Pediatric Primary Care
Hasbro Children's Hospital

Teething and Medications

Baby teethingQ&A: Can I Use Pain Medication On My Teething Baby’s Gums?

Patricia Flanagan, MD, pediatrician and chief of clinical affairs at Hasbro Children’s Hospital, addresses what can be a tough and stressful event for parents – watching their children go through the teething process. Here, she explains why some topical medications, both prescription and over the counter, can be harmful and cause unanticipated injury to children when used for teething. She also offers strategies for relieving babies’ pain without the use of topical pain medications.

​What should parents know about the teething process?

Teething is a normal part of an infant’s life and can be treated without the use of medication. Topical numbing medications rubbed on your child’s gums can be harmful if too much is used and the child swallows too much. The Food and Drug Administration (FDA) has issued a warning about the danger of the use of lidocaine in infants to relieve teething pain. In the first 6 months of 2014, the FDA reviewed 22 reports of infants and young children between the ages of 5 months and 3.5 years who have experienced serious side effects, including death, from the use of lidocaine. Health professionals are warning parents against its use and are suggesting safer options to relieve teething pain.

What is lidocaine?

Viscous lidocaine is a topical numbing medication that a patient can only get by prescription. Prescription medications should only be used by the person for whom they were prescribed. Lidocaine is not approved for use in infants for relief of teething pain and should never be used on a baby.

Why is lidocaine dangerous to infants?

Babies may swallow some of the medication, which can numb their throat and cause difficulty swallowing and increase the risk of choking. In addition, if too much lidocaine is applied or a baby swallows too much, it can be toxic and cause severe damage to the heart and nervous system. Symptoms of this damage can include jitteriness, confusion, vision problems, vomiting, falling asleep too easily, shaking and seizures. To prevent accidental ingestion, securely store all medications, including viscous lidocaine solution or benzocaine gels and liquids, out of the reach of children.

What about other over-the-counter topical anesthetics?

Another numbing medication found in some over-the-counter (OTC) products is called benzocaine. In 2011, the FDA issued a warning on these products, warning that their use on babies for teething pain can cause a rare but serious condition called methemoglobinemia. This condition causes a large decrease in the amount of oxygen being carried in the blood, which can be life-threatening. For this reason, products that contain benzocaine should also not be used in infants for teething pain. Some of the common names of products that contain this ingredient include Anbesol, Hurricaine, Orajel, Baby Orajel, Orabase and various store brands.

What are some safe ways to relieve my baby’s teething pain?

If your baby has swollen and tender gums, the American Academy of Pediatrics (AAP) recommends:

  • Gently rub or massage the child’s gums with your finger.
  • Give your child a cool teething ring or a clean, wet, cool washcloth to chew on. Teething rings should be refrigerated for a short time so they are cool – not cold or frozen. Frozen teething rings can cause damage to the baby’s gums. Chewing on a cool teething ring will help to dull the nerves in the child’s gums, numbing the pain.
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