Whether it happens early in infancy or later in the first year of life, the eruption of teeth is a rite of passage for every baby. We’ve looked at the symptoms commonly (but mistakenly) attributed to teething before on The PediaBlog:
Teething gets blamed for a lot of what parents perceive to be infant discomfort and fussiness. Symptoms of illness such as fever, excessive crying, decrease in appetite, disruption of sleep, rashes, and diarrhea are commonly blamed on teething. Interestingly, there is very little evidence that teething causes any of these symptoms. Indeed, teething is overrated as a source of misery in babies.
Parents can get fooled when their infants are having symptoms that are indicative of a serious illness rather than being caused by teething. On her excellent blog, pediatrician Jaime Friedman explains:
Babies who are teething may experience fussiness and drooling for 3-5 days prior to a tooth making an appearance. Sometimes the excessive drooling causes a rash on the face and chin. Babies may also put their fingers and toys in their mouths to relieve the feeling of pressure on the gums and the gums may appear swollen. Some babies may have a slightly decreased appetite but they should not stop eating altogether or become dehydrated. Babies DO NOT have fever, vomiting and diarrhea, common cold symptoms or weeks of discomfort due to teething. If you think your baby is having any of these symptoms you should seek medical care or call your pediatrician.
Other than using some simple measures to provide relief — parents can massage their baby’s gums, offer a cold, hard rubber teething ring to chew on, or as a last resort, give a dose of acetaminophen — treating teething symptoms with over-the-counter products is not necessary and can, in fact, be dangerous. For example, Dr. Friedman says that teething tablets have been linked with several infant deaths. She reminds us that just because something is “natural” doesn’t mean it is safe:
These tablets contain belladonna, which comes from a plant typically referred to as Deadly Nightshade. Belladonna affects the nervous system and can cause dry mouth and skin, dilated pupils, hallucinations, rapid heart rate and death[…] These tablets are homeopathic, which means they are very highly diluted to the point of just being nothing. However, because homeopathic preparations are considered supplements by the FDA and not medication, they are not studied for safety and efficacy and are not regulated for consistency of concentration, dosing or quality.
For similar reasons — they aren’t necessary and they can be harmful — teething gels containing benzocaine should also be avoided. Teething necklaces and bracelets are also hazardous and should not be placed around the neck or wrist of an infant or young child:
Children should not use teething jewelry, which can lead to choking or strangulation, according to a warning from the Food and Drug Administration (FDA).
Teething necklaces and bracelets are made of amber, wood, marble or silicone. They are marketed to relieve teething pain and sometimes are used to provide sensory stimulation to people with attention-deficit/hyperactivity disorder.
The FDA has received reports of children choking on beads that break off and an 18-month-old being strangled to death by an amber necklace during a nap.
Pediatrician John Snyder started wondering about the “amber waves of woo” when he first spotted them in his office a few years ago:
I have recently noticed one particular intervention that seems to be becoming more prevalent, at least in my practice. I’ve begun to see more and more infants sporting Baltic amber teething necklaces. These consist of multiple small beads of amber on a string that is worn around a baby’s neck, and are supposed to relieve the discomfort of teething. Before I had any idea what these necklaces were for or how they were supposed to work, my first reaction was to inform these parents of the dangers of necklaces or anything placed around an infant’s or young child’s neck. Strangulation is a known cause of accidental injury and death in children, and pediatricians are trained to discuss this as part of the routine anticipatory guidance we give to parents. In addition, we strongly advise against giving infants or young children any small items that could be accidentally aspirated, such as the beads found in a necklace of this sort. But I was equally surprised to learn that these necklaces are not intended for babies to chew or gum. Instead, they are supposed to ease a baby’s teething discomfort simply by lying against the skin.
How exactly would that work?
The alleged mechanism of action of wearing Baltic amber against your skin varies considerably based on whom you speak to, and which snake oil salesman you are buying from. They range from the hilarious to the just barely plausible.
Dr. Snyder takes down the purported benefits of amber teething products by looking at the science and doing some math here. Suffice it to say, don’t buy them and don’t use them to soothe the very minor symptoms of infant teething.