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Amber necklaces and teething babies

October 30, 2012
Let’s check the science: Amber teething necklaces – should babies wear them?

My grandchildren are all past the age when teething is a big problem, but I still shudder when I see small children wearing amber teething necklaces. Surely any parent can see that harnessing a child with such a bauble is inviting a serious strangling or choking incident. You would have to be very desperate, and very certain of the effectiveness to take such a risk, I would think. Is the risk justified? Do these necklaces work?

This article assumes you are happy to accept science as the best way of discovering the truth about the natural world. If that’s not the case for you, why not have a look at Trusting the science first?

Teething necklace

The promoters’ arguments – science or red flags?

As I would have expected, some of the claims range from the magical:

•Allows body to heal itself •Radiates soothing energy and absorbs negative energy, thus needs cleansing often •Calms nerves, stimulates intellect •Aligns ethereal and physical energies, cleanses the environment •Success in treating disorders of the kidney and bladder

to the ridiculous:

Amber teething beads work on a simple theory of mild magnetism, which has been found to have the potential to reduce mild pain, such as accompanies teething.

However, many promoters do suggest a plausible mechanism. They claim that amber contains an analgesic substance called succinic acid which is released by the beads in response to the warmth of the child’s body and absorbed through the skin (here, here and here).

Do I see any red flags? Yes, lots of them. I see appeals to ancient wisdom and esoteric energy (here), magical thinking (here), use of anecdotal evidence (here), empty edicts (such as boosting the immune system, here), and pseudoscientific jargon (here).

Being skeptical

Initially I was suspicious that the promotion of these necklaces would rely heavily on nonsense about the magical properties of crystals. But most of the sites I found based their claims on the succinic acid mechanism, so it deserves to be checked. Does amber contain succinic acid? Is it released by warmth and absorbed into the body? If so, does it have any physiological effects? Is there any scientific evidence that these beads work? My feeling is that there must be very solid evidence for their effectiveness to justify the risks of choking and strangulation.

The scientific evidence

In my search for evidence, I got off to a great start when I found this posting by Scepticon. It gave me lots of references and analysed the situation very impressively. But I couldn’t take Scepticon’s word as authority, of course. I needed to find primary sources myself.

This is what I managed to discover:

  • Baltic amber (the type usually recommended for teething) does contain succinic acid (here). Other types may not.
  • I could find no evidence that Baltic amber releases succinic acid at body temperatures. Succinic acid melts at 187 °C but it’s moderately soluble in water. So if it indeed seeps out of the amber, it couldn’t be in molten form. Body temperature (about 37 °C) would be insufficient to melt it. There is a possibility it could be dissolved by sweat.
  • Succinic acid is found naturally in our bodies and in many foods, including beer and wine (here). In some countries, it’s allowed as a food additive (number 363). Generally, it’s considered safe (here), although, just as there are no studies on its analgesic effects (see next point), there are none investigating its safety in humans. Interestingly, in bulk it’s regarded as a skin and respiratory irritant, with a risk of serious eye damage (MSDS here). The oral rat LD50 is 2.26 g/kg.
  • There is some history of succinic acid being used externally to treat pain. I could find no scientific evidence that it works. Scepticon had the same problem – no studies, no RCTs, nothing. There is a single animal study (here) showing that succinic acid may help in reducing anxiety in mice, but nothing on analgesic effects.
  • So, putting it all together, even in the unlikely event that succinic acid is released from the amber, there is no evidence that it is absorbed or has any effect. And even if it does, how sensible is it to allow a completely unregulated dose of a chemical to flow into a child’s body over a long period?
  • Apparently, the necklaces are made to break easily so that strangulation risk is reduced. But surely this would increase the risk of choking on the beads. Australian government agencies have warned against allowing children to wear them while unsupervised or sleeping (here, here).

DIY evidence

There are plenty of blogs and websites describing personal experiences of parents who have tried amber teething necklaces and have been convinced they are effective (here and here); others have the opposite opinion (here). Needless to say, such anecdotal evidence is worthless, and the examples described in the preceding links are likely to be cases of regression to the mean. In other words, in the natural course of things the teething pain eventually gets better. The only way of showing that these necklaces really work would be to conduct proper randomised controlled trials.


This is an easy call. The complete lack of any good evidence that amber necklaces relieve teething pain means that there is absolutely no benefit to offset the risk of wearing them. Remember that in risk assessment, the size of the risk depends on two factors – the likelihood of the event happening, and the severity of the consequences. In this case, one consequence could be death by choking, and in my book, that rules them out completely. I’m disgusted that they are sold in some pharmacies (here).

The Australian Dental Association has suggestions for much less risky methods of reducing teething pain (here). Why would anyone use a ‘treatment’ with such large risks and no supporting evidence?

Update 2013/03/21: At The Conversation (here), Ken Harvey explains that pharmacists are ignoring their own standards by stocking these and other products that are not backed by credible evidence.

