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Teeth Trouble

Common Dental Concerns During Pregnancy

By Kimberly A. Loos, D.D.S.

On page 2231 of the American Hospital Formulary Service (AHFS) Drug Information reference, 1995 edition, it states: "Safe use of local anesthetics during pregnancy prior to labor has not been established with respect to adverse effects on fetal development. Careful consideration should be given to this fact before administering these drugs in pregnant women." Injected local anesthetics can cross the placenta. However, the small amounts of lidocaine used in dentistry probably will not adversely affect a developing fetus. The following commentary addresses local anesthetics, in general, unless specifically stated otherwise:

Lidocaine works by preventing the initiation and transmission of nerve impulses to the brain. Without this anesthetic, these impulses would reach the brain and may be interpreted as pain. Generally, novocaine or lidocaine takes effect in about 2-5 minutes and is effective for 1-2 hours depending on the dosage, method of administration, individual patient and other variables. Novocaine and lidocaine are readily absorbed into the body after administration.

Most studies on the effects of novocaine on fetal development that I was able to locate, including one titled "Effect of infusions of glusose-novocaine mixture on the functional state of delayed-development fetuses" (translated), are published in Russian. These articles were published several decades ago. Their relevance to modern dental practice is questionable.

The filling material, amalgam, should not present any harm, if proper technique is observed by the dentist and his or her assistant. This should occur whether the patient is pregnant or not! If you have a cavity and your dentist thinks it should be a fairly simple, short procedure, it should be fine to complete the procedure. Postponing dental work due to pregnancy can sometimes cause worse problems than having the work completed. If you do decide to postpone work until after the birth of your baby, have it done soon afterwards so the cavity does not become larger and deeper.