Teething – What Should Parents Know

Recently, the FDA took action, including the popular brand-name Orajel, asking manufacturers to cease production. Teething, one of the most frustrating rites of passage for any new parent, varies for each child but usually begins between 4-6 months of age. Symptoms include swollen gums, crying, drool and a slight elevation in temperature. All of this can mess with sleeping schedules. So, what should parents know about the FDA’s action and what can they do to soothe their little one? We asked Jonathan Miller, MD, Nemours/Jefferson pediatrician.

What should parents know?

Parents should avoid teething products with benzocaine, like Orajel. There were a number of case reports when too much Orajel led to a rare disorder called met-hemoglobinemia, which leads to a problem with how hemoglobin carries oxygen. Tragically, this can be deadly although in most children, it is reversed and they come out okay. Most of the case studies are from using the gel frequently, causing a buildup in the body.

Besides the risk, it just doesn’t work that well. The numbing lasts seconds or minutes, which most parents will agree, isn’t enough. It’s just not worth it.

So, what can parents do?

Give your child something safe and cool to chew on from the refrigerator. Be careful with frozen teethers as this can cause damage to the gums. Older kids can handle pieces of a frozen bagel. If the pain is significant, talk to your pediatrician about Tylenol and ibuprofen.

Never use naturopath tablets that contain belladonna; anything that they can chew a piece off of; or amber teething necklaces which are a choking hazard.

What did you do with your kids?

We’d let them chew on the toys that they played with. Occasionally we would use a dose of Tylenol. But we tried not to medicate too much.

Anything else parents should know?

I think that people attribute a lot of symptoms to teething that aren’t. It is a regular part of development. They will start drooling or chewing, but that doesn’t mean that they are teething. Some symptoms have been associated with tooth eruption, like irritability, drooling, and sleep disturbance. However, fever (temperature over 100.4) is not associated with teething, and so fever should alert parents that the child may have something other than teething causing the symptoms.

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