Amber Teething Beads: A Follow-Up

Over the week or so I expect the page views for my amber teething necklace post to top 20,000 over the two blogs. Interest in the article has just kept increasing over the last year or so of it being up, as opposed to the majority of my posts which slip into internet obscurity within days. In anticipation of the occasion I thought I’d cover some of the comments that this post has gathered over the last few months.

Many of the comments are along the lines of “It worked for me” and “Try it yourself”.

To the first, I don’t really have much to say. I can’t peer inside the inner workings of your child and determine what is going on. But at the same time a bunch of individuals making claims of efficacy without adequate control for bias, natural history and various other contingencies is not a compelling argument to me. Plenty of others swear by practices that have no hope of working*, why should this one get more credibility based on personal experience?

As to the second, three words for you: Anecdote and Confirmation bias. I know enough to realise that I am not immune to the wiles of confirmation bias, which would make my trial just another anecdote – something I don’t accept from others so what would make my own experience any more valid? I also realise that for most people this sort of reasoning is at best foreign and at worst incomprehensible. The general thinking appears to go something like “If I try something and it seems to work, then it works – QED”.

No.

Related to this point are appeals to the “Placebo Effect”, the idea being that simply trying something helps, somehow. This may be true. But I’ll expand on the faulty reasoning behind this assertion.

The placebo effect as this seems now to be the “go-to” explanation for all things unexplained so it might be a good idea to dwell on this concept on it’s own for a bit. First off with regard to talking about the placebo effect, it depends on what you mean. The placebo effect started off being simply the improvement seen in the control group for clinical studies. It was the group that was given everything except the active treatment. Therefore by definition the placebo response is what happens when people aren’t treated. It was the catch all for everything that could affect the outcome that wasn’t due to the treatment itself: poor method design, confirmation bias, reporting bias, observer effect on the patients, regression to the mean, natural history of the disease, etc, etc.

Recently there has been some work done to see if there is a real change in people that is due to thinking they are getting an active treatment, the so called “Placebo response/effect”, this has been mixed. It is true that people will report less pain and their brain will show less activation in pain related areas. But people are susceptible to what they are told, it turns out if you tell people a cheap wine is expensive they will enjoy it more. Is there a placebo wine effect? possibly, but the wine didn’t change and neither did any underlying physiology in relation to placebo medical treatments.

In fact recent studies in asthma showed that while people reported feeling better while taking placebo their ability to perform on objective measures remained the same, while those on active medications improved. If you feel better while still having a life threatening condition are you better? I don’t think so.

So in appealing to the placebo effect you have to concede that 1. the beads don’t have any active ingredient, and 2. don’t make any difference to the underlying condition.
i.e. They do nothing.
Now notice in my original piece this is not what I say, I merely point out there is no good reason to think they are doing anything, not that they definitely aren’t. A subtle distinction I admit.

In essence the argument becomes: “If you think it works then it does”, well I would counter with why don’t you use something that we know does work and then you can capitalise on both effects: You will think it works and it will actually work too. Double goodness.

One poster asserted that amber necklaces were registered with the Therapeutic Goods Administration in Australia as a Medical Device. Arguing that this must mean they have therapeutic properties.

This one was my favourite as it was almost laughably easy to dismantle. After only a few minutes I found that this was completely untrue (you can search the TGA resister here). Not only that but there were suppliers admitting** that they couldn’t claim therapeutic benefits because they were not on the register:

“Amber Teething Necklace Information – TGA Australia

Due to regulations of the Therapeutic Goods ACT, policed by the Therapeutic Goods Administration (TGA), whose register does not recognise the claimed healing and theraputic[sic] properties of Amber we are unable to offer any detailed information on Amber Teething necklaces or Amber in general in a theraputic[sic] advisory capacity.

Therapeutic goods are defined in the Act to include goods that are represented in any way to be for therapeutic use. Therapeutic use is defined to include use in or in connection with influencing, inhibiting, or modifying a physiological process in persons.

In all amber related cases that we have seen, the TGA Panel note “that the advertisement appeared likely to breach section 42DL(1)(g) of the Act, which prohibits the publication of advertisements for therapeutic goods that are not included in the Register“” [Emphasis added]

A complaint was made against a supplier for making claims for the product and this was upheld in part because the necklaces are not on the register.

“The Panel noted, without making any formal finding, that the advertisement appeared likely to breach section 42DL(1)(g) of the Act, which  prohibits the publication of advertisements for therapeutic goods that are not included in the Register.

