Are Teething Gels Safe?

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Teething gels are a common remedy for teething pain—but are they really safe?

When Allison Ginsberg used an over-the-counter teething gel to relieve her 10-month-old son's teething pain she never expected it would lead to a trip to the emergency room.

"Zane had all the typical teething symptoms that afternoon and I put a little dab of Orajel—the recommended amount—on my finger and rubbed it on his upper gums," Ginsberg says. "At first he started crying and then he just went limp and his face turned blue. He wasn't breathing. It felt like it lasted forever but then he started crying again." After calling their pediatrician, Ginsberg and her husband took Zane to the emergency room. Doctors ran tests on Zane but couldn't find anything wrong, and the Ginsbergs are convinced the teething gel was the culprit.

"Our pediatrician told us that when babies swallow it, the gel can cause them to stop breathing," Ginsberg says.

The Trouble with Benzocaine

Most over-the-counter teething gels, including Orajel, contain the local anesthetic benzocaine to relieve pain, and it's this ingredient (as well as similar chemicals such as lidocaine and prilocaine) that may cause problems in some children.

Pediatrician Dr. John J. Jakimczyk, MD, of Acton Medical Associates in Acton, Massachusetts, does recommend Orajel, saying; "When used with the recommended dosage it shouldn't cause a problem. But there is a rare condition called methemoglobinemia that can make a child prone to have a bad reaction to the benzocaine."

According to a review in the Archives of Internal Medicine, adults and children with methemoglobinemia can experience serious, life-threatening complications when exposed to benzocaine. Infants under six months old are especially sensitive to the effects of methemoglobinemia, and the review recommends that medicines containing benzocaine carry more prominent warnings on the packaging. Most over-the-counter teething gels do warn that they should not be given to infants under four months old.