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Teething
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==Treatment== [[File:1940 govt photo minnesota farming scene chippewa baby teething on magazine indians at work.jpg|thumb|Baby teething on a magazine, 1940]] Infants may chew on objects to aid in the teething process. Teething necklaces or bracelets are not recommended as they can cause [[choking]], [[strangulation]], or irritation of the mouth.<ref>{{cite web |title=Press Announcements - FDA warns about safety risks of teething necklaces, bracelets to relieve teething pain or to provide sensory stimulation |url=https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm628932.htm |archive-url=https://web.archive.org/web/20190117035507/https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm628932.htm |url-status=dead |archive-date=January 17, 2019 |website=FDA |access-date=21 December 2018 |language=en}}</ref> Teething rings and other toys, called [[teether]]s, are often designed with textures. Some infants gain relief from chewing on cold objects. Some people freeze small chunks of fresh fruits or vegetables and put them in teething nets.{{citation needed|date=June 2020}} ===Medication=== In cases where the infant is in obvious pain, some doctors recommend the use of [[non-steroidal anti-inflammatory drug]]s (NSAIDs) or child-safe pain-relief treatments containing [[benzocaine]], [[lidocaine]], or [[choline salicylate]]. Benzocaine must be used cautiously because it can cause [[methemoglobinemia]];<ref>{{cite web|url=https://www.fda.gov/Drugs/DrugSafety/ucm250024.htm |title=FDA Drug Safety Communication: Reports of a rare, but serious and potentially fatal adverse effect with the use of over-the-counter (OTC) benzocaine gels and liquids applied to the gums or mouth |publisher=U.S. Food and Drug Administration |date=April 7, 2011 |access-date=December 18, 2011}}{{dead link|date=May 2025|bot=medic}}{{cbignore|bot=medic}}</ref> choline salicylate is related to [[aspirin]] and "may cause [[Reye's syndrome]] in susceptible children, especially those with or recovering from viral infections, or when used in combination with other NSAIDs".<ref name="autogenerated18">{{cite journal | title = Teething, teething pain and teething remedies | first = Annetta K. L. |last=Tsang | volume = 5 | issue = 4 | pages = 18 | journal = International Dentistry β Australian Edition}}</ref> 5% lidocaine gel produces [[anaesthesia]] (numbing) within 2β5 minutes, lasting for 10β20 minutes.<ref name="autogenerated18"/> However, one author concludes that, "Overall, the risks and adverse effects from inappropriate or prolonged use of pharmacological agents outweigh their potential benefits."<ref name="autogenerated3">{{cite journal | title = Teething, teething pain and teething remedies | first = Annetta K. L. |last=Tsang | volume = 5 | issue = 4 | pages = 23 | journal = International Dentistry β Australian Edition}}</ref> She points out that "the psychological trauma involved in administering medications or applying topical preparations to infants must be considered",<ref name="autogenerated3"/> and argues that "the placebo effect must not be overlooked. For example, applying a gel of 20% benzocaine in [[polyethylene glycol]] may give only a modest benefit over applying the placebo, which gives an efficacy of 60% compared with 90% for the active preparation."<ref name="autogenerated3"/> Medicines are often applied to the babies' gums to relieve swelling and pain. These gels are similar to the toothache gel that is used by adults for sore gums and toothaches, but is administered in much smaller doses. Teething gels work as a numbing agent to dull the nerves in the gums so that the pain is less noticeable. It is important to follow the directions on the package to ensure that the correct amount of medication is administered and that proper techniques are used to reduce the risk for infection. It is important not to let the medicine numb the throat as it may interfere with the normal gag reflex and may make it possible for food to enter the lungs.<ref>[http://www.medicinenet.com/teething/page2.htm#medications "Medications used to treat teething pain"]. '"eMedicine MedicineNet''. Retrieved 25 January 2010.</ref> Similar medicines are also available in powder form, as "teething powder". Some traditional medicines used to treat teething pain have been found to be harmful due to high lead content, with effects including [[toxic encephalopathy]]. Surma or [[Kohl (cosmetics)|kohl]] has traditionally been used in the Middle East and Indian subcontinent as a teething powder, as have the Middle Eastern saoott/cebagin. Santrinj β a 98% [[lead oxide]] product otherwise used as a paint primer β is also used in the Middle East as a home remedy for teething.<ref>{{cite journal | pmid = 18690981 | year = 2008 | last1 = Karri | first1 = SK | last2 = Saper | first2 = RB | last3 = Kales | first3 = SN | title = Lead encephalopathy due to traditional medicines | volume = 3 | issue = 1 | pages = 54β59 | pmc = 2538609 | journal = Current Drug Safety | doi = 10.2174/157488608783333907}}</ref>
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