Dental issues that arise during pregnancy should not be postponed. On the contrary, conditions such as pain, infection, or advanced decay can pose a direct risk to both the mother’s and the baby’s health. One of the most concerning issues in this regard is the potential effects of local anesthetics used in dental treatment on the fetus.
The American College of Obstetricians and Gynecologists (ACOG) and the American Dental Association (ADA) clearly state that the use of local anesthesia during pregnancy is safe. These organizations state that anesthetics such as lidocaine do not pose any serious risk to the mother or baby when used in appropriate doses.
Local anesthetics act on the area where they are applied and only a very limited amount enters the systemic circulation. Therefore, the likelihood of a low-dose local anesthetic reaching the baby is very low. Additionally, epinephrine enhances the effectiveness of the anesthetic, allowing for the use of less medication, and limits the spread of the anesthetic, thereby reducing systemic absorption. This actually means a safer application.
The second trimester of pregnancy (weeks 13-27) is considered the most appropriate period for planned dental treatments. Organ development is largely complete, and risks are minimized for both the mother and the baby. However, if the treatment is too urgent to be postponed, intervention can also be performed in the first or third trimester. The key here is to correctly assess the risk-benefit balance.
While some doctors prefer to use local anesthetics that do not contain epinephrine, epinephrine-containing lidocaine is classified as category B by the FDA for use during pregnancy and is widely used safely. Alternatives such as mepivacaine are classified as Category C, which requires a more cautious approach compared to lidocaine in terms of risk.
The mother’s current health status, the week of pregnancy, and the urgency of treatment must be considered before treatment, and communication with an obstetrician should be established if necessary. However, once medical approval has been obtained, reducing pain and stress is a much more appropriate approach than delaying treatment during pregnancy.
