Pregnancy and Dentistry - Safe AAA

Pregnancy and Trimesters

First Trimester from 1-14 weeks

Second Trimester from 14-28 weeks

Third Trimester from 28-40 weeks

Suggested Dental Guidelines
1)Avoid Rx during Organogenesis: Weeks 3-10: Highest risk to the fetus
2)Safest and most comfortable time for dentistry are: The last 2-3 weeks of the first
trimester, the entire second trimester and the first half of the third trimester
3)Give the patient a left lateral position in the latter half of the third trimester
4)Dentistry is not contraindicated in 2nd ½ of 3rd Trimester: It may be uncomfortable
5)DO NOT USE O2 +N2O for stress mgmt as N2O has teratogenic effects
6)Restrict excessive radiographs and take only those needed
7)Full mouth radiographics not contraindicated: Use full body & thyroid lead shield
8)Routine extractions, periodontal Rx, restorations, orthodontic Rx, placement of
removable and fixed prosthodontics and crowns can occur during pregnancy
9)Use minimum amount of epinephrine and minimum number of LA carpules

SAFE ANESTHETICS:
2% Lidocaine (Xylocaine), 1:100,000 epinephrine
4% Prilocaine HCL with 1:200,000 epinephrine (Citanest Forte)
4% Prilocaine HCL without epinephrine (Citanest Plain)



ANAESTHETIC GUIDELINES:
Best to use LAs with less or no epi. in the presence of tachycardia
Use a maximum of 2 carpules
Avoid epi. with mild to mod. Htn
Use 4% Prilocaine HCL without epinephrine (Citanest Plain) after clearance from patient’s obstetrician


SAFE ANALGESICS
Acetaminophen (Tylenol)
Codeine + Tylenol
Hydrocodone + Tylenol (Vicodin)
Oxycodone + Tylenol (Percocet)

ANALGESIC GUIDELINES
Percocet & Vicodin are category B
They are safe when used short-term and in smaller doses
Avoid Vicodin and Percocet just prior (2-4 weeks) to delivery to prevent breathing problems in the newborn
Avoid Aspirin and NSAIDS

SAFE ANTIBIOTICS
All Penicillins
All Cephalosporins
Azithromycin
Clindamycin

ANTIBIOTIC GUIDELINES
Use Pen. VK to treat acute oral infections (symptomatic for less than 3 days)
Use Clindamycin with Penicillin allergy or if the infection has been symptomatic for more than 3 days.