Why Dentists Recommend Benzocaine-Free Teething Gel

By Dr Jack Brazel BChD · Reviewed by Dr John Krezel, Specialist Prosthodontist

For decades, the standard approach to teething gels was simple: numb the area, reduce the sensation, move on. Benzocaine was the go-to anaesthetic in many over-the-counter teething products. But the professional consensus has shifted, and most dentists and paediatric bodies now recommend a different approach.

I am Jack, one of the practising UK dentists behind MamaSmiles. Here is why the shift away from benzocaine is happening, what the evidence says, and what benzocaine-free teething gels offer instead.

Why has the professional view on benzocaine changed?

The turning point was the FDA's 2018 warning against the use of benzocaine in children under 2 years of age. The concern is methemoglobinemia, a condition where benzocaine causes a change in haemoglobin that reduces the blood's ability to carry oxygen. Symptoms include pale or blue-grey skin, shortness of breath, and fatigue. In severe cases, it can be life-threatening, and it can occur after a single application.

Following the FDA warning, several benzocaine-containing teething products were withdrawn from the US market. The American Academy of Pediatrics subsequently advised against topical anaesthetics for infant teething altogether.

In the UK, benzocaine products remain on shelves with appropriate warnings. The MHRA has not issued an equivalent ban. But the direction of professional opinion is clear: most dentists and health visitors now suggest parents explore alternatives rather than defaulting to numbing products.

What are the practical limitations of numbing gels?

Beyond the specific safety concern with benzocaine, numbing gels as a category have practical limitations that are worth understanding.

The effect is short-lived. Benzocaine and lidocaine typically numb for 20 to 30 minutes. Teething discomfort can last for days. This mismatch means either frequent reapplication (which increases risk) or a return to discomfort once the numbing wears off.

They mask rather than support. Numbing addresses sensation only. It does nothing for the gum tissue, nothing for the emerging tooth, and nothing to build healthy oral care habits. It is a reactive approach that treats each teething episode as an isolated event rather than part of your baby's ongoing development.

Reduced mouth awareness. A numb baby may not feel when they bite their cheek, lip, or tongue. This can lead to small injuries that would otherwise be avoided. If the numbness spreads to the back of the mouth, it can temporarily affect the swallowing reflex.

No long-term benefit. Once the numbing wears off, nothing has changed. The tooth is still pushing through, the enamel is still vulnerable, and no protective ingredients have been delivered to the gums or teeth.

What does a benzocaine-free teething gel do differently?

Benzocaine-free gels take a fundamentally different approach. Rather than suppressing sensation, they use ingredients chosen to care for gum tissue and support emerging teeth. The shift is from reactive masking to proactive daily care.

The most effective benzocaine-free gels combine two benefits in one application:

Physical comfort through massage. The act of applying gel with a clean finger provides gentle counter-pressure on the gums. Pressure is one of the most effective natural responses to the sensation of a tooth pushing through, which is why babies instinctively chew during teething.

Ingredient-led care. Rather than numbing, the ingredients do ongoing work. Hydroxyapatite supports emerging enamel. Xylitol creates an oral environment less hospitable to decay-causing bacteria. Botanicals like aloe vera and chamomile are gentle on delicate gum tissue. These ingredients remain beneficial long after the teething moment passes.

What should you look for in a benzocaine-free teething gel?

Not all benzocaine-free gels are equal. Removing the anaesthetic is a good start, but what replaces it matters. Here is what to look for:

Ingredients that support enamel. Hydroxyapatite is the gold standard here. It is the same mineral teeth are made from, it bonds with the enamel surface, and it is safe if swallowed. A gel that protects emerging teeth from the moment they appear is doing something a numbing gel never can.

No sugar. Some gels replace numbing agents with sweeteners to make the product more palatable. If that sweetener is sugar, it is coating emerging teeth with the one substance most likely to cause early decay. Xylitol is the preferred alternative because it actually supports oral health.

Transparency. You should be able to understand every ingredient on the list. If the label reads like a chemistry textbook, ask yourself whether you would be comfortable putting it in your baby's mouth without understanding what each component does.

Professional formulation. Was the product developed by people with dental or medical expertise in infant oral care? This is a meaningful differentiator. A teething gel designed by dentists reflects a different set of priorities than one designed by a consumer goods company optimising for shelf appeal.

MamaSmiles Teething Gel was developed by two practising UK dentists using hydroxyapatite, aloe vera, chamomile, curcumin, and xylitol. It contains no benzocaine, no lidocaine, no fluoride, no SLS, no sugar, and no artificial colours. It is the product we wanted to exist for our own patients' families and our own children.

How to make the switch from a numbing gel

If you have been using a benzocaine or lidocaine gel, switching to a benzocaine-free alternative is straightforward. There is no adjustment period or withdrawal. Simply replace the product and incorporate it into a twice-daily routine: a gentle gum massage with a small amount of gel in the morning and evening.

Many parents find that the combination of a benzocaine-free gel, cool teething rings during the day, and extra comfort during peak moments is more than sufficient. The approach works with the teething process rather than trying to override it.

For a full comparison of teething gel ingredients, see our guide to teething gel ingredients explained.

The bigger picture

The shift toward benzocaine-free teething gels is not a trend or a marketing angle. It is a response to better evidence, clearer regulatory guidance, and a growing understanding that the teething period is a window of opportunity for infant oral health, not just a problem to suppress.

Your baby's first teeth are arriving. They are thin, vulnerable, and brand new. What you put on them in these early weeks and months can support their development or simply mask the process. Choosing ingredients that care for both gums and teeth is an investment that lasts far beyond the teething stage.