Are Teething Gels Safe for My Baby?
The short answer
The FDA strongly advises against using teething gels containing benzocaine (like Baby Orajel) for children under 2 due to the risk of methemoglobinemia, a rare but life-threatening condition that reduces blood oxygen levels. Lidocaine-containing products also pose overdose risks. Safe alternatives include chilled teething rings, cold washcloths, gentle gum massage, and age-appropriate pain relievers like acetaminophen if recommended by your pediatrician.
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By Age
What to expect by age
Teething gels should not be used at this age. If your young baby seems uncomfortable, it may or may not be related to teething (early teething before 3 months is possible but uncommon). Offer a clean, chilled teething ring or wet washcloth for gumming. Do not use frozen items, which can be too hard and damage gums.
As teething begins, parents often look for relief options. Avoid all benzocaine and lidocaine products. Safe options include: refrigerated (not frozen) teething rings, a cold wet washcloth, gentle gum massage with a clean finger, and acetaminophen for particularly fussy episodes (with pediatrician guidance).
Teething pain peaks during this period as multiple teeth erupt. In addition to the safe options above, ibuprofen can now be used for teething pain. Silicone teething toys designed for this age are helpful. Avoid amber teething necklaces, which pose choking and strangulation risks with no proven benefit.
Molar eruption can cause significant discomfort. Continue using safe pain management: cold foods (chilled fruit in a mesh feeder), gum massage, teething toys, and appropriate pain relievers. Some "natural" or "homeopathic" teething products have also been found to be unsafe - the FDA has warned about homeopathic teething tablets containing belladonna.
Second molars (2-year molars) can cause discomfort. Continue to avoid numbing gels. Offer cold foods, chewing toys appropriate for the age, and pain medication as needed. By this age, teething discomfort is typically less severe as children have developed coping mechanisms.
What Should You Do?
When to take action
- Your baby is mildly fussy during teething and responds to safe comfort measures
- Teething discomfort lasts a few days around each tooth eruption and then resolves
- Your baby chews on objects and drools more than usual during teething
- Your baby seems in significant pain from teething that is not relieved by safe measures
- You have questions about which teething products are safe
- You accidentally used a benzocaine product on your baby and want guidance
- Your baby shows signs of methemoglobinemia after using a numbing product: pale, gray, or blue-colored skin, lips, or nail beds, shortness of breath, confusion, or rapid heart rate
- Your baby seems excessively ill with fever over 101°F, refuses to eat for extended periods, or has symptoms beyond typical teething discomfort
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
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Related Medical Concerns
Does Teething Really Cause Fever?
Research shows that teething may cause a slight increase in body temperature, but it does NOT cause true fever (temperature at or above 100.4 degrees F / 38 degrees C). A large systematic review of studies found that teething may cause temperatures up to about 100 degrees F (37.8 degrees C), along with drooling, gum irritation, and fussiness. If your baby has a temperature of 100.4 degrees F or higher, they likely have an illness that coincidentally timed with teething, and the fever should be evaluated by your pediatrician rather than dismissed as "just teething."
Should I Give Acetaminophen or Ibuprofen for Fever?
Acetaminophen (Tylenol) can be used from birth (with doctor guidance for babies under 3 months), while ibuprofen (Motrin/Advil) is only safe after 6 months of age. Both are effective fever reducers. Acetaminophen works for about 4-6 hours and ibuprofen for 6-8 hours. Always dose by weight, not age, and use the measuring device that comes with the medicine.
Baby's First Dental Visit Timing
The American Academy of Pediatric Dentistry recommends that a baby's first dental visit should occur by their first birthday or within six months of the eruption of their first tooth, whichever comes first. This early visit establishes a dental home and allows the dentist to check for early signs of decay and provide preventive guidance.
My Baby's Head Shape Looks Abnormal
Many babies develop temporary head shape irregularities that are completely normal. A cone-shaped head from vaginal delivery reshapes within days. Mild positional flattening (plagiocephaly) from sleeping on the back is very common and usually improves with repositioning and tummy time. However, head shape changes involving ridges, a persistently bulging fontanelle, or rapid head growth changes should be evaluated to rule out craniosynostosis.
Achondroplasia (Dwarfism) in Babies
Achondroplasia is the most common form of short-limbed dwarfism, affecting about 1 in 15,000 to 40,000 births. It is caused by a mutation in the FGFR3 gene and is usually apparent at birth with characteristic features including short limbs, a larger head, and a prominent forehead. Intelligence is normal. With monitoring for specific complications and supportive care, children with achondroplasia lead full, active, and independent lives.
Adenoid Hypertrophy and Breathing
Adenoids are lymphoid tissue located behind the nose that help fight infection in young children. When adenoids become enlarged (adenoid hypertrophy), they can block the nasal airway, causing chronic mouth breathing, snoring, nasal speech, and sleep-disordered breathing. Enlarged adenoids are most common between ages 2-7 and are a leading cause of obstructive sleep apnea in young children. Treatment ranges from watchful waiting and nasal steroids to surgical removal (adenoidectomy) if breathing or sleep is significantly affected.