The U.S. Food and Drug Administration recently issued a warning about benzocaine, a local anesthetic and the active ingredient in many over-the-counter teething pain gels and liquid medications, like Anbesol and Baby Orajel. Benzocaine has been associated with a rare but serious condition called methemoglobinemia, which reduces the amount of oxygen carried in the bloodstream and can result in death in the most severe cases. The FDA advises parents and caregivers not to use products with benzocaine on kids under 2, except under the advice and supervision of a healthcare professional. See a full list of all the OTC medications that contain benzocaine.
Plus: Guide to Teething Symptoms and Remedies
Twenty-one cases of methemoglobinemia have been reported in children and adults with all strengths of benzocaine gels and liquids, but have occurred mainly in children age 2 or younger who were treated with benzocaine gel for teething.
Plus: Hyland’s Teething Tablets Recalled
Here’s what you should know about methemoglobinemia:
- People who develop the condition may experience pale, gray, or blue colored skin, lips, and nail beds; fatigue; confusion, lightheadedness; headache; shortness of breath; and rapid heart rate.
- Its signs and symptoms usually appear within minutes to 1-2 hours of applying benzocaine and may occur with the first application of benzocaine—but possibly not until a later application, so don’t assume there will never be a reaction if there wasn’t one initially.
- Symptoms of methemoglobinemia may not always be apparent.
- If your child has any of these symptoms following an application of benzocaine, seek medical attention immediately.
- Products containing benzocaine currently do not have warnings about methemoglobinemia; they should be stored out of children’s reach.
- Infants younger then 4 months of age, among others, may be at greater risk of developing methemoglobinemia.
- Patients with breathing problems such as asthma or bronchitis, among others, are at greater risk for complications related to methemoglobinemia.
To treat teething pain without the use of benzocaine, the FDA advises healthcare professionals and parents to consider the following recommendations from the American Academy of Pediatrics:
- Offer a chilled (but not frozen) teething ring
- Gently massage or rub baby’s gums with a clean finger
- Should benzocaine use be necessary, use the gel or liquid sparingly—and not more than four times daily.
Baby Orajel is now also offering a Naturals line, which is benzocaine-, alcohol- and dye-free.
Plus: Check Out All Recently Recalled Baby Products
What was the most effective teething remedy for your baby? Did you rely heavily on pain medication like Baby Orajel?