Medication
In cases where the infant is in obvious pain, some doctors recommend the use of non-steroidal anti-inflammatories (NSAIDs) or child-safe pain-relief treatments containing benzocaine, lidocaine, or choline salicylate. Benzocaine must be used cautiously because it can cause methemoglobinemia; 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". 5% lidocaine gel produces anaesthesia (numbing) within 2–5 minutes, lasting for 10–20 minutes. However, one author concludes that "Overall, the risks and adverse effects from inappropriate or prolonged use of pharmacological agents outweigh their potential benefits." She points out that "the psychological trauma involved in administering medications or applying topical preparations to infants must be considered", and argues that "the placebo effect must not be overlooked. For example, applying a gel of 20% benzocaine in polyethelene glycol may give only a modest benefit over applying the placebo, which gives an efficacy of 60% compared with 90% for the active preparation."
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. Similar medicines are also available in powder form, as "teething powder".
Acetaminophen and ibuprofen are also recommended to treat the pain and swelling that babies experience, but should not be administered to babies under six months of age. It should only be used a few times a day so that it does not mask symptoms that are being experienced due to other medical conditions and not because of teething. Products that contain aspirin should never be given to a child unless directed by a pediatrician, due to the risk of Reye's syndrome.
Some traditional medicine used to treat teething pain has been found to be harmful due high lead content, with effects including toxic encephalopathy. "Surma" or "kohl" has traditionally been used in the Middle East and Indian subcontinent as a teething powder, as have the Middle Eastern "saoott"/"cebagin". "Santrinj" - a 98% lead oxide product otherwise used as a paint primer - is also used in the Middle East as a home remedy for teething.