Few stages of early parenthood generate as many late-night Google searches as teething. Somewhere between the third sleepless night and the fifth chewed-on teething ring, most parents end up standing in a pharmacy aisle, reading the back of a few different boxes, and wondering what the difference actually is.
It's a fair question. Teething gels are not all built the same way, and the ingredient list matters more here than it does for most products — simply because of how often a teething gel goes into a baby's mouth, sometimes several times a day, for weeks at a stretch.
Here's a clear, factual look at what's typically in a teething gel, why ingredients have changed over the years, and what to actually look for when choosing one.
The Main Approaches to Teething Relief
Broadly speaking, teething products on the market today fall into three categories:
- Local anaesthetic gels — typically use an ingredient like lidocaine to numb the gum directly, providing short-term relief from the discomfort of a tooth pushing through.
- Natural, plant-based gels — use ingredients like clove bud oil or other botanical extracts, working more gently and without numbing the area (e.g. Benevits Teething Gel).
- Homeopathic granules — products like Nelsons Teetha Teething Granules take a different approach entirely: dissolvable granules containing Chamomilla (a homeopathic preparation of chamomile), given directly into the baby's mouth.
There's also a fourth category worth knowing about, mostly for historical reasons: salicylate-containing gels, which used to be more common but have become far less so due to safety guidance issued over the past two decades.
A Quick History: Why Salicylates Became a Concern
Salicylates are a family of compounds related to aspirin. At one point, some oral gels — used for both teething and mouth ulcers — contained an ingredient called choline salicylate, valued for its anti-inflammatory effect on sore gum tissue.
Concerns emerged due to salicylates' established link to Reye's syndrome, a rare but serious condition affecting children, historically associated with aspirin use. Following a small number of adverse event reports, the UK's Medicines and Healthcare products Regulatory Agency (MHRA) reviewed the evidence in 2009 and issued updated advice: oral salicylate gels should not be used in anyone under 16, in line with existing aspirin guidance for that age group.
It's worth being precise here, because this point often gets blurred in online discussion: the products actually sold as teething gels in the UK and Ireland today were reformulated well before this, and don't rely on salicylates. The regulatory change was specifically about adult-labelled oral gels for mouth ulcers and denture pain, not the children's teething products on pharmacy shelves now.
So if you're choosing a teething gel from a UK or Irish pharmacy today, salicylate exposure isn't something you need to actively rule out. That said, understanding why the industry shifted away from salicylates helps explain the broader move toward gentler formulations generally, including the rise of plant-based options.
A Note on Homeopathic Teething Granules
Products like Nelsons Teetha Teething Granules sit in a distinct category worth understanding on its own terms. These contain Chamomilla 6c, a homeopathic preparation of chamomile, given as quick-dissolving granules rather than applied as a gel.
It's worth being clear about what "homeopathic medicinal product" actually means from a regulatory standpoint: these products are licensed under a specific homeopathic registration scheme, which assesses safety and quality, but does not require evidence of effectiveness in the way conventional medicines do. The packaging itself reflects this — it's common to see homeopathic teething products described as "used within the homeopathic tradition," language that exists precisely because efficacy hasn't been clinically demonstrated to the same standard as a licensed medicine.
This doesn't mean homeopathic granules are unsafe — they're generally very well tolerated, contain no anaesthetic, and many parents like the ease of a single dissolving sachet. It simply means they sit in a different regulatory category to gels containing lidocaine or a standardised plant extract.
What to Actually Look For When Choosing a Teething Gel
Rather than focusing on a single ingredient to avoid, it's more useful to think about three practical questions:
1. Does it numb, or does it soothe?
Anaesthetic gels (containing lidocaine) work quickly but wear off after a short period, and shouldn't be used too frequently in a single day — always follow the dosing guidance on the pack closely, as these have a maximum daily frequency for good reason.
Plant-based gels, such as those built around diluted clove bud oil, work more gradually and don't carry the same dosing restrictions, making them suitable for more frequent use throughout the day as needed.
2. What's the sugar content?
Some older-style teething products included sugar to make them more palatable. For a product going into a baby's mouth multiple times a day, every day, for weeks, a sugar-free formula is generally preferable — particularly once teeth have started to emerge.
3. Is it free from unnecessary additives?
Look for a short, recognisable ingredient list. Artificial colours, flavours, and unnecessary preservatives add nothing to how well a teething gel works, and there's little reason to choose a formula that includes them over one that doesn't.
So, What Should You Choose?
There's no single "correct" answer — it depends on your child, the severity of their discomfort, and what you're personally comfortable with.
- For a baby having a genuinely difficult day with teething pain, a short-term anaesthetic gel, used according to the stated dosing limits, can provide quick relief.
- For everyday, ongoing teething discomfort, many parents prefer a sugar-free, plant-based gel that can be used more frequently throughout the day without the same dosing restrictions.
- Others prefer the simplicity of homeopathic granules, understanding that these work within a different evidence framework than conventional medicines.
If you'd rather take the natural, non-homeopathic route, look for a product that's transparent about its formulation — clearly stating it's free from synthetic additives, sugar-free, and built around a recognisable plant-based active ingredient such as clove bud oil.
A Note on Non-Gel Relief Methods
Gels aren't the only option, and they work well alongside other simple measures:
- Clean, chilled (not frozen) teething rings
- Gentle gum massage with a clean finger
- Cold, hard foods for babies already on solids (always supervised)
- Plenty of cuddles — teething is uncomfortable, and comfort itself genuinely helps
The Bottom Line
Teething gel ingredients have evolved over the past two decades, largely for good reason, and today's pharmacy-stocked products reflect that shift. Rather than worrying about an ingredient that's no longer relevant to what's actually on shelves, focus on what matters now: numbing versus soothing, sugar content, and a clean, minimal ingredient list.
If you're ever unsure which option suits your child, our pharmacy team is always happy to talk it through in store.
Anne Harty is a registered pharmacist at Ballyduff Pharmacy with 20+ years of experience in clinical pharmacy. If you have questions about teething products or your child's symptoms, visit us in store or contact us at 066 71 31111.
References
- Medicines and Healthcare products Regulatory Agency (MHRA). New advice on oral salicylate gels in under-16s, 2009.
- Medsafe New Zealand. Topical oral choline salicylate gels — safety in children, 2009.
- British Dental Journal. Bonjela unsafe for under-16s, 2009.
- HPRA
- Nelsons. Teetha Teething Granules — Patient Information Leaflet.