The FDA warned that they should not be used to relieve teething pain in children or to provide sensory stimulation to persons with special needs, such as autism or attention-deficit/hyperactivity disorder (ADHD). The FDA has received reports of death and serious injuries to infants and children, including strangulation and choking, caused by teething jewelry, such as amber teething necklaces.

"We know that teething necklaces and jewelry products have become increasingly popular among parents and caregivers who want to provide relief for children's teething pain and sensory stimulation for children with special needs. We're concerned about the risks we've observed with these products and want parents to be aware that teething jewelry puts children, including those with special needs, at risk of serious injury and death," said FDA Commissioner Scott Gottlieb.

Teething pain

"Consumers should consider following the American Academy of Pediatrics' recommendations of alternative ways for treating teething pain, such as rubbing inflamed gums with a clean finger or using a teething ring made of firm rubber. Given the breadth of the market for these teething necklaces and jewelry, we're sharing this important safety information directly to consumers in order to help prevent injuries in infants and kids."

The risks of using jewelry for relieving teething pain include choking, strangulation, injury to the mouth and infection. Choking can happen if the jewelry breaks and a small bead enters the child's throat or airway. Strangulation can occur if a necklace is wrapped too tightly around the child's neck or if the necklace catches an object such as a crib. Other concerns include injury to the mouth or infection if a piece of the jewelry irritates or pierces the child's gums.

Succinic acid

In addition to choking and strangulation concerns, amber teething necklaces contain a substance called succinic acid, which allegedly may be released into an infant's blood stream in unknown quantities. Manufacturers of these products often claim succinic acid acts as an anti-inflammatory and relieves teething and joint pain. The FDA has not evaluated these claims for safety or effectiveness and recommends parents not use these products.

In addition to avoiding using jewelry to relieve teething pain, the FDA continues to recommend that caregivers avoid using teething creams, benzocaine gels, sprays, ointments, solutions and lozenges for mouth and gum pain. Benzocaine and other local anesthetics can cause methemoglobinemia, a serious condition in which the amount of oxygen carried through the blood is reduced. This condition is life-threatening and can result in death.

The FDA will continue to closely monitor adverse event reports associated with jewelry used for relieving teething pain and will communicate further as warranted. The agency encourages consumers and health care professionals to report injuries or adverse events that occur from using teething jewelry by filing a report at 1-800-FDA-1088 or online at MedWatch, the FDA Safety Information and Adverse Event Reporting program.