Wednesday, November 14, 2012

Do You Know What Your Dentist Should Know?

Many women are asked to take antibiotics due to a dental problem. Penicillin is safe in pregnancy ( if you aren't allergic to it ). Tetracycline which is also doxycycline and minocycline should never be used in pregnancy, whether in pill or topical form. We have learned for generations now that these medicines stain baby teeth. They also stain adult teeth that develop when the baby is in utero. Fluoroquinolones also are not recommended in pregnancy and they include ciprofloxacin, moxifloxacin and levofloxacin.

Many dental patients have pretty severe pain. Opioids are safe in pregnancy. Codeine ( hydrocodone ) is often used safely in pregnancy. There are many nonsteroidal anti-inflammatory medicines that may not even require a prescription but they are only safe for a short period of time ( 2-3 days ) for acute episodes of pain.  And they are not to be used during the first and third trimesters.

Lots of pregnant women complain of dry mouth and bad breath. Mouth rinses that contain active ingredients like xylitol and cetylpyridinium are safe. But alcohol is to be avoided during pregnancy and many mouth washes contain it and as much as 9% -14% can be swallowed or absorbed.

Sometimes a pregnant woman cannot avoid dental procedures and surgery. Lidocaine is safe and mepivacaine is also. Nitrous oxide ( laughing gas ) should be used only when other anesthetics are not effective. Request that the dentist consult with your provider if it appears that nitrous oxide is the anesthetic of choice. Nitrous oxide is even to be avoided by pregnant dentists and assistants as it is exhaled by the patient!

Remember to tell your dentist and hygienist that you are pregnant. Don't assume that they know. Question what drugs are being used, for what reason and be proactive about suggesting that you need reassurance that these drugs are safe in pregnancy. Pharmacists are the best consultants when it comes to any medication, whether over- the- counter or prescribed. You can always call the pharmacist to discuss what you have been given and what alternatives there may be.

Ultimately, it is your pregnancy and your baby. Never be ashamed to question treatment. There may be something that you know that your dentist doesn't.