The website involved changed their wording to get around the regulations, spot the difference:

OLD: “natural pain relief provided by Amber works by placing the necklace on your body, this allows your skin to warm the amber beads, releasing healing oils which are then absorbed into the blood stream.

NEW: “Amber is believed to soothe naturally, when Amber is worn next to the skin it is warm and it is reputed to release natural oils that can care for the skin.”

What a difference a few words make.

At the time the comment was made alleging the necklaces were on the register I suspected that intended therapeutic benefits would be enough to fulfil the therapeutic benefits category.

This is supported both in the declaration of the supplier above and from the wording from the complaint, just prior to the excerpt above it states:

Therapeutic goods are defined in the Act to include goods that are represented in any way to be for therapeutic use. Therapeutic use is defined to include use in or in connection with influencing, inhibiting, or modifying a physiological process in persons.

In representing the advertised products to have an “active ingredient”, to release “healing oils which are then absorbed into the blood stream”, and to relieve teething in infants, the advertisement clearly constituted an advertisement for therapeutic goods.” [Emphasis added]

Lets say though that the product had been registered with the TGA or will sometime in the near future, I would note that unless the administration was in possession of studies that are not published elsewhere there is no way that they could be sure that an actual benefit is occurring. Bringing us right back where we are now.

As an extra note on the activities of the Australian government on this topic I found it amusing to see that the Australian Competition and Consumer Commission issued a safety warning about Amber teething beads end of September last year (see here and here and here).

I say amusing because, while it’s not impossible, I do find it unlikely that one branch of the government is condoning their use while another warns against them. Luckily this is not actually the case.

Finally, this post is not intended to address every conceivable objection to my arguments, merely a survey of what has been proffered so far. I am not really convinced by anything I have yet seen but I remain open to changing my mind so long as the evidence is of good quality. It doesn’t have to be much, a good start would be something that suggests succinic acid has the analgesic properties attributed to it. Then we could address whether succinic acid is released from the beads at ambient/skin temperature. Finally we would need to tackle whether the succinic acid is absorbed topically in any significant dose (decent dose response curves could be obtained at stage one of this theoretical research programme).

All three of these items would need to be looked at in order to state that amber beads have good plausibility for what they are marketed for.

[Update 29/4/13: Apparently there is a chain email circulating blaming amber beads for a case of SIDS. This seemed implausible to me and a very brief check seems to back up my gut feeling. There is no reason to think that amber beads contribute to SIDS at all. For a more thorough break-down go here: http://www.hoax-slayer.com/amber-teething-necklace-sids.shtml . I am not one who feels we need to latch onto any reason to vilify our intellectual opponents and spreading misinformation (especially easily debunked misinformation) is a big no-no in my book.]

————————————————————————————————

*Not that I think this product has “no hope” of working, it could as far as I know. We just can’t make that determination on the basis of anecdote and there are no trials that I’m aware of.

** Argh, this site seems to have removed any trace of of this page. Should have archived it. It has essentially been replaced with this (archive):

In keeping with Australian Fair Trading guidelines no therapeutic claims are made and no medical advice is offered. The material provided on allaboutamber.com.au is for information and educational purposes only and is not a substitute for medical treatment or diagnosis. We assume no responsibility for treatment or cure of any illness or disease. If you have a health problem we recommend seeking medical advice from your qualified natural/health professional. This information is strictly a source of general information and is not intended for use as a tool for self-diagnosis. All About Amber provides this information for you to make your own decisions, if you want to use them on your own family, we believe they work for us and please read the reviews to gather many other peoples opinions.

Which seems to me to be saying “We can’t claim the beads have any healing powers directly, but they really do.”

They haven’t yet learned this lesson for Hazelwood jewellery (archive)though:

How does hazelwood jewellery work?

Hazelwood products are believed to help to create an alkaline environment in your body, which may help, precent[sic] and appease many of the symptoms caused by being to acidic. Hazelwood, being an alkaline wood, has the natural property of absorbing and neutralizing the body’s acidity through contact with the skin. By doing so, the necklaces can also help with digestion, constipation, eczema, migraines, acid reflux, heart burn, nausea, arthritis, skin problems, etc. If you suffer from one of these issues, it is highly probable that you are suffering from an acidity imbalance, and hazelwood may be able to help you alleviate these symptoms in a natural way.  Most people who suffer from an unbalanced pH are unbalanced towards the acidic. This condition forces the body to borrow minerals—including calcium, sodium, potassium and magnesium—from vital organs and bones to buffer (neutralize) the acid and safely remove it from the body.

Hhhhm, perhaps another post is in order. And a complaint.

