infection by human herpesvirus 6 (HHV-6), which infects 90% of children by age 2. "The symptoms of elevated temperature and facial rash could be explainable by infection with the HHV-6 agent, which is ubiquitous among infants of teething age." Other viruses may also cause fevers which may be misattributed to teething, but the oral involvement that may occur with herpes viruses makes misdiagnosis a particular risk for such infections. Treatment Infants may chew on objects to aid in the teething process. Teething necklaces or bracelets are not recommended as they can cause choking, strangulation, or irritation of the mouth. Teething rings and other toys, called teethers, are often designed with textures. Some infants gain relief from chewing on cold objects. Some people freeze small chunks of fresh fruits or vegetables and put them in teething nets. Medication In cases where the infant is in obvious pain, some doctors recommend the use of non-steroidal anti-inflammatory drugs (NSAIDs) or child-safe pain-relief treatments containing benzocaine, lidocaine, or choline salicylate. Benzocaine must be used cautiously because it can cause methemoglobinemia; choline salicylate is related to aspirin and "may cause Reye's syndrome in susceptible children, especially those with or recovering from viral infections, or when used in combination with other NSAIDs". 5% lidocaine gel produces anaesthesia (numbing) within 2–5 minutes, lasting for 10–20 minutes. However, one author concludes that, "Overall, the risks and adverse effects from inappropriate or prolonged use of pharmacological agents outweigh their potential benefits." She points out that "the psychological trauma involved in administering medications or applying topical preparations to infants must be considered", and argues that "the placebo effect must not be overlooked. For example, applying a gel of 20% benzocaine in polyethylene glycol may give only a modest benefit over applying the placebo, which gives an efficacy of 60% compared with 90% for the active preparation." Medicines are often applied to the babies' gums to relieve swelling and pain. These gels are similar to the toothache gel that is used by adults for sore gums and toothaches, but is administered in much smaller doses. Teething gels work as a numbing agent to dull the nerves in the gums so that the pain is less noticeable. It is important to follow the directions on the package to ensure that the correct amount of medication is administered and that proper techniques are used to reduce the risk for infection. It is important