Pregnancy: is anesthesia possible during dental treatment?
Pregnant women do not have to give up local anesthesia for dental treatment. However, only absolutely necessary treatments should be done during the first three months of pregnancy.
The dentist can choose an appropriate agent after carefully weighing the benefits and risks.
proDente Tip: Complete scheduled dental treatments before pregnancy if you want to have children.
“Local anesthetics, the so-called local anesthetics, can pass the placental barrier. However, there are no observations of harm to the growing baby from properly administered local anesthesia during dental treatment in pregnancy,” explains Univ.-Prof. Dr. Dr. Monika Daubländer, Chair of the Interdisciplinary Working Group on Dental Anesthesia (IAZA).
Local anesthetics in pregnancy
Just like many other medicines, local anesthetics can pass through the placenta.
The transfer of the substance from the mother’s bloodstream to that of the child is more pronounced, the less the local anesthetic is bound to proteins in the blood.
The dentist therefore chooses local anesthetics for pregnant women that have a high binding rate for protein.
Dentists often use the active ingredient articaine for local anesthesia during pregnancy after a careful risk-benefit analysis.
Articaine crosses the placental barrier to a lesser extent than other local anesthetics.
No harm to the child
Several studies with over 600 pregnant women show that no negative effects of articaine on the baby are to be expected from dental treatment in the second and third trimesters of pregnancy.
On the contrary, prophylaxis at the dentist and necessary treatment of teeth and gums are recommended during pregnancy.
It is possible that the final treatment of the tooth or teeth and gums by the dentist will not take place until after pregnancy.
There are no systematic studies on articaine for the first trimester of pregnancy.
However, there is no evidence of an increased risk of malformations in the baby.
In addition to articaine, bupivacaine can also be used.
Overall, there are no reports of germ-damaging effects of local anesthetics in the treatment of teeth and gums during pregnancy.
Addition of adrenaline in small doses useful
The administration of local anesthetics dilates the blood vessels. In order to prolong and intensify the effect of the local anesthetic and to reduce the blood flow to the tissue during the treatment, the addition of adrenaline is useful.
It has a vasoconstrictive effect. So less anesthetic gets into the bloodstream and to the baby.
“There is nothing to be said against the use of adrenaline, even in pregnant and breastfeeding women,” explains Daubländer.
“However, the adrenaline should be dosed as low as possible and the mother’s pre-existing conditions as well as risk factors must be taken into account.”
In addition to articaine as a local anesthetic, lidocaine can also be given during lactation.
Even after higher doses, the concentrations in breast milk are so low that they have no effect on the infant.
Also, lidocaine does not appear to have a negative effect on the onset of lactation.