As a brief aside, as it seems there are quite a few parents out there hungry for this information if you know of a good parenting or early childhood publication that would be willing to print the original article (probably in an altered form) then let me know.

And I’ll stop there before the footnotes become longer than the post.

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  1. just found this story and thought it might be relevant to the conversation:
    http://www.australiandoctor.com.au/news/tga-releases-list-of-tested-cam

    a couple of key quotes:
    “Officially, all TGA registered products are evaluated for quality, safety and efficacy.

    But evidence-based medicine campaigners have long warned that this is not the case for most registered complementary medicines, as they were “grandfathered” onto the register without an assessment, misleading consumers.

    This has now been confirmed, with the TGA last week releasing a list of “evaluated registered complementary medicines”, including only a small fraction of those registered.”

    • Jamie
    • April 28th, 2012

    Thank you for both of these articles. I see these things everywhere and can’t believe how widely accepted they are, so I did a search for “real study on amber teething necklaces”– needless to say, there aren’t any…

    • Glad to be of service. :)

    • Tim@Melbourne
    • May 15th, 2012

    Hi Scepticon

    I feel obligated to refute your comments regarding the placebo response/effect in this thread, not on grounds of defense of amber bead use, but on grounds of critical thinking. Placebo effect or response only becomes relevant when the subject being tested is cogniscent of a treatment possibly occuring. The cohort in discussion here, newborns to 4 year olds are not old enough to comprehend the necklace that is being placed on them is a supposed treatment. Therefore this point in your reasoning is entirely moot. A good discussion otherwise though, and you have raised some points that I had not considered whilst debating whether or not to give amber a go with my grizzly bubba.

    Keep the dialogue happening.

    • You do raise a valid point about the placebo effect as it is popularly understood. However this is only partially correct. The placebo effect has seeped into popular conscious as the subjective (or objective in some cases) change in a person’s condition based on the perception that they are being treated. This can be investigated as it’s own phenomenon, but it is not the complete picture of the placebo response.

      The placebo response is essentially any improvement that is not due to the treatment. As such the individual need not be aware that they are being treated as it includes any improvement – ie as noted above – regression to the mean, miss-reporting etc. So a baby may appear to get better (and may actually be better, or simply not fussing at that moment – which for parents amounts to the same thing) and this might be considered placebo as it is not due to the treatment.

      However we need not even go to this explanation in order to see that the baby’s recognition of the situation is not required for the “placebo effect” to be in force. All we need is to recognise that it is the parent’s perception of the situation that matters here. The baby can not tell us that he/she feels better – we must infer it from our observation. Now we can focus on the parent as the origin of the placebo response. If you think that the beads work (the hypothetical “you”, not you in particular) then you may focus on the times that the baby is calm, you may re-interpret fussing as simply tiredness rather than teething pain, or perhaps your calmer mental state affects the baby and helps them calm creating a self reinforcing loop. I’m not particularly convinced by that last one but it’s a possibility that I can’t rule out.

      So, while it is true that the placebo effect explanation in popular culture is foiled in just the way you suggest it reflects a shallow understanding of the placebo response and what it can/can’t do and how it is promoted in the arena beyond the narrow range of applicability it has within controlled studies.

      I am glad that you are applying critical thinking to these claims and do keep it up.

      • A couple of final thoughts,
        placebo is offered by some who might admit that we can’t prove there is an effect from the beads but want to claim that the act of using them is still beneficial. My point here is that either way is a losing proposition. Either the beads don’t work in which case you must appeal to placebo and basically admit there is no good reason to use the beads.
        Or they do work, but we have no good evidence of it. In which case placebo doesn’t help either.

        If anyone wants to claim that there is an effect and placebo is not the mechanism then good evidence must be provided.

        • For further clarification I found this paper that describes the distinction I’m trying to make.
          In the terms used by the paper Tim is referring to the “True placebo” while I’m referring to the “Perceived placebo”. Note that in anecdotes we have no way to distinguish between true and perceived placebo.

          (paper can also be found here as I had issues with the above link)

  2. The local rag (I hesitate to call it a newspaper) just ran a story (uncritically) about a mother using one of these necklaces instead of conventional medicine, and while Googling for a good rebuttal I came across your article. Nice work.

    The original story is here: http://www.townsvillebulletin.com.au/article/2012/05/15/330031_kidspot.html

    Hopefully they post my comment.

