Benzocaine Teething Products: What You Need to Know

Toddler sitting outside with teddy bear

By: Dr. T. Jann Caison-Sorey, senior medical director at Blue Cross Blue Shield of Michigan

 The U.S. Food and Drug Administration (FDA) recently warned that over-the-counter teething products containing benzocaine are dangerous for infants and young children. As of May, these products began being pulled from shelves and companies are required to add warning labels to all other benzocaine oral health products. The FDA is urging parents, caregivers, retailers and the general public to take precaution and raise awareness around the risks associated with all benzocaine oral health products.

What is Benzocaine?

Benzocaine is a temporary, topical pain reliever found in over-the-counter health products. It often treats itching, insect bites, minor burns, cuts, and scratches. In addition to this, benzocaine treats oral pain and can be found in infant’s teething products to relieve sore gums. Since this medication is still currently available over-the-counter, a doctor may on occasion, provide guidance on proper use and dosage, depending on the condition or injury.

What Makes Benzocaine Unsafe?

The FDA reports that teething products for infants containing benzocaine can cause a rare, but serious condition called, “Methemoglobinemia.” This blood disorder results from too little oxygen being delivered to the cells and tissues. Methemoglobin is a condition where the “hemoglobin” (in the body’s red blood cells) is hindered in its ability to carry healthy oxygen to the cells and tissues of the body. The result is that the body becomes severely oxygen starved. Though Methemoglobin can be hereditary, it can also occur when the body is exposed to Benzocaine, the ingredient found in oral health products, often used for the temporary relief of minor oral pain or discomfort. Those who carry a genetic form of the condition have a higher likelihood of having complications of Methemoglobin; however, most don’t acquire it genetically. If there is a lack of immediate recognition and the condition goes untreated, methemoglobinemia can be fatal.

Symptoms of Methemoglobinemia

Symptoms of methemoglobinemia can vary but often appear within minutes to less than an hour after using benzocaine products. Those who have asthma, bronchitis, heart disease, and/or are elderly have a higher risk for complications. If a child or loved is involved and displays symptoms of methemoglobinemia, immediate emergency medical attention is required. Some of the signs to look out for include:

  • Skin Discoloration (Pale Skin, Cyanosis (bluish color of Lips or Nail Beds)
  • Shortness of Breath
  • Rapid Heart Rate
  • Confusion
  • Fatigue
  • Headache
  • Lightheadedness

Alternatives to Benzocaine Products

Although benzocaine products are often used as a remedy for teething pain, consider safer alternatives that can be just as effective. For infants, the American Academy of Pediatrics recommends the use of benzocaine-free teething rings or similar items made with firm rubber that can be cooled in the refrigerator to help ease teething discomfort. Another useful technique is for parent/caregivers to use clean hands to gently massage an infant’s gums with one finger. For adults, the American Dental Association recommends those with mouth sores use over-the-counter pain relief medications or a warm salt-water rinse. It’s also crucial to avoid smoking or tobacco products and limit alcohol intake.

Dr. T. Jann Caison-Sorey is a pediatrician, adolescent medicine physician and senior medical director at Blue Cross Blue Shield of Michigan. For more health tips, visit AHealthierMichigan.org.

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