Most medicated teething gels are not safe for babies and young children. The FDA has issued its strongest warnings against two of the most common active ingredients found in teething gels, and has urged parents to stop using homeopathic teething products entirely. Non-medicated approaches like chilled teething rings and gentle gum massage are now recommended as the first option for soothing teething pain.
Why Numbing Gels Are Risky for Babies
Teething gels have historically relied on two numbing agents: benzocaine (found in over-the-counter products) and lidocaine (available by prescription). Both carry serious risks for infants and young children.
Benzocaine can cause a condition where the blood loses its ability to carry oxygen effectively. Symptoms include pale, gray, or blue-colored skin, lips, and nail beds, along with shortness of breath, rapid heart rate, and fatigue. This reaction can develop even after the gel has been used before without problems, and it can be fatal.
Lidocaine poses a different but equally dangerous set of risks. Because babies drool heavily and swallow frequently, they can easily ingest too much of the gel. The FDA reviewed 22 cases of serious reactions in children between 5 months and 3.5 years old who were given lidocaine solution for mouth pain. Those cases included seizures, severe brain injury, heart problems, and deaths. The FDA now requires a Boxed Warning, its strongest safety label, stating that lidocaine should not be used for teething pain.
A practical problem compounds the medical risk: numbing gels wash away quickly in a baby’s mouth. Saliva dilutes and displaces the gel within minutes, which tempts parents to reapply more frequently or use larger amounts than intended.
Homeopathic Teething Products Aren’t Safer
Parents who turn to “natural” or homeopathic teething tablets and gels face a different kind of danger. The FDA tested homeopathic teething products from Hyland’s and CVS and found that the amount of belladonna (a toxic plant extract) varied wildly from tablet to tablet. Some tablets contained levels of the active compounds atropine and scopolamine far exceeding what the label stated. Caffeine content was also inconsistent.
This isn’t a matter of theoretical concern. The FDA issued a direct warning urging parents to dispose of homeopathic teething tablets containing belladonna. Hyland’s voluntarily recalled its teething tablets nationwide in 2017, and the FDA sent warning letters to multiple other homeopathic manufacturers. Because homeopathic products are not held to the same manufacturing standards as conventional drugs, inconsistent dosing is a built-in risk rather than a rare manufacturing error.
What Works Instead
Both the FDA and the UK’s health guidelines recommend starting with simple, non-medicated options. These work well for most babies and carry no risk of a harmful reaction.
- Chilled teething rings. A solid teething ring cooled in the refrigerator (not the freezer, which can be too cold and hard on tender gums) gives babies something firm to bite against. The cool temperature helps reduce swelling in the gums.
- Gum massage. Gently rubbing your baby’s gums with a clean finger provides counter-pressure that many babies find soothing. A clean, damp washcloth works the same way.
- Pain relievers by mouth. If non-medicated methods aren’t providing enough relief, infant acetaminophen is an option for babies 2 months and older, and infant ibuprofen can be used starting at 6 months. Both are available as liquid suspensions with weight-based dosing on the label. Acetaminophen should not exceed 5 doses in 24 hours, and ibuprofen should not exceed 4. Avoid ibuprofen if your baby is dehydrated or vomiting.
UK guidelines from NICE follow the same order: try gum massage and teething rings first, then consider sugar-free pain reliever suspensions dosed by weight and age if those don’t work.
Signs That Need Immediate Attention
If your baby has already been given a benzocaine product, watch for skin, lips, or nail beds turning pale, gray, or bluish. Rapid breathing, unusual tiredness, or a fast heart rate are also warning signs. These symptoms can appear within minutes to hours of application and require emergency care.
For lidocaine exposure, signs of trouble include seizures, unusual drowsiness, or difficulty breathing. If a child swallows a large amount of any lidocaine product accidentally, that’s a medical emergency.
Teething itself, while uncomfortable, does not typically cause high fevers or diarrhea. If your baby develops a fever above 100.4°F or seems genuinely ill rather than fussy, something other than teething is likely going on.
What’s Still on Store Shelves
Despite the FDA warnings, you may still find benzocaine-based oral products marketed for adults (toothache relief, for example) on pharmacy shelves. These are not intended for infants. Some teething gels now sold contain no active numbing ingredient at all, instead relying on ingredients meant to soothe through texture or mild cooling. Read the active ingredients panel carefully. If a product lists benzocaine or lidocaine, it should not be used on a baby or young child.
In the UK, low-dose lidocaine teething gels remain available but are restricted to pharmacist supervision. The pharmacist is expected to confirm that non-medicated methods have already been tried and to advise on proper use. This supervised access reflects a more cautious middle ground, but the core recommendation remains the same: try everything else first.