    • I see what you mean about that story, they couldn’t even get their woo straight. At the end it felt like I was reading an advertorial. In case you’d like a local answer and haven’t seen it yet the young australian skeptics have a post on them here:
      http://www.youngausskeptics.com/2012/01/amber-jewellery-doesnt-assist-with-teething-but-can-be-deadly/

      had to laugh, after only a few days they worked…yeah the teething pain couldn’t possibly have gone away on it’s own in that time. :)

    • rockmel
    • May 22nd, 2012

    I would love someone to do the blind experiment – 75 babies, 25 amber necklaces, 25 plastic but identical in appearance fakes and 25 control. An objective, e.g length of time crying and a subjective e.g parent’s impression criteria to judge efficacy. I’m sure any perceived effect is down to parents evaluating their child’s behaviour differently as a result of the treatment.
    Personally, I’ve tried one day without, one day with a amber necklace my daughter received as a gift, and no real difference.

    • That would be interesting. About parents evaluating their child’s behaviour differently – I was discussing this aspect with a colleague and thought that perhaps if you thought the beads helped with teething pain you might re-interpret any grizzly/fussy behaviour as indicative of something else eg tired, hungry, thirsty, etc. I doubt that babies become perfectly calm all the time with the beads on.

    • dotheywork
    • June 6th, 2012

    This very well might be a dead topic at this point but I wanted to chime in anyways – I live in Canada and came across this post while searching to see if there was an evidence that the ‘Amber Teething Necklace’ could actually have any negative side effects (a side from a rash or potential choking hazard etc.) My situation is quite different than the rest and I’m really curious to see if anyone has actually come across any data supporting potential dangers or health risks of using these necklaces. I had heard of the necklaces for the first time a few weeks ago and was immediately interested as we prefer to steer clear of any form of pharmaceutical drugs etc. My daughter is almost two years old and her teething ‘symptoms’ haven’t been horrible (for a few of the teeth she had a fever and was fussy but mostly not much complaining) anyways her bottom canine teeth have been taking forever to come in and we noticed she seemed slightly bothered last week, on Friday I purchased the necklace and within a few hours she actually got a fever and became quite miserable… I took the necklace off thinking maybe it had something to do with it and her fever did go down slightly but she didn’t seem to fully ‘recover’ we decided to put the necklace back on in case it was just great timing we got the necklace and figured we would see if it helped any… she has been wearing the necklace for 4 days straight now and really has not gotten much better – pretty up and down. Definitely seems like just ‘teething’ symptoms but this is probably the worse stint yet so it’s seems really strange that this time around while wearing the necklace her symptoms are actually WORSE. I am going to take the necklace off tonight and see how things go… my original mind set is that if there is no medical harm, risk or danger of wearing the necklace then why not? Whether or not there is any ‘evidence’ of it working makes no difference to me – in fact I would side with word of mouth and personal experience over most ‘scientific studies’, it’s quite different then the comparison to the asthma example… I get that, just because people ‘feel better’ doesn’t mean they are better, they still have asthma etc… I think this is a totally different debate, these are completely different ‘conditions’, teething symptoms do not does not present an ‘illness’ to cure it is literally just symptoms you want to get rid of… so the ONLY thing that matters is how the child feels (so long as they are not at any health risk) there is no ‘cure’ for ‘teething’ you just either do or don’t suffer from symptoms. My question is – is there any chance of ACTUAL health dangers of using the amber necklaces? Could this necklace actually have CAUSED her to exhibit ‘teething symptoms’ opposed to helping??

    • Like you I have not found any evidence that they cause harm directly. I say as much in the original post (here if you haven’t seen it). The only report I have seen is one that a commenter made on the original post where his son seemed to have some sort of allergic reaction. Given it’s a single case and we have no way of knowing what conditions were also present at the time I’m not really convinced by it. But you can make what you can of it if you like (comment is Here).

      I would say that if your child has been feeling unwell for 4 days you should forget about focusing on the necklace and take her to the doctor it’s more likely that she has picked up an infection than is having a reaction to the necklace.

      I hope everything works out for you.

        • Becky
        • June 15th, 2012

        Fevers should NEVER be chalked up to teething. If a baby has a fever, it is an illness.

        This readers comment makes me sad about the state of scientific education.

          • Becky
          • June 15th, 2012

          And my failure to use an apostrophe makes me sad, too. ;)

            • dotheywork
            • June 15th, 2012

            Hey Becky – I have read that as well “fevers should not be attributed to teething etc.”… however I trust my instincts and there are simply many things “science” or “science education” for that matter cannot explain. My daughter has only had a fever a few times in her life so far… each and every time it lasted for 2-3 days and she just happened to be teething, coincidence? I think not. I understand teething does not “cause” a fever, but it’s seems obvious to me that while teething your immune system could potentially be on the weaker side making room for a heightened level of susceptibly to “illness”. So I think it makes perfect sense if she has a fever and is grasping at her mouth in obvious pain, the fever most definitely could be related to teething. Fever does not equal illness, fever is our body’s way of FIGHTING off illness. As it turns out my daughter is/was just fine and funny enough when we removed the necklace, the following morning she was absolutely, horribly miserably – clearly in severe pain. We put the necklace back on and she was literally 100% in good spirits within an hr. All in all, my conclusion: Amber Teething necklaces DO work. I could care less what the “science” says – or “how” it works – it just does, at least for her (for pain management).
            Thank you both for your input!

