Teething pain in infants

Eruption of the first teeth in a child under two: the gum swells, the child chews on objects, sleeps worse and drools more. It resolves on its own, and teething does not cause fever above 38 degrees or diarrhea – when those appear, the cause is looked for elsewhere. Numbing gels with local anesthetics are banned in this age group because benzocaine causes methemoglobinemia.

ICD-10 K00.71 drug

Also known as: Primary tooth eruption discomfort

Marketing claims without evidence base

The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.

FBenzocaineNot recommended · Local anesthetic, aminobenzoic acid esterBenzocaine gels were rubbed on babies' gums for decades while teeth were coming through. That practice is unsafe. In 2018 the FDA required over-the-counter oral benzocaine gels to be withdrawn for children under two: the drug has no proven benefit for teething, and methemoglobinemia after it is described in hundreds of cases. The Spanish ficha técnica draws the line its own way: the product is not used under 6 years without medical supervision, because children are more sensitive to systemic benzocaine toxicity. Methemoglobinemia starts quietly – blue lips, shallow breathing, drowsiness, tachycardia – and in an infant it develops within minutes. Teething itself causes neither high fever nor diarrhea, and a chilled teething ring and gum massage are what help. If a pharmacy recommended an anesthetic gel for your child's gums, consider seeking a second opinion from a pediatrician.

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit