The Dangers of Teething Gels

As a healthcare professional, I have stood right where you are. I have looked into the teary eyes of a fussy baby and felt the desperation that comes with teething. You just want the crying to stop, and you want your little one to feel comfortable. For generations, parents reached for a tube of numbing gel to rub on sore gums. It seemed like the standard thing to do. However, in my practice, the conversation around teething gel safety has changed dramatically in recent years.

I want to talk to you today not just as Dr. Anita Sabeti, but as a partner in your child’s health. We are going to explore why these once-popular remedies are now considered dangerous, look at the data behind the warnings, and most importantly, discuss the safe, effective alternatives that will help your baby—and you—get some rest.

The False Promise of Instant Relief

It makes sense why we are drawn to gels. When we have a headache, we take a pill. When we have a cut, we apply an ointment. So, when a baby has sore gums, applying a numbing agent seems logical. The marketing for these products used to promise instant relief, often showing a peacefully sleeping infant on the box.

However, the reality of the mouth makes these gels largely ineffective. The mouth produces a significant amount of saliva, especially when a baby is teething and drooling excessively. When I explain this to parents in my clinic, I remind them that any gel applied to the gums is washed away within minutes.

This creates a dangerous cycle. You apply the gel, the baby swallows it, the effect wears off (or never really starts), the baby cries again, and you apply more. This leads to the baby ingesting far more medication than intended, which is where the real danger lies. We need to look at the ingredients to understand why this matters.

Understanding the Benzocaine Warning

The primary ingredient that has caused the most concern in the medical community is benzocaine. This is a local anesthetic used to numb tissue. While it might be safe for an adult to use on a canker sore in moderation, it poses a severe risk to infants and children.

The condition we are most worried about is called methemoglobinemia. That is a long, intimidating word, but the concept is straightforward. Benzocaine can change the form of hemoglobin in your baby’s red blood cells. Hemoglobin is the vehicle that carries oxygen to the body’s tissues. When benzocaine affects it, the blood can no longer carry oxygen effectively.

Recognizing the Signs

In the rare but serious event that a baby develops this condition, the signs can be terrifying. They include:

• Pale, gray, or blue-colored skin, lips, and nail beds.
• Shortness of breath.
• Fatigue and confusion.
• Rapid heart rate.

This can happen after just one application, or it can happen after several. Because of these risks, the FDA has taken a strong stance. Data Point #1: In May 2018, the FDA issued a strict warning stating that over-the-counter oral health products containing benzocaine should not be marketed for treating sore gums in infants and children under 2 years of age.

This wasn’t a minor suggestion; it was a major shift in pediatric safety protocols. It effectively removed these products from the “safe” list for babies.

Visualizing the Risk: Oxygen Saturation

To help you understand the impact of methemoglobinemia, I have created a visual representation of how this condition affects oxygen levels in the blood. In a healthy baby, we want oxygen saturation to be near 100%. When this reaction occurs, those levels drop dangerously.

The Trap of “Natural” Homeopathic Remedies

After the warnings about benzocaine came out, many parents pivoted to “natural” or homeopathic teething tablets and gels. I completely understand this instinct. We tend to equate “natural” with “safe.” However, in the world of unregulated supplements, this is not always true.

Many homeopathic teething products traditionally contained Belladonna (deadly nightshade). While the amounts were supposed to be microscopic (diluted), manufacturing inconsistencies meant that some tablets contained unsafe levels of this toxic plant.

Data Point #2: Following an investigation into adverse events, the FDA found that inconsistent amounts of Belladonna in homeopathic teething products posed an unnecessary risk to infants and urged consumers to stop using these products immediately. This led to a massive recall of popular brands that parents had trusted for years.

The lesson here is that just because something is sold at a health food store does not mean it has passed the rigorous safety testing required for prescription medication. When it comes to teething gel safety, I advise my patients to steer clear of unregulated substances.

Viscous Lidocaine: Why a Prescription Isn’t Better

Sometimes, parents ask me if they can use prescription-strength viscous lidocaine instead. They assume that if I prescribe it, it must be safe. However, I rarely, if ever, prescribe this for teething.

Viscous lidocaine is a thick gel. If a baby swallows it, it can numb the throat and the gag reflex. This creates a serious choking hazard. If your baby cannot feel their throat, they might have trouble swallowing their own saliva or milk, leading to aspiration (breathing food into the lungs). Furthermore, if too much is absorbed into the bloodstream, lidocaine can cause heart problems and seizures. The risks simply outweigh the benefits, especially when the pain of teething is temporary and manageable through other means.

Comparison: Risky vs. Safe Soothing Methods

To make this easier to digest, I have outlined the differences between the old methods we are moving away from and the modern, safe methods I recommend in my office.

Safe Alternatives That Actually Work

Now that we have covered what not to do, let’s focus on the positive. How do we help our babies? The mechanism of teething pain is inflammation. The tooth is pushing through the gum tissue. To treat this, we need two things: cold and pressure.

The Power of Cold

Cold acts as a natural anesthetic. It numbs the gums safely without chemicals. I recommend using a solid rubber teething ring placed in the fridge. Please avoid placing them in the freezer; a frozen ring can be too hard and might bruise the baby’s delicate gums. A cool, damp washcloth is another fantastic tool. You can tie a clean washcloth in a knot, dip it in water or breastmilk, chill it, and let the baby chew on the textured fabric.

Massage and Pressure

If you have ever bumped your shin, your first instinct is to rub it. That pressure distracts the brain from the pain signal. The same applies to teething. Wash your hands thoroughly and use your finger to firmly massage your baby’s gums. You might be surprised at how quickly they settle down. The pressure counteracts the internal pressure of the erupting tooth.

Systemic Pain Relief

If the baby is truly miserable, cannot sleep, and the cold rings aren’t working, it is okay to use medication. Acetaminophen (Tylenol) or Ibuprofen (Motrin/Advil) are safe when dosed correctly. Ibuprofen is generally only for babies over 6 months old. Always consult your pediatrician for the correct dosage based on your child’s weight, not just their age. This treats the pain from the inside out and avoids the swallowing risks of gels.

For more detailed information on safe medication dosing and product warnings, you can visit the FDA’s official guide on soothing teething pain. It is a resource I often share with parents in my clinic.

When to Call the Doctor

Teething can cause irritability, drooling, and mild fussiness. However, as a doctor, I want to make sure we don’t blame everything on teething. Teething does not usually cause high fevers (over 100.4°F or 38°C), diarrhea, or widespread rash. If your baby has these symptoms, do not assume it is just the teeth. It could be an ear infection or a virus.

If your baby seems inconsolable despite your best efforts with massage and cold, give your pediatrician a call. We are there to help distinguish between normal teething pains and something that might require medical attention.

Final Thoughts on Keeping Baby Smiles Safe

Navigating parenthood is about making the best choices with the information we have. Years ago, we didn’t know the full extent of the risks associated with benzocaine and homeopathic gels. Now that we do, we can make safer choices.

I hope this guide helps you feel more confident in managing this milestone. Throw away the gels, stock up on washcloths, and remember: this phase, like all others, will pass. Your baby’s smile is precious, and protecting their health is the most important job we have. By focusing on physical remedies like cold and pressure, you are choosing a path that is not only safer but often more effective for your little one.