Lactation and Dental Guidelines with AAA

SAFE ANESTHETICS
2% Lidocaine, 1:100,000 epinephrine (Xylocaine)
0.5% Bupivacaine with 1:200,000 epinephrine (Marcaine)
4% Septocaine with 1:100,000 and 1,200,000 epinephrine (Articaine)
4% Prilocaine HCL with 1:200,000 epinephrine or without epinephrine (Citanest Forte/Citanest Plain)
3% Mepivacaine (Carbocaine)
2% Mepivacaine (Carbocaine) with 1 :20,000 Levonordefrin (NeoCobefrin)

ANESTHETIC GUIDELINES
Inject LA after the baby has been fed
Stage I hypertensive lactating patient: Use LA with 1:200,000 epinephrine
Avoid epi. in stage II Htn. patient
Defer routine dental treatment in a stage III hypertensive lactating patient

SAFE ANALGESICS
Acetaminophen (Tylenol)
Codeine + Tylenol (Tylenol # 1-3)
Hydrocodone + Tylenol (Vicodin)
Oxycodone + Tylenol (Percocet)


ANALGESIC GUIDELINES
Patient takes pain medication after breast feeding and keep a 2 hour interval with the next feed
Opioids pass through the breast milk: Use lower doses and prescribe Opioids only when absolutely needed


SAFE ANTIBIOTICS
All Penicillins
All Cephalosporins
All Macrolides
Clindamycin

ANTIBIOTIC GUIDELINES
Take antibiotic after breast feeding & keep 2 hour interval with the next feed
Minimize antibiotic use due to risk of altering the baby's intestinal flora and promoting resistant pathogens growth

Read more...

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.
Read more...

NDBE material

Let me know if you are interested in NBDE preparation material
Read more...