From the Guidelines
To manage teething pain in infants, I recommend a combination of non-medication and medication approaches, prioritizing the safety and well-being of the child. For non-medication relief, offer your baby a clean, chilled (not frozen) teething ring or a cold, wet washcloth to chew on. Gently massaging your baby's gums with a clean finger can also provide temporary relief. For medication options, you can use acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) for babies over 6 months, as recommended by recent guidelines 1. The appropriate dose is based on your child's weight, so check the product label or consult your pediatrician for the correct amount. Avoid teething gels containing benzocaine as they can cause a rare but serious blood condition, as highlighted in various studies 1.
Some key points to consider when managing teething pain include:
- Teething pain occurs because as teeth push through the gums, they create inflammation and pressure, causing discomfort.
- Most children have their first tooth emerge around 6 months, though timing varies widely.
- The pain typically comes and goes during the teething process, which continues until about age 2-3 when all 20 primary teeth have erupted.
- If your baby develops a fever over 100.4°F, severe irritability, or other concerning symptoms during teething, contact your pediatrician as these are not typical teething symptoms and may indicate another issue.
It's essential to prioritize the child's safety and well-being when managing teething pain, and to consult with a pediatrician if you have any concerns or questions. The most recent and highest quality study 1 provides strong recommendations for managing chronic pain associated with temporomandibular disorders, which can be applied to teething pain management. Augmented cognitive behavioural therapy, jaw mobilisation, and trigger point therapy are recommended interventions that can be adapted for teething pain management in infants.
From the FDA Drug Label
Temporarily relieves pain associated with the following mouth and gum irritations: toothache sore gums canker sores braces minor dental procedures The answer to teething pain is not directly addressed in the provided drug labels.
- The labels mention relief of pain associated with toothache, sore gums, canker sores, braces, and minor dental procedures.
- However, teething pain is not explicitly mentioned as an indication for the use of benzocaine (TOP) 2. The FDA drug label does not answer the question.
From the Research
Teething Pain Symptoms and Relief
- Teething is a normal process in infants, accompanied by symptoms such as sensitive and painful gums, mouth ulceration, drooling, feeding difficulties, lack of sleep, and crying 3.
- These symptoms can be alleviated with teething aids like cold teething rings and over-the-counter treatments, including analgesic and anaesthetic gels 3.
Risks Associated with Teething Gels
- Topical application of benzocaine-containing gels can cause severe methemoglobinemia in infants, a potentially fatal disorder 4, 5, 6.
- Parents should be cautious when using such medications, as the process of teething is benign and physiologic, and the risks associated with these medications can be lethal 4, 5, 6.
Efficacy of Teething Treatments
- A systematic review of existing literature on teething treatments found that some therapies, such as homeopathy and non-pharmacological treatments, may have a favorable effect on signs and symptoms related to teething 7.
- However, the certainty of the evidence is very low due to methodological flaws and heterogeneity in the existing literature, and further high-quality investigations are necessary to draw definitive conclusions 7.
Treatment Options
- Cold teething rings and over-the-counter treatments, such as analgesic and anaesthetic gels, can provide pain relief and alleviate teething symptoms 3.
- New gels with hyaluronic acid may be more effective than anesthetic gels in improving signs and symptoms such as pain, gingival redness, and poor sleep quality 7.
- Non-pharmacological treatments can be effective, especially against excess salivation 7.