant formula might increase the risk of dental fluorosis, most cases are mild.

Once your child’s adult teeth come in (usually around age 8), the risk of developing fluorosis is over.

More Information

• 
  Good Oral Health Starts Early​
• 
  Fluoride a Powerful Tooth to Prevent Tooth Decay​

Last Updated

11/30/2020

Source

American Academy of Pediatrics (Copyright © 2020)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Why It’s Important to Take Care of Baby Teeth

​By:
Patricia Braun, MD, MPH, FAAP

Seeing your baby’s
first tooth is an exciting milestone! Most little ones will get their first (primary) teeth around 6 months of age, though tiny teeth can emerge as early as 3 months.

Did you know that cavities can develop as soon as your baby has teeth? Since baby teeth will eventually fall out, it might not seem all that important to take good care of them. But as it turns out, your child’s first teeth are essential to the health of their permanent teeth—and the foundation for lifelong health.

These are just some of the reasons to take extra-good care of your child’s first (primary) teeth. Read on to learn more.

How do cavities develop in baby teeth?

Cavities can form when the shiny surface of our teeth—the
enamel—is harmed by common bacteria living in our mouths. The bacteria feed on sugary substances left behind from what we eat and drink. In the process, they create acids that attack tooth enamel, opening the door for tooth decay to start.

Even the natural sugars in breast milk and formula can kick-start the process of tooth decay. And even though primary teeth start falling out when kids are around 6 years old, what happens before then will influence your child’s dental health over the long term. Research shows that diet and dental hygiene habits during a child’s infant and toddler years reduces the risk of tooth decay as they become older.

Why it’s crucial to take good care of baby teeth

Even though we’ve made great strides in preventing tooth decay, it is the most common chronic health problem seen in children. In fact, 23% of all kids will get cavities before their 5th birthday. Consider that:

• Decayed baby teeth may need to be taken out by the dentist, which can be painful and frightening for your child (and costly for your family).

• Missing baby teeth leave gaps, causing nearby teeth to shift around. This can keep your child’s permanent teeth from coming in correctly, which might mean braces later on.

• Kids (and adults) need healthy teeth to speak clearly and chew their food thoroughly, the first step in healthy digestion. A bright, shining smile gives a child confidence, too—an essential part of making friends, getting along in school and enjoying life.

9 everyday steps for keeping your child’s teeth healthy

Here are steps recommended by the American Academy of Pediatrics (AAP) for preventing cavities in babies and young children.

• 
  No bottles in bed. Putting your child to sleep with a bottle allows the sugars found in formula and breast milk to linger on teeth, setting the stage for tooth decay. (In fact, many doctors and dentists refer to early cavities as
  baby bottle tooth decay).

• 
  Handle pacifiers, spoons and cups with care. Tooth decay-causing bacteria can easily move from mouth to mouth. So, for example, you should avoid putting a pacifier in your mouth and then giving it to your child, or tasting your baby’s food before offering them a bite from the same spoon.

• 
  Cleanse little mouths after each meal. Even before your infant’s first teeth break through, it is important to get into a healthy routine. Wipe the gums with a clean, damp washcloth or gauze pad after each feeding. When baby teeth come in, switch to a soft-bristled toothbrush with a smear (about the size of a grain of rice) of fluoride toothpaste. Around your child’s first birthday, create a healthy routine of brushing 2 times daily for 2 minutes each time. Consider setting up a bedtime routine of brushing your child’s teeth after their last feed, reading them a book and then getting them to bed at a regular bedtime—brush, book, bed.

Studies suggest that breastfeeding during a child’s first year can help reduce the risk of tooth decay by half. This may be because of other effects breast milk has the immune system or
microbiome (the balance of good and bad bacteria). Still, whether you give your baby breast milk or formula, you should wipe their gums and any erupting teeth after feedings to minimize risk of decay.

• 
  Introduce a cup around your child’s first birthday. Teaching young ones to drink from a cup can help prevent tooth decay. Plan to begin moving your child from the breast or bottle to a lidded cup around 12 months. Milk, breast milk and formula can be given at mealtimes, but fill your child’s cup with plain water in between.

• 
  Avoid using cups or bottles to soothe your child. When little ones get fussy, it’s tempting to offer them a little formula or milk, but this exposes little teeth to sugars for long periods. Use a regular pacifier to calm your child, but be sure not to dip it in honey or any other sweetener.

• 
  Skip the sugary drinks. Fruit juice, soda and sweetened drinks aren’t good for your little one’s teeth. In fact, the AAP does not recommend juice for babies under 12 months. After that, limit juices to 4 ounces per day and mix them with water (half-water, half-juice is best). See “Recommended Drinks for Children Age 5 & Younger.”)

• 
  Limit sticky fruits and treats. Some foods can cling to a child’s teeth, giving bad-guy bacteria plenty of sugar to feast on. Sticky foods that promote tooth decay include raisins and other dried fruits, gummy candies, taffy, fruit roll-ups and snack bars with honey or molasses. Try to limit these foods in your child’s diet and have kids brush or rinse with plain water after eating them.

