From 2019 onwards, teething gels that contain lidocaine will only be sold in pharmacies.
The Medicines and Healthcare products Regulatory Agency (MHRA) has advised that pharmacists are best placed to provide guidance when babies are teething.
The MHRA stated that the medicines should only be used when other, non-medicinal options do not provide adequate relief. This advice follows a review which also recommended that the administration instructions and safety warnings should be updated, too.
The President of the Royal Pharmaceutical Society Ash Soni said: "It's natural for parents to be concerned if their baby is experiencing discomfort with sore gums when teething. Your local pharmacist can provide parents and caregivers of teething babies with expert advice and recommend the best course of treatment. Your pharmacist is always a good first port of call for any common condition your child develops.
“It’s advised that you give a teething baby something to chew on like a teething ring that’s been in the fridge but, if that isn’t enough, then your pharmacist can give you expert advice about using a teething product containing lidocaine and how to use it safely.”
The MHRA review concluded that there's not enough evidence of benefit to using teething gels containing lidocaine as a first resort, rather than trying non-medicinal options first. Evidence of any risk associated with these products is very small given their wide usage, but a pharmacist or healthcare professional can provide the most appropriate guidance.
Dr Cheryll Adams CBE, Executive Director of the Institute of Health Visiting said:
“Teething is a normal process, alongside some resultant pain, however, this can prove distressing for the baby and its parents. Parents should talk to their health visitors if they are concerned that their baby is overly distressed, but their first action should be to offer the baby a cold teething ring, or similar, to bite on to relieve their discomfort and/or to massage the baby's gums with a clean finger. If this isn't effective and the baby is persistently distressed, then they can speak to a pharmacist who may feel that it's appropriate to offer a pharmaceutical treatment.”
When do babies start teething?
For most babies, the first tooth tends to come through at around six months. It can push through in a matter of days. Alternatively, you might find your baby displays the symptoms of teething without any teeth materialising for a month or two.
If your baby has reached six months, and there are no teeth yet, you needn’t worry: all children are different when it comes to this aspect of their development. Some babies get their first tooth at four months while others have to wait until around their first birthday.
If your baby has passed his first birthday, has no teeth but is developing in all the other ways – weight gain, bone and hair growth – then don’t worry. His teeth will be along soon and there’s no reason to think that he’s developmentally behind. In fact, some experts argue that there’s an upside to a delay: the later a baby’s milk teeth come along, the less time there is for them to decay before they’re replaced by his big teeth.
If your baby is developing slowly in all departments, however, you should consult your doctor.
“My four-month-old has become super fussy and is crying all the time. I have a feeling it may be early teething.”
“They seem to be teething forever before a tooth appears!”
“My baby used to like chewing my finger. She dribbled like mad, cried quite a lot and got really red cheeks.”
“My son is a mess and on a nap strike (he napped four hours a day before he started teething).”
How long does teething last?
About a year, although it can take longer. Most babies have all their milk teeth by the age of two-and-a-half. If your baby is in the throes of teething, and the prospect of this going on for months or even years sounds alarming, then rest assured that the early stages are often the worst and most babies settle down afterwards.
That said, it’s likely your baby will go through a difficult patch at around 12 months when he gets his molars (the big teeth at the back). Some Mumsnetters say the molars are the worst part of teething. So don’t be too concerned if your baby is particularly uncomfortable during this stage and remember that the worst will soon be over.
My son is teething and he's gone off his favourite foods. I've forgotten what a good night's sleep feels like!
Is teething painful?
The short answer is ‘yes’ but the truth is more complicated. Teething is a byword for tetchy babies and there are plenty of Mumsnetters who talk in hushed tones about “teething hell”. We don't wish to play down the difficulties but there are parents for whom it goes surprisingly smoothly. This is because all babies are unique and react differently to the pain. Some will grin (gummily) and bear it. Others will scream the house down. A few just look sad and subdued.
Your baby’s teeth started developing while he was in your womb. Back then his tooth buds were forming but now his teeth are pushing up through his gums and that’s as painful as it sounds – not dissimilar, in fact, to how it felt when you got your wisdom teeth.
Read next: The best baby spoons for weaning
What are the symptoms of teething?
The symptoms might last only a few days but, if several teeth come through at once, they could persist for months. A few lucky babies don't experience much discomfort. The majority, though, will express some displeasure, understandably. Your baby won’t exhibit all of the symptoms but, if you spot a combination of any of the following, then he’s probably teething:
- Sore and swollen gums.
- Redness where a tooth is coming through.
- Drooling and dribbling more than usual.
- Refusing feeds and discomfort while eating.
- Gnawing and chewing objects, such as limbs, toys, you.
- Rubbing his face.
- Trouble sleeping.
- Flushed cheeks.
Over the years, people have made many claims about teething but we think it's important to dispel two of them:
- Diarrhoea. Some parents believe that teething causes their babies to suffer from diarrhoea. While there's plenty of circumstantial evidence for this, the connection has no scientific basis. It is possible though that all that gnawing on objects they find lying around means they are more prone to picking up tummy bugs at this time.
- Fever. Same as above. If your baby is suffering from fever that’s unfortunate and should be monitored, but there’s no evidence to indicate that it’s brought on by teething.
