Bonjela has often been used in teething children to soothe irritated gums. I’ve tried using it on Gavin several times – both when he was teething and when he had an ulcer. He didn’t take very well to the gel and I think it had something to do with the aniseed flavour. Indeed, the first time I tried to use it on him, he howled even more when I applied the gel and tried to wipe it off! As a result, we never really used it much.
Recently, my SIL brought it to my attention that there has been a health warning issued in Australia advising against the use of Bonjela in children under 16 years old because one of its active ingredients – salicylate – was believed to be a potential cause of Reye’s Syndrome. The initial warning came from the UK after three children who had been treated with Bonjela were suspected to have Reye’s Syndrome.
All three children made a full recovery and though Reye’s Syndrome had not been confirmed in any of them, the advice against the use of Bonjela in under 16 year olds remains. The sentiments being that since there are other alternatives available, there is no sense in taking unnecessary risks.
The advice is against the use of the products Bonjela and Bonjela Cool Mint Gel (the latter isn’t sold here). Bonjela Teething Gel, however, has been given the all clear for continued use in children (although this isn’t sold here either).
That raises another question – does that mean all other products containing salicylate should not be used in children under 16 years of age? If I recall correctly, Listerine mouthwash contains salicylate as an active ingredient. Well, there are other reasons not to use Listerine regardless of your age (Listerine has a high concentration of alcohol, the presence of which in mouthrinses has been linked to cancers in the mouth), but I’m digressing.
A recent article from New Zealand, however, has declared Bonjela safe for use after the Medsafe group had reviewed all the data and were satisfied with the safety of the product. The concerned they raised was the possibility of unintentional overdose as the New Zealand Poisons Centre data revealed an overuse of the product. They urged users to stick to the recommended dosage.
There’s a good Q&A article on this topic located here.
Personally, I’m inclined to agree with Medsafe. A 30 year history of usage in children for teething purposes and no reported cases of Reye’s Syndrome? I think that’s a pretty good history. For most medical studies, a 10 year history is considered “long-term”.
When it comes to topical creams and ointments, there is definitely a tendency of over applying and it is very easy to “exceed recommended dosages”. In the mouth of a child, everything gets swallowed. When you consider how little their bodies are, it really isn’t surprising that you can easily end up with an accidental overdose.
Let’s not just talk about overdoses in children. Some adults have been known to create new applications for certain “over-the-counter” drugs. In dental school, I saw cases of “aspirin burns” that resulted because patients decided to directly apply an aspirin to an aching tooth to “manage the pain”. Yup, they think of everything…
But, as they say, why take unnecessary risks when there are viable alternatives? If you do decide to err on the side of caution and stop using Bonjela, my medical friend has brought another product to my attention called Dentinox Teething gel. The active ingredient is lidocaine hydrochloride which is in a topical anaesthetic we used to use in the dental clinic. The concentration in Dentinox Teething gel is a lot lower though – 0.33% as opposed to the 2% concentrations we used to in the clinic setting.