Beware the teething trap. Many products don't work, and can even be dangerous

(MENAFN- The Conversation) If you imagine a teething child, what do you see? An irritable tot with a fever, in pain, and generally unwell?

Teething's a normal developmental process that peoplehave long associated with illness . However, the evidence says otherwise.

How strong is this evidence? Is there anything you can do to help a teething child? What about teething gels and teething necklaces?

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Teething is when new teeth emerge through the gums, and usually starts at about six months of age.

Areviewof 16 studies found that although teething was linked with signs and symptoms, these were usually mild involving gum irritation, irritability, and drooling.

Although body temperature may be slightly raised, the review found poor evidence to suggest teething caused fever. Many symptoms linked to teething, like irritability, sleep disturbance and drooling, are difficult to measure objectively and are based on what parents report, which is subjective and may be inaccurate.

And, as teething comes and goes, and its timing is relatively unpredictable, recording even measurable symptoms like temperature changes in a reproducible, reliable way is virtually impossible.

So teething problems seem to beover-reported in the types of studiesthat rely on people remembering what happened.

Other biological triggers may in fact explain the symptoms traditionally linked to teething. Teething coincides with normal changes in children's immunity; the mother's antibodies are transferred to babies in pregnancy and help protect the baby in the first 6-12 months of life, but start to wane at about the same time as teething.

This, together with behavioural changes as infants start to explore their surroundings, increases the chances of catchingviral infectionswith symptoms like those reported for teething.

Separation anxiety and normal changes in sleep patterns may also account for irritability and sleep disturbances, which may be mistakenly attributed to teething.

As teething symptoms are generally likely to be mild and focused on the mouth, parents are warned againstpresuming that signs of illnessin other parts of the body are due to teething. That's because this may delay the detection of potentially serious infections that may need medical attention. It may also delay parents getting help settling their child to sleep.

The search for solutions to the perceived problem of teething may lead parents to pin their hopes on gels, toys and other products, none of which have been scientifically assessed to alleviate teething symptoms.

Nevertheless, teething gels usually contain a variety of ingredients that help relieve supposed teething-related symptoms. Some, such as therecently discontinuedAdelaide Women's and Children's Hospital Teething Gel, contain the anaesthetic lidocaine.

Very little lidocaine is absorbed into the body when applied to the gums, andonly minor complicationslike vomiting have been reported in Australia. However, accidental swallowing and applying too much can lead to poisoning, resulting in seizures, brain injury, and heart problems.

The decision to discontinue the gel follows a2014 warningissued by the US Food and Drug Administration against using teething gels with topical anaesthetics, after reports of infant and child hospitalisation and death.

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There have also beenwarningsabout teething gels containing benzocaine. This is another anaesthetic applied to the gums that can lead to a dangerous and fatal blood condition called methaemoglobinaemia, which affects the blood's ability to carry oxygen.

Another common ingredient in popular teething gels is choline salicylate, an anti-inflammatory similar to aspirin. This increases the risk of liver disease and brain injury if the child eats too much. This may alsocarry the risk of Reye syndrome , a rare but serious condition that can lead to seizures, loss of consciousness and death. Reye syndrome has beenlinked to the use of aspirin in children , particularly during viral infections.

A case of suspected teething gel-induced Reye syndromein 2008 led to the products being contraindicated (warned against) in children inthe UK .

Anumber of young Australian childrenwho used too much salicylate-containing teething gel have also reportedly been hospitalised with side-effects.
But the products are still available in Australia.

Although a range of 'natural' and homeopathic teething solutions are heavily marketed to parents of young children, these too haverisks .

A manufacturerrecently recalleda range of natural teething gels after cases of reported poisoning. AndUS regulatory authorities foundthe same range contained higher than reported levels ofbelladonna , a poisonous plant that despite its dangers is used as a homeopathic pain killer and sedative.

In searching for 'natural' therapies, parents are also turning to amber teething necklaces that supposedly relieve teething symptoms. Amber is afossilised tree resinthat has historically been suggested to have anti-inflammatory properties.

However, several widely reportedcases of strangulation
have led to warnings from bothUSandAustralianregulatory authorities. There is currently no scientific evidence these necklaces work.

The Australian Competition and Consumer Commission(ACCC) says amber and other 'teething' necklaces, even when mothers wear them, are:

…colourful and playful in design, and may be confused with toys.

All toys for children aged 36 months and below, including teething toys, are strictly regulated byAustralian standards . As the ACCC warns, teething necklaces are unlikely to fulfil this requirement.

So what are the best options to relieve teething symptoms? With a lack of any good-quality evidence to recommend any specific therapy,expertssuggest the best remedy is affection and attention.

Rubbing a clean finger on the gum, or applying gentle, firm pressure with a cooled (but not frozen), clean washcloth or teething ring may provide some relief. Although it's hard to know exactly how these work, they are unlikely to lead to serious problems.

Teething can be a difficult time, but it will eventually pass. In the meantime, it is important that parents avoid falling prey to supposed cures that are not only unproven, but are also potentially dangerous.

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