Over-the-Counter Treatment Options for Teething Pain
When you’ve tried all the non-pharmacological options and your baby is still not getting adequate teething pain relief, there are safe over-the-counter medications available. Both oral analgesics (pain relievers) and topical anesthetic (numbing) agents can be used to help relieve teething pain. Never rub oral analgesics directly on the gums as the drug is not designed to be used this way and <1>. Always ask a health care provider, such as your pharmacist, to help you choose a safe and effective teething pain medication for your baby.
Oral Analgesics
Acetaminophen (Tylenol®)
Acetaminophen is a very common pain reliever used in managing teething pain <2>. This medication can be given with or without food, but if the baby is experiencing upset stomach, give the medication with food. Acetaminophen is available conveniently as suspension infant drops. Remember to shake the suspension well to ensure that the medication is equally distributed prior to using the medication. Some of the side effects of this drug include upset stomach and rarely liver toxicities <3>. This medication is dosed based on the baby’s weight and can be given every 4 to 6 hours as needed. It is highly recommended that you ask your pharmacist for help in calculating the appropriate dose for your baby. Pediatric Dosing: 10-15mg/kg/dose orally every 4 to 6 hours as needed (Maximum dose: 65mg/kg/day) |
Ibuprofen (Advil®)
Another oral analgesic option commonly used in treating infant teething pain is ibuprofen <2>. Ibuprofen is also available conveniently as suspension infant drops. The suspension should be shaken well prior to use to ensure that the medication is equally distributed. Some common side effects of this medication include belly pain, throwing up, diarrhea and constipation. This medication should be taken with food to prevent stomach upsets and more liquids to prevent constipation <3>. Similarly, this medication is dosed based on the baby’s weight and can be dosed every 6 to 8 hours as needed. Ask your pharmacist for help in calculating the right dosing for your baby. Pediatric Dosing: 5-10mg/kg/dose orally every 6 to 8 hours as needed (Maximum dose: 40mg/kg/day) |
Topical Anesthetics
Benzocaine (Orajel®)
Benzocaine is a topical anesthetic agent used for temporary teething pain relief <2>. This medication is available as a topical gel formulation. A very thin layer of the gel can be applied to the affected gum areas up to four times daily. The numbing effects will last for about 30 to 45 minutes. Because it causes a numbing effect, if swallowed, this can affect your child’s swallowing ability. Ensure that you wait at least one hour after applying the gel before feeding your baby <1>. Using this medication can cause some skin irritation. There is a rare but serious side effect with the use of this medication, called methemoglobinemia <3,4>. Methemoglobinemia (click here to learn more) can lower oxygen release into the tissues and can result in signs and symptoms of bluish discoloration of the skin, nausea, and difficulty breathing. If the baby exhibits any of these symptoms, seek immediate medical attention <4>. Ask your pharmacist to help you decide whether or not this agent is right for your baby! |
References:
1. Bourassa M. Patient Self-Care. Chapter 87: Teething. 2nd ed. Toronto, ON: Canadian Pharmacists Association; 2010:851-856.
2. Tsang AKL. Teething, teething pain and teething remedies. International Dentistry South Africa 2010:12(5):48-61.
3. Lexi-comp Online. Accessed June 26, 2013.
4. Lehr J, et al. Benzocaine-Induced Methemoglobinemia in the Pediatric Population. Journal of Pediatric Nursing 2012;27:583-588.
Images:
http://abcnewsradioonline.com/storage/news-images/GETTY_H_050511_InfantMedicineDropper.jpg?__SQUARESPACE_CACHEVERSION=1321025597224
http://drugline.org/img/drug/tylenol-infants-suspension-drops-23895_1.jpg
http://www.wellpharmacy.ca/image/cache/data/104-054-500x500.jpg
http://drugline.org/img/drug/orajel-17155_2.jpg
1. Bourassa M. Patient Self-Care. Chapter 87: Teething. 2nd ed. Toronto, ON: Canadian Pharmacists Association; 2010:851-856.
2. Tsang AKL. Teething, teething pain and teething remedies. International Dentistry South Africa 2010:12(5):48-61.
3. Lexi-comp Online. Accessed June 26, 2013.
4. Lehr J, et al. Benzocaine-Induced Methemoglobinemia in the Pediatric Population. Journal of Pediatric Nursing 2012;27:583-588.
Images:
http://abcnewsradioonline.com/storage/news-images/GETTY_H_050511_InfantMedicineDropper.jpg?__SQUARESPACE_CACHEVERSION=1321025597224
http://drugline.org/img/drug/tylenol-infants-suspension-drops-23895_1.jpg
http://www.wellpharmacy.ca/image/cache/data/104-054-500x500.jpg
http://drugline.org/img/drug/orajel-17155_2.jpg