              • Becky
              • June 15th, 2012

              Babies are teething pretty much continually from six months or so until two years, so it is not at all surprising that when a baby has a virus or bacterial infection, she’d also be in the process of teething. Fever indicates an illness, because if there were no illness there’d be nothing for the body to fight off. There’s some evidence in favor of an elevate body temperature related to teething, but there’s also evidence contradicting this association, and a solid fever, ie. over 101 F, should always be considered a symptom of illness as it isn’t associated with teething.

              I can’t understand how you can conclude that it DOES work when just a few days ago, it seemed to make your child’s symptoms worse, not better. It is far more likely that it has nothing to do with the necklace whatsoever. Symptoms come and go. This is why we have science to provide evidence, rather than anecdote.

            • Have to concur with Beck here, the “science” you refer to with such disdain is how we determine causal relationships from coincidental relationships. Just because science can’t explain something (or doesn’t currently have an explanation – this is not the same thing) doesn’t mean you can just insert whatever explanation makes you feel good, and I imagine thinking you can instinctual know what is wrong with your child makes you feel in control.

              I expect people a couple hundred years ago felt they could “just know” that blood-letting was helping their loved ones as well. Unless they all just happened to have Haemochromatosis then we can safely say that wasn’t the case. Without carefully controlled observations they just couldn’t tell; some people got better, some died, what was responsible? For them it may as well have been a mystery. Then we developed organised science, clinical trials, pharmaceutical interventions and our life expectancy sky-rocketed. That’s what “science” has done for us.

              I don’t mean to be harsh but when someone posts a distinctly anti-science rant I get a bit forthright.

              • And I’ve got to jump in here and quickly address Becky’s assertion that fever equals illness or infection. That is not true at all. I’m a mother of 7 children, and with my family M.D. of 35+ years to back me up, I can assure you that both children and adults can run a mild or “low grade” fever when illness and/or infection are not present. Some common examples: teething (yes, it happens simply because the gums are inflamed in response to the tooth cutting through), ovulating (sorry if too much information, but this is also medically documented) and lactating (i.e. when a mother’s milk first comes in).

    • Nicola
    • June 21st, 2012

    Dear Scepticon,
    Thank you for these fantastic posts on the amber necklaces. It is incredible how many people are wasting good money on this nonsense! All I can say (from experience) is that parents can get rather desperate….Love your work.

    • Kelie
    • July 11th, 2012

    If there is no real evidence that they don’t work. No real evidence that the do. They pose no danger. And a mom at the end of her rope needs a thread of hope to cling to. What’s the harm?

    • Evidence of efficacy is a separate question from evidence of safety. Though in neither case can we say the absence of evidence means we can assume they are either safe or effective.

  3. Thank you! Thank you for your thoughtful posts and citations! It’s heartwarming to find some sense in the muck and mire of the interwebs.

    • Thanks for the positive comment, I really appreciate it.

    • Dr. L
    • September 10th, 2012

    Scepticon,

    Thanks for you article! I’m a pediatric resident training Canada. I’ve seen these amber necklaces often and to me it seem as though simple intuition should be enough to realize they are not a good idea. Alas, the frequency in which I see them seems to say otherwise.

    I don’t go into elaborate debates with parents on the issue. Most of the time by simply saying “I don’t see how they could possibly work and they are an obvious choking hazard” is enough for parents to say “ya, I thought so…”

    Your article summarizes my thoughts exactly; only worded much better than I ever could. I’d appreciate if you wouldn’t mind me posting the article around on a few of the bulletin boards at work.

    Like many issues in pediatrics (and all areas of medicine for that matter…) there is a ubiquity of information out there and it’s difficult to decipher the good from the bad. That’s why I am currently in my 5th year of medical training with another 4 to go. We learn which information is founded on scientifically sound information and which is likely just companies trying to turn a profit. I am confident that the Amber Necklaces fall into the ladder category here.

    Thank you for eloquently summarizing what we pediatricians are trying to get out there.