• 
  Make water the family drink of choice. Regular tap water, which usually contains fluoride to strengthen tooth enamel, is the healthiest drink for your child’s teeth. Drinking plenty of water cleanses your child’s mouth and helps maintain saliva flow, which also washes away decay-causing bacteria.

• 
  Learn more about fluoride. Decades of studies have shown that fluoride is
  a superhero in fighting tooth decay. Most kids get the fluoride they need from tap water and toothpaste that delivers fluoride. Your pediatrician or dentist may also apply a fluoride varnish to your child’s teeth, a helpful step 2-4 times a year that can continue as your child grows.

Not sure if your local water supply has fluoride? Use this
online map to find out. If you’re wondering about fluoride safety, read what a
dentist who’s also a mom has to say.

When should I take my child to the dentist?

When your baby’s first tooth appears, it’s time to schedule their first dental visit. This is the ideal time to learn more about dental care for kids and what you’ll need to do as they grow.

Over time, your dentist can help you set up a healthy family routine, explaining everything from how to
teach little hands to brush and floss to fitting young athletes with the right
mouthguard.

The role your pediatrician plays

Since babies see the doctor several times before their first birthday, pediatricians have the opportunity to check inside little mouths. It can be difficult to spot warning signs in baby teeth, so your pediatrician’s expert eye is especially helpful.

As your child grows, your pediatrician will offer tips and suggestions that support the expert care your family dentist will provide. They can also apply fluoride varnish to your child’s teeth in partnership with your child’s dentist. In addition, In addition, pediatricians can help parents learn more about special risks that make some children more cavity-prone. For example, preemies often have weaker tooth enamel than babies born at full term. Certain health conditions and medicines can reduce saliva flow, making brushing and flossing even more important.

Making cavity prevention a family priority

Kids learn from the adults around them. That’s why parents and caregivers should take excellent care of their own teeth. As one dentist puts it: “Bad teeth don’t necessarily run in the family, but bad dental habits do.”

Set a positive example by letting little ones watch while you brush and floss. Explain that this is something we do twice a day, morning and night, even when we’re away from home. Mark dental appointments on the family calendar, which shows kids that regular checkups are a top priority. Some children benefit from going to the dentist more than every 6 months to help them avoid getting cavities or keep cavities that have already started from getting worse.

Encourage good habits by adding fun to your child’s routine. Toddlers and preschoolers may enjoy
brushing to music or marking their progress on a tooth care
calendar. The American Dental Association offers free
coloring and craft sheets you can download and share, too.

Remember

Healthy baby teeth set the stage for a lifetime of good dental health. Teeth play a crucial role in helping us speak clearly, smile confidently and chew our food thoroughly, which nourishes our bodies for overall good health.

Setting a good example helps prevent tooth decay now and in the future.

Along with your family dentist, your pediatrician plays a key role in caring for your child’s mouth and teeth.

More information

• 
  Good Oral Health Starts Early: AAP Policy Explained
• 
  Baby’s First Tooth: 7 Facts Parents Should Know

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Graph of teething in children, signs of teething in infants

The birth of the first child is associated with a lot of unknown for young parents, so many new things await them ahead. Of course, parents are worried about the baby growing and developing properly. Gradually, the baby goes through important stages: he begins to smile, roll over from his back to his side, sleep without waking up all night. Another significant event that parents are looking forward to is the appearance of the first tooth. Parents are concerned about the question: “When do children start teething?”

Signs appearance teeth

You will notice this by the behavior and condition of the child. When teething, the child pulls everything into his mouth to scratch his gums. His salivation increases, his appetite worsens, and his gums swell. The baby is naughty and sleeps restlessly.

If your child has a fever and/or diarrhoea, you should make an appointment with the pediatrician. These symptoms cannot be attributed to mild malaise during teething. Remember that the child’s immunity is just beginning to develop at this age. Babies put all toys and objects, clean or dirty, into their mouths, so they are at risk of contracting bacteria and viruses.

How to help baby relieve pain

Pediatric dentists have developed a number of tips and tricks to help relieve pain and discomfort in babies. Current medicine does not recommend applying topical anesthetic gels and liquids to the gums due to the risk of toxicity in children 2 years of age and younger. Another outdated remedy recognized as harmful to the teeth is to dip the nipple in sugar or honey.

Don’t worry, there are many simple and harmless ways to make your child’s life easier. Try giving him a clean, durable teether or a chilled nipple. Store spare teethers in the freezer so you always have them on hand. Cold foods, such as ice cream and frozen fruit, are good for helping to combat unpleasant symptoms if the child can already eat them. Gently massaging your gums will help relieve the pain. If the pain is severe, see your pediatrician who can recommend an over-the-counter medicine for babies. Be careful and notice which way works best for the child.

