Drugs Affecting Foetus and Nursing Infants

A teratogen is a drug or chemical that induces alterations in the formation of cells, tissues and organs and thus creating physical defects in a developing embryo or foetus.

Drug induced changes can occur only during organogenesis; however, drug induced toxicologic changes affect the foetus after completion of tissue or organ formation because these drugs induce degenerative changes in formed tissue or organs.

To be safe, drugs that are known to be innocuous to the embryo or foetus should be used in the dental management of pregnant women. Drugs with unknown teratogenic potential should be prescribed only after consultation with the patients gynaecologist. Drugs with known teratogenic effects should not be used during dental procedure.

Dental treatment during Pregnancy

Oral health is important during pregnancy and should not be neglected. The rise in hormone levels during pregnancy causes the gums to swell, bleed and trap food causing increased gum irritation. Preventive dental work is essential to avoid oral infections such as gum disease, which has been linked to pre-term birth.

Foetal organ development occurs during the first trimester; it is best to avoid all potential risks at this time if possible. During pregnancy, avoid elective dental treatment, such as routine dental X-rays and whitening of teeth and bonding, especially during the first trimester. However, if dental pain is experienced, emergency treatment and minimal emergency X-rays should be completed immediately with consultation between dentist and obstetrician. If non-emergency dental work is needed during the third trimester, it is usually postponed until after the birth. This is to avoid the risk of premature labour.

Dental Care During Pregnancy

• Ask the patient if they are pregnant.
• Ask the names and dosages of all medications they are taking – including medications and prenatal vitamins prescribed by their doctor as well as any specific medical advice given. Alter the dental treatment plan based on this information.
• Encouraging your patients to undergo regular periodontal (gum) examinations is very important because pregnancy causes hormonal changes.
• Advice rinsing mouth with water or a mouth rinse if patient is suffering from morning sickness and have bouts of frequent vomiting. Also prescribe toothpaste with a bland taste.
• Advice healthy, balanced and nutritious diet devoid of sugary snacks. Additionally, some studies have shown that the bacteria responsible for tooth decay are passed from the mother to the child.
• Baby's first teeth begin to develop about three months into pregnancy. Healthy diets containing dairy products, cheese and yogurt are a good source of these essential minerals and are good for baby's developing teeth, gums and bones.

Safe drugs in Pregnancy

Some Medications Considered Safe for Use During Pregnancy

Safe drugs for Lactating Mothers

Medications Commonly Prescribed for Maternal Ailments During Breast-Feeding