A Case Study For The Curious: Teething Relief For Infants
As a parent, Dr. Ku knows how concerning it is to see your children in pain, particularly when they are young and teething. And sometimes with the accompanying desperation for a full night of sleep, many parents reach out to us with questions regarding pain relief and teething gels for their children. While we already have a lot to say about these, a recent retrospective study analyzed the health records of children under four who were exposed to these gels—and we found the case study interesting enough that we wanted to share.
This was a study of infants and small children exposed to topical benzocaine (a topical anesthetic used for tooth pain commonly found in teething gels). The results of this exact study (in tandem with work done at the FDA) has led these over-the-counter teething products to be removed from store shelves entirely. Below, we walk you through the results of the study and also highlight how the FDA has altered its recommendations for parents.
As dental health professionals we stay up-to-date on all recommended changes from both our dental governing boards as well as the federal government. If you have any questions about current practices or changes in procedure, please let us know. We will be happy to walk you through how any related decision was made.
Background
An increase in the number of children who were experiencing severe side effects after using benzocaine-based teething gels caused the FDA and dental researchers to explore the link and make new recommendations based on data.
The children most at risk for severely adverse symptoms—such as shortness of breath, blue or grey skin coloring, dizziness, and rapid heart rate—were primarily under two years old. Since benzocaine is found in many homeopathic teething gels, many parents used the product thinking it was safe.
Research on this subject has been ongoing for nearly a decade after the FDA received notification in an uptick in cases of benzocaine reactions among young children. Even today the Agency is still investigating 10 deaths and more than 400 reports of seizures that have been thought to be linked to these homeopathic teeth remedies. The FDA believes that one of the active ingredients, belladonna, which is commonly classified as a natural pain killer, was the ingredient to blames. It’s imperative that this ingredient be tightly controlled since eaten in unsafe levels it can be deadly. Unfortunately, as a result of an FDA investigation and other studies, it was shown that belladonna had not always been properly diluted in teething gels—which led to overdoses in children.
While the FDA did stop short of requiring teething gels to be removed from the shelves altogether, it did send a stern warning letter to companies and advised parents to speak with their dentist or other medical professional prior to using any teething gels on their children. Finally, the FDA once again reiterated its stance on teething gels last month by reminding parents that they aren’t necessary and instead offering other options like wet washcloths, teething rings or gum massagers.
How the standards changed as a result
After the FDA released its first warning letter in 2010, many dentists began to stray away from offering teething gels as an alternative pain relief method. Studies like this one help guide medical professionals in their daily practice—dentistry and medicine are fields where we are always continuing our education. Today, we work collaboratively with parents to explain the possibly dangerous side effects of homeopathic teething gels, and instead offer advice on alternative solutions.
While this investigation and the removal of product from many shelves made the news, the professionals at our practice are always looking at deeper studies that don’t hit the front pages of the press. When new and noteworthy advancements are made, we stay informed though our professional organizations as well as through continuing education that the whole team participates in. If you ever see any dental news that interests you, reach out through our Facebook or leave a comment and we will be sure to tell you what else we’ve seen and learned!