As the mom of an 18 month old, teething seems to be a frequent conversation topic these days. At home, at work, out with my mom friends…it seems to come up all the time. Teething can be frustrating and challenging for parents. I will see families in the office or Emergency Department at their wits end from all the crying and fussing. Is it teething? Ear infection? Something else? Parents are clearly relieved to find out their child’s symptoms are from teething – but now what? Unfortunately, we have little to offer parents in the way of symptom relief from teething other than reassurance that this, too ,will pass. This often leaves parents with a host of recommendations from well -meaning friends. But, sorting through which remedies will work or are safe for your child can be challenging. Do teething necklaces work? Is Orajel safe? Should I try homeopathic therapies?

Infant teething begins sometime around 4-8 months and continues intermittently for the next two years. Children generally have all of their primary teeth by age 3. Primary teeth are also known as baby teeth, milk teeth, or deciduous teeth. All babies experience teething differently and at different times – even children from the same family may get teeth at different times. One child may have mild fussing and another may be irritable for days. Teething can cause significant discomfort and increased drooling in children. Parents also often report low grade fevers, diarrhea, and irritability. Studies have not supported the association between diarrhea/fevers and teething, but anecdotal evidence suggests that for some children there may be a correlation. There are a variety of over-the-counter and home remedies available for teething and it may be a matter of trial and error to find the best solution for you and your baby.

1. Acetaminophen/Ibuprofen– Over-the-counter pain relievers often provide the best relief for children with pain associated with teething. These medications can be given safely over a several day period and are generally well tolerated. Make sure to follow dosing instructions as provided by your physician. Do not use ibuprofen in children under 6 months.

2. Homeopathic medications: There are multiple formulations of “natural” or homeopathic medications sold over the counter. These often contain belladonna, clove oil, or chamomile as the active ingredients. These products are presumed to be safe for children; however, no studies have been done to evaluate safety level or appropriate dosage levels for kids.

3. Benzocaine or numbing medications: A variety of over-the-counter medications contain oral numbing agents. We do not recommend the use of teething products containing benzocaine or other topical numbing agents. Benzocaine usage has been associated with a rare blood disorder that can lead to death.

4. Amber teething necklaces: Amber teething necklaces are made from Baltic amber and contain succinic acid. The succinic acid is thought to have natural anti-inflammatory and pain relief properties and is absorbed through the skin when the amber is worn. Anecdotal evidence suggests that for some babies Baltic Amber can reduce teething symptoms. While the amber itself is safe, the beads can be choking hazards and the necklace can pose a strangulation risk. If you chose to use an amber necklace make sure that your child is supervised at all times while wearing the necklace. Do not let your child sleep in necklaces or any other jewelry.

5. Teething jewelry for mom: A variety of companies are now selling kid-friendly, non toxic jewelry for moms. It is often marketed as teething or nursing jewelry. The jewelry is designed to be safe for babies to play with and put in their mouths. Many moms report that their babies enjoy playing and chewing on the beads and stones. This jewelry should only be worn by mom and should be stored safely out of your child’s reach.

6. Mesh teething feeder: Mesh teething feeders can be useful for soothing sore gums and pain associated with teething. The mesh portion can be filled with frozen (slightly thawed) fruits or vegetables. The screw on top/handle ensures that baby can easily handle the teething feeder and keeps food contents contained to prevent choking. Children should be supervised while using this product.

7. Teething rings, biscuits, wet washcloths: Simple and easy. Teething rings and toys can be chilled in the fridge and often provide some relief from tender gums. We do not recommend freezing these products. Teething biscuits or chewing on a cool wet wash cloth can also provide relief.

8. Brushing and care of teeth: It is important to practice good dental hygiene as soon your child’s first teeth erupt. For children under one it is sufficient to wipe the teeth and gums down with a wet clean cloth 1-2 times daily. Children ages 1-2 can brush their teeth with plain water or fluoride-free toothpaste. Read ingredient labels closely as some children’s toothpaste brands contain juice or other sugar derived additives for flavor. Around the age of two children should switch to using a pea-sized amount of standard fluoride containing toothpaste 2 times daily. It is great to let kids “practice” brushing their teeth but parents also need brush their children’s teeth to ensure a thorough job is done.