Teething pain? Don’t use benzocaine, try these safer strategies instead

September 24, 2018

Providence Health Team

The Food and Drug Administration (FDA) has warned parents for more than a decade against using creams containing benzocaine to stop their children’s teething pain. However, illness and deaths have continued, and the FDA is taking regulatory action against companies who don’t voluntarily remove the ingredient in medications for young children.

What is benzocaine and why is it unsafe?

Benzocaine is a local anesthetic used in topical pain relievers and is the active ingredient in many over-the-counter medications. The FDA strongly warns that benzocaine should not be used for teething and should not be used to treat children young than two years of age. The use of this ingredient may cause the condition methemoglobinemia, where the amount of oxygen carried to the brain is greatly reduced. Benzocaine, as a topical treatment for teething pain, can ultimately be life-threatening.

How and why do babies teeth?

Most children begin teething at four months and get their teeth in pairs. The first teeth to appear are generally the two lower incisors, followed by the two front teeth. However, the development of teeth varies from child to child. As a tooth emerges, it causes pressure on the gums. This pressure can cause an uncomfortable sensation which most children relieve using counter pressure — biting down on something hard. But just because your baby is gnawing on something doesn’t mean he or she is in pain.

Do babies need teething medicine?

Teething is completely normal for young children, and while they may experience mild irritability, drooling, and puffy gums, they don’t necessarily need medication to relieve these symptoms. Most teething creams, gels, and sprays wear off in a matter of minutes and are not very effective.

Are there natural ways to treat teething?

There are many alternative and safe ways to treat your young child’s teething pain. The American Academy of Pediatrics recommends gently rubbing or massaging their gums with your finger, or giving them a teething ring to chew on. Take care that the ring isn’t frozen, or it may end up hurting their gums. It is also important that the teething ring is made of rubber, not plastic. Plastic teething rings may contain an endocrine disrupting agent known as bisphenol-A (BPA) that can contribute to obesity, diabetes, and hyperactivity.

One mom-approved teething trick is using a chilled washcloth. Place a washcloth in a plastic bag and refrigerate it. Once removed, the ridges of the washcloth will massage your child’s teeth as they chew.

Are there any safe medications available to treat teething pain?

Non-prescription pain relievers can also be used to relieve teething discomfort, such as acetaminophen and ibuprofen in infants’ dosages, although it is recommended that you speak to with your doctor first and don’t give them to babies under six months of age.

What teething strategies should you avoid?

Hard foods such as certain crackers, frozen bagels, carrots, and bananas should be avoided as they could potentially be choking hazards. Do not apply rubbing alcohol to your baby’s gums, as it could potentially be poisonous. Homeopathic teething tablets have no scientifically proven benefits, and teething necklaces are strangulation and choking hazards.

Dr. Elizabeth Meade cautions parents about amber teething necklaces and offers effective alternatives: Watch the video.

When should you call the doctor?

Teething does not cause fever or diarrhea, although it may be seen in conjunction with those conditions. However, illnesses such as ear infections and urinary tract infections can be the underlying cause of fever or crying, so contact your pediatrician if you notice your child’s symptoms aren’t resolving or if your parental instincts tell you something may be wrong.

Do you have questions about teething and other baby-related health issues? The Circle by Providence app gives you provider-approved advice and resources relating to pregnancy and parenting.

Circle by Providence app for expectant and new moms: