Our first tooth typically appears before we turn 1 year old -- usually around 6 months -- and those pearly whites continue to erupt through the toddler years until we have a full set of 20 baby teeth around the age of 3. The first teeth to emerge are usually the central incisors, which are the four front teeth on the top and bottom jaw.
While you may find your baby is relatively symptom free during the teething process, most babies give at least a few indications that they're uncomfortable. Babies who are teething can become fussy and irritable, and may not want to eat, drink or sleep. You might find them chewing on everything from fingers to toys to furniture. It can be a painful process, with sore, swollen gums and a lot of drool. Luckily, teething symptoms aren't a day in, day out complaint during the teething years. Most babies and toddlers are bothered during the few days prior to a tooth erupting, and thankfully there are remedies available to help soothe the pain and inflammation that comes along with teething.
Not all parents choose to give their child pain relievers during the teething cycle, but for those that do, three common remedies are over-the-counter teething (OTC) topical pain relievers, OTC oral pain relievers and teething tablets.
Topical pain relievers such as teething sprays and gels are local anesthetics that work quickly -- these treatments are rubbed directly on the baby's gums. Topicals are controversial, however, because these remedies often contain benzocaine as their active ingredient. The Food and Drug Administration has warned that benzocaine is associated with methemoglobinemia, a blood disorder that causes an abnormal accumulation of hemoglobin. Methemoglobinemia is a rare but serious side effect, so some parents choose to avoid topical remedies and instead reach for other types of pain relievers such as acetaminophen (Tylenol) or ibuprofen (Advil or Motrin).
These OTC pain relievers are trusted by many parents and pediatricians, but they don't come without risk of side effects, either. Acetaminophen reduces teething pain, but might cause nausea and vomiting in some people, and it may increase the risk of liver disease. Acetaminophen is also commonly bundled with other ingredients used to treat coughs and sore throats -- ingredients that aren't necessary for teething relief. Non-steroidal anti-inflammatory drugs such as Advil and Motrin reduce inflammation and pain, but have been linked to gastrointestinal bleeding.
Some parents choose to use alternative teething remedies instead of OTC drugs. Let's look at teething tablets along with other alternative ways to give your baby relief.
Teething Tablets and Other Alternative Teething Remedies
Teething tablets, also called teething pellets, are homeopathic alternatives to over-the-counter teething relief and are primarily made by Humphreys Pharmacal and the Standard Homeopathic Company (under the name Hyland's), two companies known for their homeopathic products.
How do tablets and infants go together? The way these work is fast and easy. You'd place two or three of these soft tablets under your child's tongue, where they are designed to dissolve instantly. You can also dissolve them in a teaspoon of water (especially convenient if you would rather not put tablets in the mouth of babes). Tablets can be used four times a day. They are all-natural, made without artificial dyes or flavorings, numbing ingredients (such as benzocaine) or preservatives (such as parabens). The active ingredient list includes chamomile to relieve irritation, coffee seeds for calming, calcium phosphate for growing teeth and belladonna to relieve inflammation.
It's the belladonna that creates controversy about teething tablets.
Belladonna, a plant also known as deadly nightshade, is potentially toxic. Its leaves and roots have been used in medicines -- and poisons -- for thousands of years. Belladonna poisoning affects the nervous system. It can cause agitation, muscle weakness, flushed skin, lethargy and sleepiness, constipation and problems urinating, labored breathing, and seizures. Because of this ingredient, the FDA issued a recall of Hyland's teething tablets in 2010. As of August 2011, they have yet to be reintroduced.
Teething tablets aren't evaluated by the FDA, nor are they recommended by the agency or by health care professionals because, beyond the potential toxicity, belladonna's use has not been proven to be clinically beneficial.
Teething tablets aren't the only alternative teething remedy, though. For those parents who prefer a drug-free teething process, try the remedy long recommended by pediatricians: Rub your baby's tender gums with your (clean, please) finger to help to ease pain. Cold objects for chewing are another safe and drug-free remedy. Frozen rubber teething rings or frozen wet washcloths will help to reduce gum inflammation. Remember, teething is temporary. Break out the ice cubes!
More Great Links
- American Dental Association. "Baby Teeth." (Aug. 19, 2011) http://www.ada.org/3084.aspx
- Humphreys Pharmacal, Inc. "Original Teething #3" (Aug. 19, 2011) http://www.humphreysusa.com/personal-teething.htm
- Hyland's. (Aug. 19, 2011) http://www.hylandsteething.com
- Mersch, John. "Teething." MedicineNet.com. 2011. (Aug. 19, 2011) http://www.medicinenet.com/teething/article.htm
- Nemours. "Teething Tots" 2008. (Aug. 19, 2011) http://kidshealth.org/parent/general/teeth/teething.html
- PKIDS. "Ibuprofen vs. Acetaminophen." (Aug. 19, 2011) http://www.pkids.org/files/pdf/phr/08-06whichpainkiller.pdf
- WebMD. "Teething - Topic Overview." 2009. (Aug. 19, 2011) http://www.webmd.com/parenting/baby/tc/teething-topic-overview
- U.S. Food and Drug Administration. "Benzocaine Topical Products: Sprays, Gels and Liquids - Risk of Methemoglobinemia." 2011. (Aug. 19, 2011) http://www.fda.gov/safety/medwatch/safetyinformation/safetyalertsforhumanmedicalproducts/ucm250264.htm
- U.S. Food and Drug Administration. "FDA Issues Consumer Safety Alert." 2010. (Aug. 19, 2011) http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm230761.htm
- U.S. National Library of Medicine. "Belladonna." 2010. (Aug. 19, 2011) http://www.nlm.nih.gov/medlineplus/druginfo/natural/531.html