I recently came across a short article published by the American Dental Association (ADA) about teething. The article can be found here: http://www.mouthhealthy.org/en/az-topics/t/teething. I was particularly interested in the article because never in my 7+ years of dental education (which includes 4 years of dental school, one year of an advanced program in general dentistry, and 2+ years of orthodontic residency) did I ever learn one thing about emerging dentition. In fact, it wasn’t until I had my first child that I realized the hole in my dental education. And now I’m going through the teething phase again with my second child.


I encourage you to read the ADA’s article for yourself, but I wanted to highlight a few statements from the ADA and comment on a few others. Perhaps this will leave you better educated about teething.

First, I think they nailed the normal signs of cutting teeth. For any of you who have experienced a teething baby, the amount of saliva produced is incredible, as is the seemingly never-ending irritability. However, I disagree with their “not normal” signs including fever, diarrhea, and rash. My oldest son had this triad with EVERY new tooth coming into his mouth! I think parents should be aware that fever, diarrhea, and rash can be signs of other health issues, and, therefore, monitored closely, but they should not automatically consult a pediatrician for these signs each time a tooth is erupting.

I also want to highlight their recommendations for how to soothe/not soothe your baby. Every parent wants to soothe their crying and irritable infant, but please, please, please avoid the teething gels you find at drug stores! Many of them have benzocaine as their active ingredient and benzocaine, can, albeit very rarely, trigger a lethal reaction in the blood. Benzocaine does work as a topical anesthetic, but it is NOT worth the risk on a teething baby.

Side note: this lethal reaction to benzocaine is not unique to infants; it can occur in adults too, but the most common over-the-counter usage of benzocaine seems to be in teething products.

Likewise, the homeopathic versions without benzocaine are often not FDA tested for safety, nor have they been shown to be effective in reducing the discomfort associated with teething. So, pretty much all of your drug store solutions are either dangerous, untested, or not effective.

That pretty much leaves teething rings and pacifiers as the best solutions. Make sure that the teething rings/pacifiers are clean and I recommend that they be chilled in the refrigerator or freezer for added effect.

In conclusion, teething is not the most fun stage for infants (or their parents). You can expect an irritable child and enough drool to warrant full time bib wear or extra changes of clothes. Do NOT use teething gels found at corner drug stores and supermarkets. Do use clean teething rings and/or pacifiers. And, if you find that they don’t work that well, join the club and, rest assured, this too will pass.

 

UPDATE: IN THE NEWS

FDA: Some Homeopathic Teething Products Contain “High Amounts” Of Toxic Substance.

Reuters reported the US Food and Drug Administration is cautioning consumers about homeopathic teething tablets and gels after finding “high amounts of a toxic substance” in some of the products. After conducting a laboratory analysis, the health regulator found “the amounts of belladonna, a toxic substance, sometimes far exceeded the amount claimed on the label of these teething tablets.” Varying amounts of belladonna may cause seizures, muscle weakness, and exhaustion. Read the full article.

 

Dr. Joosse