Teething Products: Options and Risks

Products meant to soothe teething pain may be putting baby at risk

Overview of Teething

Babies are generally born without teeth and don't begin teething until they are 4 to 7 months old. A total of 20 baby teeth usually come in by the time the child reaches age 3. The level of pain caused by teething can vary from child to child, but there are some tell-tale signs that a baby is teething:

• Excess saliva and drooling
• Rubbing their gums
• Inability to sleep
• Irritability
• Appetite loss
• Low-level fever

As teething can be painful, parents and caregivers often reach for medications and teething products to help soothe the child's pain. Unfortunately, many of these medications and products can be harmful for baby.

What is Safe to Use?

The American Academy of Pediatrics (AAP) recommends treating teething pain by rubbing the child's gums with a clean finger or providing the child with a room temperature, firm rubber or plastic teething ring. Supervision is also key to ensure the child doesn't accidentally choke on the teething ring.

Teething Gels and Topical Medications

Many gels, ointments, sprays, and lozenges advertised to reduce teething pain contain the local anesthetic benzocaine. Though these types of topical medications may seem to be easing pain initially, they are generally ineffective, as they are washed away within minutes.

Aside from the general ineffectiveness of benzocaine products, the use of benzocaine can sometimes cause a serious - and sometimes fatal - condition called methemoglobinemia. This condition is marked by a higher-than-normal quantity of methemoglobin (a form of hemoglobin) in the blood. Because methemoglobin does not carry oxygen, when the level is too high, there is less oxygen travelling to different areas and tissues in the body. This oxygen deprivation often presents with blue-tinted lips and skin.

Teething Jewelry

Many bracelets, necklaces, and other jewelry are available that are made of various materials (wood, marble, silicone) and are marketed to help relieve teething pain. However, many of these materials can actually cause damage to the child's gums. This type of jewelry also poses a risk of strangulation or choking. Using only teething rings/teethers made of hard plastic or rubber mitigates these risks.