Update 2013/08/21: The Therapeutic Goods Administration in Australia has ordered one supplier of amber necklaces to remove claims from its website. The claims, that amber teething necklaces are a “natural analgesic” that provide “natural relief from teething problems” were judged by the TGA to be “misleading, unsubstantiated and in breach of the advertising standards code.” The ABC has the story here.

Update 2013/11/09: Clay Jones has a great article on teething at Science-Based Medicine. Basically, the gist is that teething doesn’t really produce any serious symptoms at all, and that all the ‘treatments’ used to soothe infants through teething episodes are unnecessary.

Update 2014/04/12: In another Science-Based Medicine post, pediatrician John Snyder exposes more of the nonsense behind amber necklaces, as well as advising that it’s neither necessary nor advisable to use drugs of any kind to treat teething in infants.

Update 2015/03/01Amber teething necklace warning after toddler nearly strangled from the Daily Telegraph (Sydney).

Further reading

Cutting Teeth, Part 1: The Fascinating History of Teething by Chad Hayes MD.

Cutting Teeth, Part 2: Teething Today by Chad Hayes MD.

Illustration modified from a photo by David Green on flickr.

This is one of ScienceOrNot’s Let’s check the science series.
  1. travmathes permalink


    You definitely have no kids of your own by reading all of your stupid comments to others after they have *all* gave you a testimony of how it works for their child. I personally just purchased one myself for my daughter, which I have no received yet, but if you had kids of your own- you would understand that you want to do everything possible to help them with all the pain and discomfort it causes them when teething. Get off the “scientology” bull sh!t and just realize that people are just doing what they can to help out their children. If it works that’s great, if not oh well. Seeing how you shoot people down after they specifically say it DOES indeed work for their child is ignorant and seems as if your just mad the “science” was proved wrong (which it is time in and time out)

    • Jacqui permalink

      Hahaha. All credibility lost with the Scientology accusation.

      If people were doing everything they could to help their children they wouldn’t be attaching portable choking hazards to their bodies. You can truly help your children by being skeptical of what’s marketed to them and for them, and by teaching them the importance of critical thinking. In the past, people offered testimonials about the benefits of bloodletting with leeches over thousands of years. By your logic, sticking a few leeches to your kids is ok because it seems to have worked for so many others who have produced anectodal evidence over the past 2000 years.
      This one could possibly also fall under the appeal to nature fallacy, which has been more damaging than ever lately.

      People really do hate when their flawed beliefs are challenged.

    • Joe permalink

      Are you stupid? What’s wrong with teething gel? As a father of two, I would rather apply a very small dose of a well recognised analgaesic directly to the gums than risk any chance of death by strangulation or choking.

    • I have three children and five grandchildren. Seven of them survived teething quite happily without resort to amber necklaces or any other magical remedies. The eighth has not yet started teething, but I’m pretty sure she won’t be subjected to any either.

      “Scientology”?!?!?! Where does that come into it?

      Update 2014/07/16: The youngest grandchild’s first tooth has just appeared. It’s well though the gum, and it’s obviously been through for quite a few days. The parents were surprised when they found it – there had been no unusual behaviour or symptoms.

  2. I agree with Mark. My granddaughter was having a tough time teething, drooling, pain and red cheeks. The amber necklace has stopped the drooling and red cheeks and has helped a great deal with the pain. She didn’t wear the necklace for a few days and the red cheeks and drooling started up again.

    This works for my granddaughter and that’s all I care about. My daughter in law is from Mongolia. Her mother used amber necklaces on her and her sisters when they were teething.

    Perhaps science hasn’t preformed the proper tests to prove this works.

  3. Shaz permalink

    This article is cute but lacks reliable sources. Research more and patronise less THEN put the word science in your URL.

  4. Dawn permalink

    My three youngest have worn these from onset of teething. It definitely reduced the drooling, and acidic poops. We have never had safety issues, it’s worn mostly under their clothes and they don’t even realize its on them. You worry about choking hazard if the strand breaks as it should….but there is a knot between each bead so that at most the child would put one bead on their mouth. It is too small to obstruct their airway should they swallow it.

  5. Monica permalink

    I originally bought the necklace for a 8 month old for teething. But when it came the 4 year old wanted to “try them on” So I let her. She is past the teething stage but has suffered with terrible growing pains at night The first night she wore them she slept thru the night without waking once or a single whimper. Now you can’t claim the placebo effect here because I didn’t expect any thing to happen and neither did she, she was just wearing a necklace for awhile. was it a fluk? I don’t think so, She has continued to wear them for 6 months now and has continued to sleep pain free every night. From a medical perspective, her pediatric Dr. was thrilled to see them around her neck. I of course had to get another necklace for the 8 month old and we have seen wonderful results with teething. matter of fact she wasn’t teething when we put them on and didn’t even know when she was til teeth appeared. As far as choking, the beads are too small to cause a choking hazard. And as far as a strangle hazard, there are a lot more things that they encounter on a day to day basis that I would consider more of a hazard than their necklaces. And I would much rather they wear a simple necklace around their neck than poke OTC drugs in them to ease their pain. To each their own, but these work for us and we love them!

Trackbacks & Pingbacks

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