Abstract
BACKGROUND: Various remedies are available to parents for relieving teething symptoms in their infants and toddlers. Some remedies, such as amber necklaces, have no evidence of their efficacy, yet are being widely marketed and increasingly used across North America. On the contrary, teething necklaces are unsafe, corroborated by recent reports of suffocation accidents and death attributed to their use. There is no published literature on the prevalence of teething remedies and what may determine parents’ choices. OBJECTIVES: The primary objective was to assess the prevalence of unsafe teething remedies, especially teething necklaces. The secondary objective was to determine any association between the use of unsafe teething remedies and (a) socioeconomic status (SES), and (b) maternal education. DESIGN/METHODS: Children aged 12–18 months in a mid-sized Canadian city visiting their primary care providers for routine well-baby checks were included. Children aged <12 or >18 months and those with chronic medical conditions were excluded. Parents completed a survey about their child’s teething symptoms and the remedies used to relieve them. Unsafe remedies were based on recommendations published by the Canadian Paediatric Society and American Academy of Pediatrics. They included oral-numbing gels, necklaces (Amber and Hazelwood), and liquid-containing teething rings. RESULTS: Out of 130 surveys, 123 were included for statistical analysis due to missing data. Mean (SD) infant age was 14.47 (2.56) months, and mean (SD) age at first tooth was 6.92 (2.00) months. Overall, 98% of families used teething remedies with 67% of them using unsafe remedies. Of these families, 27% used Amber and 5% used Hazelwood necklaces. 28% of families used more than one unsafe remedy. No significant correlations were found between unsafe remedy use and SES or maternal education. However, a significant negative correlation was noted between SES and use of oral-numbing gels (Spearman’s rho = -0.23, p=0.01). CONCLUSION: This study showed that a majority of parents are using unsafe teething remedies for their infants including Amber teething necklaces, despite lack of evidence to support their efficacy and recommendations against their use. Use of unsafe teething remedies transcends SES and education level. With recent reports of child injury and death associated with their use, the findings of this survey support the need for a new approach to parental education about the safety of teething remedies.