Orajel for teething? No, says FDA, which tied drug to breathing issues
Last month, the Food and Drug Administration told manufacturers to stop marketing over-the-counter teething products with the drug benzocaine. You know these products as Anbesol, Baby Orajel, Cepacol, Chloraseptic, Hurricaine, Orabase, Orajel and Topex as well as the store-brand versions.
“Because of the lack of efficacy for teething and the serious safety concerns we've seen with over-the-counter benzocaine oral health products, the FDA is taking steps to stop use of these products in young children and raise awareness of the risks associated with other uses of benzocaine oral health products,” said FDA Commissioner Dr. Scott Gottlieb in the press release.
So, what's the problem with a little Baby Orajel on your baby's gums?
People noticed that babies sometimes struggled to breathe when using these treatments. They had a condition called methemoglobinemia, which is an elevated amount of methemoglobin in the blood. That reduces the amount of oxygen in the blood.
Dr. Arti Lal, a pediatrician at Baylor Scott & White Clinic - Austin, Northwest, says that babies were being sent to the emergency room to get an antidote for methemoglobinemia. Even with an antidote, it's still scary to see your baby struggling to breathe, she says. “You don't want your baby to have that.”
The first signs that there were problems with benzocaine, were about a decade ago, Lal says, but the announcement last month is a much stronger statement from the FDA.
Of course, let's also go back to the fact that those over-the-counter treatments also didn't really work.
Lal says she likes to remind parents that teething is a normal physiological occurrence. It's what the body does in the process of getting teeth.
Most babies start teething around 5 or 6 months, but it can start as early as 4 months and as late as 10 months, Lal says. It usually goes until age 2 or 2 1⁄2. The first year is definitely the most painful because of the type of teeth as well as it being a new experience for babies.
To ease that pain, Lal recommends cleaning your hands and then rubbing your baby's gums gently with your finger.
You also can keep teething toys in the refrigerator or clean, wet washcloths. The cold is soothing, but only use the refrigerator, not the freezer. The freezer could damage gum tissue and cause it to die.
Parents also can give babies ibuprofen or acetaminophen to help with the pain.
Your grandmother's trick of putting a little bourbon on a wash cloth or on your finger on baby's gums, also isn't a good idea. It doesn't really work on the actual teething problem, and now you have an intoxicated baby.
Teething often comes with a lot of drool. Sometimes the gums will be very red, and they can even bleed. If that's happening a lot, you should see a pediatric dentist, Lal says.
Teething does not cause a fever. If your baby has that, something else is happening. Lal says she's known parents who thought it was just teething when it was meningitis. A fever should be checked out.
Teething also should not be causing babies to wake up at night, she says.
It also doesn't make babies more hungry. They might seem like they want to eat all the time, but that's just because they want to gnaw on something, Lal says. She likens it to the puppy who always wants to tear something up.
“They're just trying to feel better,” Lal says.