    Dr. L

    • Thanks for the comment. Feel free to edit/distribute either post (this and the original) how you see fit, I’m happy to be of service.

    • Actually, come to think of it I could re-edit these two into a single article covering all aspects and with a less “bloggy” feel to it if that would be helpful?

      • OK for whoever wants it I’ve uploaded a version of these two posts onto google Drive. I’ve cleaned it up a bit, replaced broken links changed the wording here and there etc.
        link is:
        https://docs.google.com/document/d/1ewDAcxoJQAqiY2q_supjDIRYoRawLZ8BNa8keHFROTA/edit

        I just ask that if you use it please let me know so I have a rough idea what is being done with my material.

        • Becky
        • September 11th, 2012

        I’m not who you’re replying to, but that would be awesome!

        • Cool, you can refer to the google drive link above or if more convenient I can email you a copy.

      • Becky
      • September 11th, 2012

      I just wanted to comment on the scientific method, and scientific studies themselves. In my experience, which isn’t much really, I’ve worked as a research assistant for a University and taken a few statistics courses, the scientific method is a rather flawed methodology. Is it plausibly the best methodology for discerning true possibility from improbability? Probably. Yet, the current fashion of thinking of science as fact, rankles me some. The scientific method is not intended to PROVE anything, it merely attempts to disprove, and winnow things down so that we can make a guess at the possibilities. Any theory derived using the scientific method should be subjected to repeated frequent testing by many different individuals, in an attempt to disprove said theory. Any single study does not a theory make. Any study is subject to bias, at many points along the way from the beginning sample population to the point that a paper is written peer-reviewed, often by individuals with their own biases and agendas, then published in journals with their own agendas. Throughout the entire process, a few polishes or tweaks here and there , or even an unconscious personal bias, can easily lead to flawed data and conclusion. Then there’s the problem in studying people, you just can’t control for every factor. After that you also have to consider the concept of wave particles in physics, which may seem irrelevant here, but it’s a strange phenomenon that basically shows an individual sees what they expect to see. Thus, personal bias may be more crippling to science than we even realize. Factor it all together and often published studies can be just as bogus as anecdotal evidence. Do I still look to scientific studies to get a facsimile of truth? Yes, but to believe in scientific studies is just as naive as believing wholeheartedly in anecdotal evidence. I personally choose science as I find the methodology comforting, but I’d be foolish not to recognize it’s just a different kind of stumbling about in the dark searching for answers. A different sort of grasping on to what feels true.
      I’d be interested to read your thoughts on it.

      • I substantially agree with what you’ve written with a few caveats. With regard to the idea that scientific methodology is flawed, I find myself tempted to butcher a Winston Churchill quote a bit:
        Science is the worst way to gather knowledge, except all the others that have been tried.

        I completely agree with your observations about biases, but I think you might over generalise a touch.

        Were we restricted to a single small study on any one question looked at from only one angle – we would be lost. Science would have no hope of progress and every result would be worse than useless.
        Fortunately this is not the case, for many areas we have a large inhomogeneous body of researchers looking at questions from multiple angles and replicating the findings of others.
        The probability then is that each individual will have their own biases and blind spots and errors in procedure but the aggregate will cancel these tendencies and we can move forward. Using this approach we can slowly triangulate on hypotheses that more and more closely approximate the truth.

        Thus we need not put our faith in individual studies, in fact to do so would be folly. We can however survey the totality of evidence in a domain and come to reasonable conclusions, much more reasonable than uncontrolled anecdote.

        I’m sure you are familiar with John Ioannidis’ paper outlining why most papers published are false.
        This may seem to be disheartening, but the self correcting mechanisms of science do work eventually, and that is the most powerful tool we have.

        No other domain of knowledge gathering has measures designed for self correction in this way.

        So is science flawed, absolutely, it’s a human endeavour and so is subject to all the foibles that entails.
        But it works, and I would argue, much better than anecdote. We have tens of thousands of years of anecdote, but after a mere few hundred years of science we are putting robots on Mars.

        • (Another) Becky
        • September 12th, 2012

        “After that you also have to consider the concept of wave particles in physics, which may seem irrelevant here, but it’s a strange phenomenon that basically shows an individual sees what they expect to see.”

        Hmmm, this is not at all what the concept of wave particles in quantum physics claims.

        While science is not infallible, it is self-correcting. Scientific conclusions are always somewhat tentative, and open to further evidence, but that doesn’t mean that the scientific method isn’t our best way for gathering information. It absolutely is.

        • Yes, I decided not to delve into that one, at best it’s a gross simplification, at worst simply wrong.
          But I’ll admit that it’s a complex topic open to interpretation and that is how I feel it should be taken here.

