Recent Changes in Teething Product Recommendations

OCTOBER 02, 2016
The FDA recently issued a warning against the use of homeopathic teething tablets and gels for infants and children.1 Everyone should stop using these products, which are sold by CVS, Hyland’s, various other retail stores, and online, and dispose of them immediately.

Homeopathic teething products haven’t been evaluated or approved by the FDA for safety and efficacy.1 Additionally, there’s no known health benefit to using these products for teething. 
 
The FDA has received reports of adverse events including seizures in infants and children given these products. Pharmacists should educate parents to seek medical care immediately if their child experiences seizures, shortness of breath, lethargy, muscle weakness, skin flushing, constipation, trouble urinating, or agitation. They should also report any adverse events associated with teething products to the FDA.

Pharmacists can educate patients on safe ways to ease discomfort from teething pain. Teething usually starts between ages 4 and 7 months and may cause irritability, crying, low-grade temperature, excessive drooling, and the desire to chew on something. The American Academy of Pediatrics recommends chewing on teething rings and clean, cool, wet washcloths.2
 
Educate parents with these helpful tips to prevent cavities for new teeth:
  • Clean teeth with a soft child’s toothbrush
  • Avoid having babies fall asleep with a bottle to prevent milk from pooling around teeth
Benzocaine gels and liquids for mouth and gum pain also shouldn’t be used in infants, as they can lead to a serious and fatal condition called methemoglobinemia.3 This occurs when the amount of oxygen carried through the bloodstream is reduced. Children younger than 2 years are at the greatest risk for this condition.

Symptoms of methemoglobinemia include:
  • Pale, gray, or blue-colored skin, lips, and nailbeds
  • Shortness of breath
  • Fatigue
  • Confusion
  • Headache
  • Lightheadedness
  • Tachycardia
Methemoglobinemia should be treated immediately in the hospital setting to prevent brain injury and death.
 
Prescription oral viscous lidocaine 2% solution also shouldn’t be used to treat infants and children with teething pain. Children can accidentally swallow too much, which can result in seizures, severe brain injury, and heart problems.

Overall, pharmacists are a great resource for parents to discuss teething recommendations.

References
  1. FDA. FDA warns against the use of homeopathic teething tablets and gels. fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm523468.htm
  2. American Academy of Pediatrics. Teething: 4 to 7 months. healthychildren.org/English/ages-stages/baby/teething-tooth-care/pages/Teething-4-to-7-Months.aspx.
  3. FDA. Benzocaine and babies: Not a good mix. fda.gov/ForConsumers/ConsumerUpdates/ucm306062.htm. 


Jennifer Gershman, PharmD, CPh
Jennifer Gershman, PharmD, CPh
Jennifer Gershman, PharmD, CPh, received her PharmD degree from Nova Southeastern University (NSU) College of Pharmacy in 2006 and completed a 2-year drug information residency. She served as a pharmacy professor at NSU’s College of Pharmacy for 6 years, managed the drug information center, and conducted medication therapy management reviews. Dr. Gershman has published research on prescription drug abuse, regulatory issues, and drug information in various scholarly journals. Additionally, she received the Sheriff’s Special Recognition Award for her collaboration with the Broward, Florida Sheriff’s Office to prevent prescription drug abuse through a drug disposal program. She has also presented at pharmacist and physician continuing education programs on topics that include medication errors, prescription drug abuse, and legal and regulatory issues. Dr. Gershman can be followed on Twitter @jgershman2
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