Pregnancy is the time for cheers as well as taking care of one's health, not excluding oral health. Oral diseases are shown to have links with the health of the mother and fetus. A proper oral care routine should be established to avoid the onset of any dental problems. But if there arises a need for dental treatment, then what medications should be employed and how should the patient be treated?
Antibiotics falling in the tetracycline category (tetracycline, Minocycline, Doxycycline) should be strictly avoided. They can cause staining of the milk teeth as well as the adult teeth of the fetus.
Fluoroquinolones (Ciprofloxacin, Levofloxacin, Moxifloxacin, Norfloxacin, Ofloxacin, Nalidixic Acid) should also be avoided. Although there are no known congenital malformations or any other complications, theoretically, they may cause spontaneous abortion. That is why this group should be avoided if possible.
Penicillin, Clindamycin, Amoxycillin, Cephalosporins, Azithromycin, Cephalexin, Metronidazole, are some of the safe drugs that may be used if urgently required.
Some opioids like Oxycodone are considered relatively safe in pregnancy. Others like Codeine and Hydrocodone are considered safe for a short period of time.
The safest pain killer is Acetaminophen.
NSAIDs like Ibuprofen should be avoided especially in the third trimester. Aspirin and Naproxen are also contra-indicated.
Lidocaine and Mepivacaine are considered safe during pregnancy. Nitrous oxide may pose some risks, although this is a bit controversial.
Fluoride mouthwashes are indicated. Chlorhexidine can be used for a short time. Any mouthwash with alcohol should be avoided.
The second trimester to the middle of the third trimester is the safest to perform an elective dental treatment. The dentist should ensure that the visits are short and well ventilated. The patient should be seated in the supine position. The dental chair should be propped up with the pregnant woman's right hip elevated. This will ensure proper blood circulation. If an X-ray is urgently required, then using a lead apron and low exposures provide safe means for it.