The teething baby: A warning about certain medicines

Coping with teething is no fun for anyone, especially your baby. Some parents use medications containing an anesthetic chemical called benzocaine to help soothe sore gums.  Benzocaine can be found in over-the-counter medicines like Orajel, Baby Orajel, and Orabase. oragel   But the use of benzocaine gels and liquids for mouth and gum pain can lead to a rare but serious—and sometimes fatal—condition called methemoglobinemia, a disorder in which the amount of oxygen carried through the blood stream is greatly reduced.  In the most severe cases, methemoglobinemia can result in death. Children under 2 years old appear to be at particular risk.  It can be difficult for parents to recognize the signs and symptoms of methemoglobinemia when using these products at home. Symptoms can occur within minutes to hours after benzocaine use, and they can occur after using the drug for the first time, as well as after several uses. Methemoglobinemia may cause permanent injury to the brain and body tissues, and even death, from the insufficient amount of oxygen in the blood. teething

Danger Signs- Symptoms of methemoglobinemia include:

  • pale, gray, or blue-colored skin, lips and nail beds
  • shortness of breath
  • fatigue
  • confusion
  • headache
  • light-headedness
  • rapid heart rate

Since the US Food and Drug Administration (FDA) first warned about potential dangers in 2006, the agency has received 29 reports of benzocaine gel-related cases of methemoglobinemia.  Nineteen cases occurred in children, and 15 of the 19 cases occurred in children under 2 years of age. The FDA repeated the warning in April 2011 and remains particularly concerned about the use of benzocaine products in children for relief of pain from teething. For these reasons, I recommend that parents avoid using benzocaine products for children younger than 2 years. If your child has any of these symptoms after using benzocaine,  stop using the product and seek medical help immediately. Teething: What’s a Parent to Do? Here are some alternatives for treating teething pain:

  • Give the child a teething ring chilled in the refrigerator.
  • Gently rub or massage the child’s gums with your finger.
  • Give the appropriate does of acetaminophen or ibuprofen.

I also recommend parents try using Bonjela (available at Boots and Watson). It has a pain reliever and not an anesthetic. If these remedies don’t provide relief, contact me for advice on other treatments.

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