How can I help my teething baby?
Nobody wants to see their baby in distress, and this can be a challenging time for both of you, but remember that it’s necessary, we have all been through it and it does end eventually. Here are some suggestions which might help to ease your baby’s pain:
- Play with him. Distraction is one of the best ways to counter pain. Playing with your baby will help to take his mind off things.
- Give him something good to chew. As mentioned, teething babies chew anything they can get their hands on. This can be dangerous (keep him away from the coal scuttle) but it can have its benefits and could help with weaning. As long as he’s not younger than six months, give your baby sliced apple or raw carrot to chew – a breadstick or bit of crusty bread will also work – but remember never to leave him unattended when he’s eating.
- Dummy. There are plenty of dummy discussions on Mumsnet, about the pros and cons, but one pro is that it can help ease the pain and offer some comfort.
“My daughter is teething very badly. She's my first, so I'm not sure what's best. Do you have an advice?”
“Nurofen and lots of Dentinox. Teething powders had no discernible effect on my kids.”
“Amber teething necklace – magic!”
“Anbesol was brill for my son and teething powders helped my daughter.”
- Keep him clean. Excessive dribbling can make your baby’s face sore. So gently wipe away his saliva with a clean cloth. It’s time-consuming but it’s better than him getting a rash, which will only add to his agitation.
- Start brushing. As soon as you baby’s first tooth comes through you should start brushing his teeth with fluoride toothpaste. Get him into the habit early and you should have fewer problems keeping him brushing later on.
- Register with a dentist. Do this as soon as your baby's first teeth start coming through.
- Don’t be hard on yourself. A teething baby can try anyone’s patience and some Mumsnetters describe feeling angry towards their babies, even though they know they’re suffering. This is natural, especially if you’re suffering from sleep deprivation, so try to stay calm, don’t blame yourself and remember that there’s big difference between having horrible thoughts towards your baby (or at least towards your baby's teeth) and acting on them.
Should I use teethers and gels?
My daughter is teething at 14 months. Each tooth takes about two weeks to come through and the best thing to use is ibuprofen. Powders and gels don't do much.
If the practical steps listed above are doing little to ease your baby’s pain then you might want to invest in one of these products, all used by Mumsnetters with varying degrees of success:
- Teethers. If your baby is chewing and gnawing a lot then giving her a baby teething toy can be a source of relief and distraction for her. Things have moved on since the days of bog-standard teething rings, although they’re still available, and the market is now full of gel-filled teething rings, giraffe-shaped teethers and much more. Some rings can be placed in the fridge before use, as the cool will soothe your baby’s gums, but follow the instructions that come with the product.
- Gels. Mumsnetters have their personal favourites and will tell you which teething gels they find most effective. On the whole, though, they agree that gels are a useful way to ease pain. Gels contain local anaesthetic and antiseptic and should be applied to the gums with a clean finger or piece of cotton wool. The gel will numb your baby’s gums and ease the pain. The effect won’t last long and might be washed away by your baby’s saliva (especially if he’s very dribbly), but don’t be tempted to apply more than the manufacturer’s instructions recommend.
- Painkillers. If your baby is really suffering you can give him a sugar-free painkiller that’s specifically for babies. These contain a small dose of paracetamol or ibuprofen. Follow the manufacturer’s instructions for dosage. Never give aspirin to children under 16 years old.
- Alternative remedies. You won’t be surprised to hear that there’s zero medical evidence that alternative remedies can help. However, pharmacies stock homoeopathic teething powders, as an alternative to gels, and some Mumsnetters say they have helped their babies. If you're going to try powders, make sure you choose a brand that’s sugar-free. Other parents will swear by amber necklaces or bracelets. Again, there's no scientific evidence that supports this theory but it won't do any harm if you fancy giving it a try – do follow the manufacturer's safety recommendations though – particularly if you're putting anything around your baby's neck.
What Mumsnetters say
“Get a nice squidgy teething ring and put it in the fridge, then let them chew it. My baby also used to like chewing my finger. They dribble like mad when teething and cry quite a lot. Mine got really red cheeks. He seemed to go through all this for ages before his first tooth even appeared!”
“When my daughter was teething, she was grizzling, had a runny bottom, was chewing fingers, rubbing ears, and had red cheeks. But my son was the complete opposite, showed no symptoms except being a bit grumpy.”
“My daughter started teething and it was like someone had come in the night and swapped babies. It was hard but I just tried to remind myself how painful toothache is and that it wasn't her fault, although I was tempted on more than one occasion to give her to a passing stranger. The difficult bits come in fits and starts usually, as the teeth move down the gum. It is hard but it does pass.”
“Powders were not much use for my baby, despite many parents raving about them, but others might have more luck with them. For us, Calprofen was the best, as it reduced swelling of the gums.”
“The molars are the worst as they grind up through the gums so they take longer. At this stage your baby might be off her food, as it might hurt to eat. Cucumber sticks sometimes help as they are cool and hard enough to chew.”
“If you are cross with your baby for keeping you up while teething, you’re just tired and you should remember that none of us are at our best when sleep deprived. There’s a big difference between thinking, ‘Go to sleep, you bloody monster,’ and actually doing something to harm a baby.”
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