Several years ago, the FDA began warning parents about using benzocaine-based gels to ease the discomfort of teething. Benzocaine is a local anesthetic that’s used in many over-the-counter remedies for not just teething but toothache, sore throat, canker sores, and more.
Think Orajel, Anbesol, Cepacol, and such.
Why the warning? As we’ve noted before, though benzocaine can offer quick, if short-term, relief, it can also
damage gum tissue by triggering a process called hemolysis. Red blood cells are destroyed, transformed into a kind of hemoglobin (called methemoglobin) that can’t carry oxygen. The gums turn mushy and dark.
In some cases – such as with long-term use or overuse – benzocaine can trigger a condition called methemoglobinemia, in which oxygen levels in blood are greatly reduced. Seeing more cases of this disorder cropping up in very young children (as “blue baby syndrome”), the FDA has now twice recommended against teething gels that contain the ingredient.
Now, this week, they’ve issued yet another warning. Maybe third time’s the charm.
“Given the accumulating evidence regarding benzocaine’s association with methemoglobinemia, we are taking necessary action to work with industry to discontinue the distribution and sale of over-the-counter benzocaine oral health products intended for teething pain, and add warning information about methemoglobinemia and a contraindication against use for teething pain and against use in children under two years of age to the remaining oral health care drug products containing benzocaine,” said Janet Woodcock, M.D., director of the FDA’s Center for Drug Evaluation and Research. “As part of the action, the agency is also requiring that prescription local anesthetics add updated warnings about their risk of this condition.”
The main symptom of methemoglobinemia is the skin, lips, and nail beds turning slightly blue or gray. Other symptoms include shortness of breath, fatigue, headache, lightheadedness, and an elevated heart rate.
Fortunately, there are good alternatives to benzocaine teething gels, such as rubber teething rings and eco-friendly teething toys. You can also offer relief by simply massaging your baby’s gums gently with a finger.
See this excellent post from Mama Natural for more natural remedies to ease teething pain.
And, yes, in case you were wondering, benzocaine can damage the gum tissue of adults, as well, so it’s worthwhile to reach for other options, such as herbal remedies, when you need immediate help at home with alleviating oral pain.
Either way, remember that, herbal or otherwise, such remedies are really just short-term solutions. Only by seeing your dentist can you address the actual cause of your pain and give you long-term relief.
Image by liz west