FDA Rules These Products Are Unsafe For Children
Last month, the FDA warned consumers that over-the-counter teething products that contain benzocaine are unsafe and should not be used on children. The FDA also sent letters to multiple manufacturers asking them to stop selling the products. And it’s about time!!!
I get a lot of questions regarding teething and I have never been an advocate of these products for relieving any mouth or teething discomfort. Prior to the FDA’s decision, there were often reports of adverse reactions to these products. Without enough information and research on the cause of these reactions, I couldn’t and wouldn’t recommend their usage to patients. Now the FDA has come to a conclusion that they are, in fact, unsafe and therefore not recommended. Some of these products include brands like Anbesol, Baby Orajel, Cepacol, Chloraseptic, HurriCaine, Orabase, Orajel and Topex. These products also come in a number of application types including gels, sprays, ointments and solutions.
So why are these items dangerous and why shouldn’t they be administered to children? Using these teething products can lead to something called methemoglobinemia, wherein the red blood cells capacity to carry oxygen to tissues of the body is greatly reduced. Essentially, the oxygen level in blood can get dangerously low, resulting in elevated levels of methemoglobin in the blood and can ultimately lead to death. The FDA notes, “Signs and symptoms may occur after using benzocaine for the first time, or after prior uses and may appear within minutes to 1 to 2 hours after using benzocaine. These include pale, gray- or blue-colored skin, lips and nail beds; shortness of breath; fatigue; headache; lightheadedness; and rapid heart rate.” Obviously, your child experiencing discomfort from teething is never fun, but the symptoms and repercussions from the benzocaine are certainly not worth the risk.
Further, there is no guarantee that the teething products were ever an effective means of relief. The American Academy of Pediatrics notes that pain relievers and medications that are rubbed on the gums for teething are not useful because they wash out of the baby’s mouth within minutes and as we now know, may present safety concerns. The AAP recommends using a teething ring made of firm rubber (not frozen), or to gently rub or massage the child’s gums with a finger to relieve teething symptoms.
But, just to play devil’s advocate and complicate the picture even further, I’d like to remind you about a study published last year that found that “Almost 90 percent of the teethers we bought were labeled as BPA-free, but we found BPA in almost every product and most were labeled as non-toxic.” While we don't know exactly what the ramifications of BPA in teething products mean for long-term health impacts on babies, I prefer to avoid chemicals when practical, especially when they are directly entering my little one's mouth!
And while we’re at it we may as well address amber necklaces - I’m cool with these, so long as they are used under direct parent supervision. Babies should NEVER be allowed to sleep or nap with these anywhere near them due to the risk of accidental strangulation or suffocation from aspirating a stray bead.
My recommendation for teething pain is a frozen dampened wash cloth - cheap, non-toxic and super easy to clean. Speaking from personal experience, it works well too (just make sure they don't get too much of it in their mouth at one time!)
As with other baby stages that can be tough on both baby and parent, remember this too shall pass. Know that by not using gels or ointments, you’re making the right decision for your child. I welcome any questions from parents about this topic, as I know teething can be tough. Hang in there!