What are pharmacists recommending for infant teething treatment?

J Am Pharm Assoc (2003). Jan-Feb 2018;58(1):79-83.e1. doi: 10.1016/j.japh.2017.10.009. Epub 2017 Nov 15.


Objectives: In 2011, the Food and Drug Administration issued a warning to avoid the use of any benzocaine-containing products for infant teething treatment owing to a risk of methemoglobinemia. Several benzocaine-containing products targeted for infant teething are currently available over the counter. Pharmacists are commonly asked for medical advice in the community, and there is no current literature evaluating what pharmacists are recommending for infant teething. The objectives of this study were to evaluate what pharmacists are currently recommending for infant teething treatment and assess what percentage would inappropriately recommend a benzocaine-containing product.

Methods: From March to June 2016, a 16-item in-person paper-and-pen questionnaire was administered to 200 pharmacists in the San Francisco Bay area at 115 outpatient over-the-counter pharmacies. Questions included demographic information, work and educational background, infant teething recommendations, and preferred educational resources.

Results: The overall response rate was 94.3%. One-half (50.5%) of the pharmacists' approaches to infant teething treatment was to recommend a nondrug option first and then, if needed, an over-the-counter medication. A majority (63.0%) of the pharmacists surveyed would inappropriately select a benzocaine-containing product.

Conclusion: Despite warnings, the majority of pharmacists would still inappropriately recommend a benzocaine-containing product for treatment of infant teething. Further education is warranted to ensure that all pharmacists, health care providers, and consumers are aware of the potential harm of benzocaine use in infants.

MeSH terms

  • Adolescent
  • Adult
  • Benzocaine / adverse effects
  • Benzocaine / therapeutic use
  • Community Pharmacy Services / statistics & numerical data*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Infant
  • Male
  • Methemoglobinemia / chemically induced
  • Middle Aged
  • Nonprescription Drugs / adverse effects
  • Nonprescription Drugs / therapeutic use
  • Pharmacists / statistics & numerical data*
  • Surveys and Questionnaires
  • Tooth / drug effects
  • Tooth Eruption / drug effects*
  • Young Adult


  • Nonprescription Drugs
  • Benzocaine