05/31/2018  |  
Don’t Use Benzocaine for Children’s Teething Pain!

When young children experience teething pain, it's natural for concerned parents to want to help. But for the past several years, the U.S. Food and Drug Administration (FDA) has warned consumers against using over-the-counter (OTC) treatments for teething discomfort that contain benzocaine. Now, the agency is taking action to get the products off store shelves because they are associated with a rare but potentially dangerous illness.

According to a May 23, 2018 press release, "OTC oral health products containing the pain reliever benzocaine for the temporary relief of sore gums due to teething in infants or children should no longer be marketed and [the FDA] is asking companies to stop selling these products for such use. If companies do not comply, the FDA will initiate a regulatory action to remove these products from the market."

Benzocaine, a topical anesthetic (pain reliever), is marketed under a number of brand names including Anbesol, Cepacol, Hurricaine, Orajel and Topex. It's also available as a generic medication or a store brand, and may come in the form of a gel, spray, ointment or lozenge. Regardless of the name or the form, however, it's unsafe for babies and young children to use.

What's the trouble with benzocaine? The medication is associated with a disease called methemoglobinemia—an uncommon but serious and potentially fatal condition. This illness occurs when the blood contains elevated levels of methemoglobin, a hemoglobin-like protein. Because methemoglobin carries less oxygen to body tissues than hemoglobin, an excess of this substance can cause shortness of breath, fatigue and dizziness—and in more severe cases, seizures, coma and death. Several drugs, including some local anesthetics like benzocaine and lidocaine, can trigger a large increase in methemoglobin levels. The problem is especially acute in young children.

So what can parents do to ease discomfort that may be caused by teething? According to the American Academy of Pediatric Dentistry, there are a number of simple things that may help.

  • Give young children a clean rubber teething ring that has been chilled in the refrigerator (not frozen), or a cold, wet washcloth to chew on. A chilled pacifier may also be helpful—but be sure anything you put in baby's mouth is free of potentially harmful substances like lead paint.
  • Try gently massaging the gums with a clean finger—this can counteract the pressure of an emerging tooth and help soothe the irritation.
  • If pain persists, ask your doctor or pharmacist to recommend an over-the-counter pain reliever, such as acetaminophen or ibuprofen, in a dosage that's appropriate for your child. However, do not give your child alcohol in any form!

For more information about teething, see the Dear Doctor articles Teething Troubles and Children's Dental Concerns and Injuries.

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