  4. ““After that you also have to consider the concept of wave particles in physics, which may seem irrelevant here, but it’s a strange phenomenon that basically shows an individual sees what they expect to see.”

    This is truly Deepak Chopra-levels of misrepresentation/misunderstanding of quantum physics.

    Look people, neither Heisenberg’s uncertainty principle nor the Copenhagen interpretation of quantum physics means that reality is whatever you choose it to be.

    As Feynman famously said: “If you think you understand quantum mechanics, you don’t understand quantum mechanics.”

    • Donna
    • October 3rd, 2012

    Thanks so much for these posts! I’m a health writer in the U.S. researching baltic amber teething necklaces and appreciate your thorough and reasoned post on this subject. What I’m wondering is whether the babies might be somewhat distracted from their teething pain because they are wearing the necklaces. It might be interesting to do a study where you have the babies wear the baltic amber necklaces for one week and then switch to regular old beads for the second week, and see if there’s any difference in their teething behavior from one week to the next.

    • That’s a good question and the experiment is on the way to an answer, I am reminded that many parents who consider them to work seem to point out that their children pay the beads no attention at all.

      This may or may not be true, I don’t know, but imagine that most would dismiss that idea. It’s intriguing though I think.

  5. K so I have read both articles and yes I jumped on the mommy band wagon and ran out to get my unknown teething necklace for my baby …. First off it does work it is day and night with her with it on

    The thing that worries me thought is the oil in it … for the past week her temps have been extremely low 95.5 , 95 and lower is hypothermia she is the only one in a home of 5 that is low she is not sick at all the only thing I can think is the necklace is giving her high doses and bringing her down so low …. I took it off 2 days ago her temp has returned to normal with it off , I have searched and scoured the web for side effects of the necklaces and cannot find a thing did you find anything in your research that would suggest there is a negative side effect the the wonder necklace I am scared to put it back on so till I find out I am not

    • I have not found anything regarding negative side effects. I lean toward the no effect view.
      Given this I suspect that the two events are unrelated and give you the same advice as I gave another commenter, treat the symptom as it’s own thing and use your judgement as to whether it is serious enough to visit the doctor.
      That way you are covered even if it is the necklace…. simply removing it does not guarantee that things will be fine if it is the cause.

  6. Placebo Effect: Change of Attitude. It is pretty amazing that when people believe they are doing something to help, often it does… (but not for everything.) I’ve seen this happen the most with “natural” pain relief (and teething necklaces fall into this category.) It’s more than belief… it is more proof that pain is very much a mental state (to a certain extent) and when you actively “do” something to help, most people change their attitude. So, that is why the placebo effect can work on moms and dads, even though their child is the one experiencing the discomfort. How is that possible? Because they don’t view the fussiness the same way. Suddenly, the baby being fussy is caused by something else, is the exception to the rule, or is just the baby “finding her voice.” Kind of like the glass half full. Anyways, it’s still a nice change of perspective towards a healthier attitude. Too bad the necklaces are a choking hazard!

    • momrage
    • March 6th, 2013

    I just stumbled onto this post while searching for answers about these teething necklaces I keep seeing on small children. Putting a necklace (and often times more of a “choker”) on a baby/toddler seems pretty counterintuitive to me. What happened to actual teethers? I give my 15 month old frozen vegetables (like whole green beans) to chew on. Once they’re thawed, she just eats ‘em…or throws them on the floor.

    Thank you for this post and ongoing discussion!

    • ConcernedMommy
    • March 14th, 2013

    Thanks Scepticon. I saw these beads on a 6 month old baby recently and was rather concerned about the possible choking/strangulation hazard as well as the constant discomfort of having to wear a beaded necklace night and day. I was later told that they’re for teething and are all the rage. Since I have a 5 month old who is teething badly, I researched it just in case I’m missing a valuable teething tool. The theory behind the beads sounded compelling but at the end of the day, I was much more comfortable with using proven acetaminophen (albeit very sparingly). Then reading your post reassured me even more about my decision. By the way, I am not one who is skeptical of the power of holistic methods or the possible healing power of stones/crystals. But this latest trend is a bit OTT for me. Thank you again!

    • Thanks for your interest, so long as we keep in mind that regardless of the result it’s the process we should keep in mind – ie something may or may not work but so long as we approach it thoughtfully and with an eye to the evidence we should come to a reasonable conclusion.

      Thanks again.