Schedule eruption teeth

Noticing increased salivation, parents immediately begin to look for the first tooth in the child’s mouth. The two central incisors of the bottom row appear first when the baby is about 6 months old. However, no two children are the same; The first tooth may appear at 5 months or at 12 months. So, the correct answer to the question “when children start teething” is: “any time they want.”

After the first teeth appear, on schedule or off schedule, you are wondering when to expect the next ones. The top two central teeth erupt at about age 9up to 13 months. Between the ages of 13 and 16 months, many babies have four front teeth at the bottom and four at the top. The remaining milk teeth, lateral incisors and molars, should erupt by the age of 2 to 3 years. It’s a long process, but when it’s over, the baby will have 20 milk teeth!

Important Role Baby Teeth

Some parents feel that baby teeth are not very important because they will eventually be replaced by permanent teeth. However, that is why it is necessary to take care of baby teeth! They not only make the baby’s smile beautiful, they help him learn to speak and chew food. These 20 teeth form the necessary space for the development, growth and proper positioning of the permanent teeth.

The importance of taking care of your baby’s teeth and gums right from the start of teething cannot be overemphasized. Specialists of the Russian Medical Server consider oral hygiene and regular visits to the dentist to be the best methods for preventing dental diseases. The last baby tooth will fall out in a child’s early teens, around age 12. Be patient and surround your child with care so that this difficult period passes safely.

Timing of teething – Article

Author:

Marbery Gedrean
| Checked by: Shteba Victoria Petrovna

| Last revised: October 18, 2020.

Most parents are very concerned about how teething (and gums) affects their babies in everyday life. Although we cannot fully predict exactly how each baby will react to their first tooth. However, we can learn about teething symptoms and how to soothe your baby during this difficult time. In general, the more we know about teething, the better we can help our babies get through it. Let’s figure it out.

Timing of teething

One of the most common questions parents ask is, “How long does it take for babies to teeth?”. It is useful to know both the time frame for the appearance of the first tooth and the time frame in which all teeth erupt. In general, teething is an ongoing process that occurs between the ages of 6 and 24 months. Although your baby has twenty milk teeth that will appear within two years, teething, fortunately, only causes pain and irritation at the time when the tooth is about to break through the gum. It is not known exactly how long it will take for a tooth to fully erupt, but on average experts say it can erupt within 1-7 days per tooth. However, teething symptoms usually only last a couple of days, so if a baby experiences discomfort for an extended period of time, it’s safe to assume it’s not teething.

Chronology of teething

In most babies, the first teeth are erupted at the age of 6 to 7 months, but this can happen earlier or later. Generally, your baby’s teeth are most likely to appear in the following timelines:

6-7 months

During this time, the first teeth begin to erupt. The first teeth to erupt are usually the lower central incisors, which are the two middle teeth at the bottom. Children at this age become more active. They begin to grab and pull objects towards them, transfer objects from one hand to the other, and may even begin to crawl. It’s important to keep an eye on small objects within your baby’s reach, as he’ll want to put everything in his mouth during teething!

8 to 13 months

Between 8 and 12 months your baby will have upper central incisors. In addition, sometime between 9 and 13 months they will have upper and lower teeth next to their upper central incisors (these are called lower and upper lateral incisors). In addition to teething, it is important to understand that other important milestones in gross motor development are also achieved during this developmental window. Most babies are able to sit up, stand up unassisted, take their first steps, pick up and throw objects, roll a ball, and grasp objects.

13 to 20 months

Typically, between 13 and 16 months of age, your baby’s first molars come in at about the same time. Shortly thereafter, their fangs will appear in both the top and bottom rows, between about 16 and 20 months.

From 20 to 30 months

At the final stage of teething, the back teeth or second molars appear in the bottom row of the baby. While most teething symptoms appear the same in both toddlers and babies, there are some differences as your baby grows older. First of all, your baby can now tell you about their discomfort and pain, unlike non-verbal babies. On the other hand, many toddlers will not show any signs of discomfort and will not complain of pain at all during the passage of molars. For other babies, the pain can be significantly worse because their first molars are larger than their other molars. They may even complain of a headache or jaw pain!

Toys that can help

Teethers are teething toys that help to greatly relieve the symptoms of teething in children, while keeping them occupied during play. Because teething babies are always looking for something they can chew on, teething toys are specifically designed to soothe gums and temporarily ease teething.

“6 months? But my 3 month old is teething right now!”

Some babies start teething early at 6 months – and usually it’s a little thing you don’t have to worry about!

Many babies begin to drool more often and explore their world by bringing their hand to their mouth to chew at about 3-4 months. This is completely normal and is often accompanied by teething after some time.

If you suspect that your little bundle of joy, which can be much less joyful during gum pain attacks, is teething, look for symptoms such as:

• drooling, the surest sign;
• capriciousness – unfortunately, also a frequent indicator of common childhood worries;
• slight temperature increase approx.