Oman


Safer substitutes for teething gel available in Oman's shops


when too many doses of viscous lidocaine are given to infants and young children, or when they accidentally swallow too much, it can result in seizures, severe brain injury, and heart problems. Photo credit: Supplied

Muscat: Gently rubbing or massaging a child's swollen and tender gums with your finger or giving a cool teething ring or a clean, wet and cool washcloth to chew on, are safer than using a teething gel, a paediatrician said.

"Cool the teething ring or washcloth in the refrigerator for a short time, making sure it's cool — not chill like an ice cube. If the object is too cold, it can hurt the gums and your child. The coolness soothes the gums by dulling the nerves, which otherwise transmit pain," Dr Paul Joseph, paediatrician at Badr Al Samaa Hospital in Ruwi, said.

Last week, the Sultanate's Ministry of Health (MoH) had issued a circular to all healthcare professionals to inform them about the US Food and Drug Administration's (FDA) notification that Oral Viscous Lidocaine 2 per cent solution should not be used to treat infants and children with teething pain.

FDA has issued a boxed warning to be added to the prescribing information (label) to highlight this information.

Viscous lidocaine
When too many doses of viscous lidocaine are given to infants and young children or they accidentally swallow too much, it can result in seizures, severe brain injury, and heart problems.

Cases of overdose due to wrong dosage or accidental ingestion have resulted in the hospitalisation of infants and children, or even death.

"Too often well-meaning parents, grandparents and caregivers want to soothe a teething baby by rubbing numbing medications on the infant's gums, using potentially harmful drugs instead of safer, non-toxic alternatives. This might have prompted the medical authorities to issue such a warning," Dr Shibu Mohammed, dermatologist at Badr Al Samaa, said.

Meanwhile, as different types of formulations of Lidocaine are registered in Oman to treat different types of conditions, the Ministry of Health is in the process of asking the manufacturers of Oral Viscous Lidocaine 2 per cent solution to include this information in the patient information leaflet.

According to a pharmacist, teething gels for children available in Omani markets have only 0.33 per cent of Lidocaine.

The Institute for Safe Medication Practices — a nonprofit organisation dedicated to preventing medication errors — has received reports of teething babies suffering from the overdose of viscous lidocaine.

Symptoms include jittery behaviour, confusion, vision problems, vomiting, falling asleep too easily, shaking and seizures.

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