    • mat bulba
    • May 13th, 2013

    I have a thought – and i welcome your considered response. Could one of the commonly found enzymes in the mouth be catalysing some form of reaction? perhaps releasing the succinic acid and maybe there could be some form of synthesis occurring with some other commonly found molecules in the mouth or proteins from milk? it would be simple to test with some: Amber, basic enzymes ~(a lot of spit would do the job!), a shaking incubator and a high performance liquid chromatograph linked to a mass spectrometer (from this we could see what if any molecules are released from the amber when it is in contact with commonly found mouth enzymes). IF we found a release of succinic acid we could then try the same experiment with the addition of breast milk to see if any interesting molecules are synthesised – i believe this would be a step in the right direction – unfortunately i will not have access to a lab for a few months anyone else out there interested in getting to the bottom of this thought? responses welcome

    • That’s a very creative approach and I’d be interested to see the results. It could prove an answer to at least part of the puzzle except for one thing: The beads are not meant to be chewed on.

      They are intended to simply rest against the baby’s skin, releasing their healing goodness through touch alone. Parents in fact often put them around the baby’s ankle and claim results. Many parents claim that even around their neck the child does not even notice the beads are their and they still work.

      So if this did prove to be a viable mechanism we would still be left with the majority of cases to explain – or to propose that parents are simply not paying enough attention to thier children to notice them gnawing on the beads. I imagine that would be even less well received than my suggestions – and I don’t see any reason for that to be the case.

    • Susie
    • July 17th, 2013

    Thanks for this article. I have a three-year old and a baby and I’ve lost count of the number of times people have told me that I should try these beads (and homeopathy, but that’s another story!). I’m a sceptic so I’ve never been tempted, although I admit I’ve never known enough about them to come up with a good argument. Now I can tell them why I think they’re nonsense! It seems that when it comes to babies suffering, all logic and reason goes out the window. Thanks again.

    • You’re welcome. It’s natural to want to relieve the suffering of our little helpless ones, the trick is not to lose our sense in the processes. :)

    • Jenn
    • August 31st, 2013

    You might try EcoParent magazine for a publication venue, Thanks for the info.

    • I’ll look into that thanks.

      • After finding this on the website:

        “When the fire element is in balance, the heart is strong and healthy, the mind is calm and sleep is sound. When the fire element is imbalanced, we may either lack joy (depression) or have an excess of joy (mania). Indicators of an imbalance in the fire element include agitation, nervousness, heartburn, and insomnia.”

        for a TCM book, I’m thinking maybe not

    • Froglet
    • December 6th, 2013

    I found your article whilst fact-checking something a colleague at work said. She swears the amber necklace calmed her kid’s teething pains and was recommending it to a relatively new mum in the office.
    Initial colleague said her health worker had recommended it to her.
    I despair that UK health professionals are doing this.

    • chris
    • January 11th, 2014

    I am all for natural and organic living but when it comes to my babies.. safety and lonrg term effects are my main concern. I am appalled by how many parents are using these so their babies stop drooling and are less cranky. Really?? Use a bib and find ways that your baby feels soothed so that when you turn your head for a minute or two they won’t strangle or choke to death. And there is no way in this world a parent can say their children are supervised every second of everyday. I have a10 month old baby girl who has yet to get her first tooth. Is she fussy sometimes.. yes. However she loves cuddles and attention and something to chew on. .. give her those things and she is great. I am not convinced teething causes enough pain or discomfort to use product that is this questionable.

    • When it comes to teething the stage is set for the ultimate in confirmation bias. Babies are always grumpy about something and this is a temporary condition – so what ever you do it is likely to “seem” to work. So I’d agree that the best course of action is to ride it out and make baby and yourself as comfortable as you can with cuddles and cool chews.

    • Laura
    • March 9th, 2014

    I was hoping to seek permission to reproduce parts of your original article, with an aim to produce a flyer/leaflet which I would hope to distribute around various family friendly venues in Brighton and Hove, UK.
    As a parent and sceptic myself I have recently become incensed enough to want to do something about the pseudoscientific nonsense I see otherwise intelligent, normal people subscribing to in my daily life (specifically those related to parenting).
    My aim would be to produce a series of leaflets to place alongside those touting the quackery and nonsense which are so popular where I live. A drop in the ocean, yes. But I feel I need to do something positive with the rage!

    • I created a google doc version of these posts for such an occasion:
      https://docs.google.com/document/d/1ewDAcxoJQAqiY2q_supjDIRYoRawLZ8BNa8keHFROTA/edit?usp=sharing

      Please use whatever you wish :)

        • Laura
        • March 10th, 2014

        Thank you! That’s brilliant =D

        Keep up the good fight!

        Laura

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