Anesthesia during pregnancy and dental treatment: myths and misconceptions

In women, after the birth of a child, the condition of their teeth deteriorates greatly. This is due to the fact that during gestation the mother transferred most of the calcium to the baby, and after birth she continues to give away the valuable mineral through breast milk. As a result, the mother's teeth are destroyed. In this case, you need to go to the hospital, where painkillers are often used during procedures.

Ultracaine is a modern anesthetic that is often used in dentistry. The drug acts locally and exhibits a therapeutic effect 1.5 - 3 minutes after administration of a small dose. The anesthetic effect lasts for 1 to 5 hours. Nursing mothers are wondering whether they can use the medication for dental treatment. According to doctors, this is a safe drug for lactation.

Description of dosage forms

Ultracaine is a transparent solution with a neutral aroma, which is packaged in carpules (glass cartridge capsules). To administer it, you need a special syringe into which a cartridge and a thin needle are installed. The injection is quite painless due to the small diameter of the needle. Usually, even small patients tolerate the procedure well. The needle and cartridge are used once, after which they are disposed of.

The drug is based on articaine and adrenaline (epinephrine, which constricts blood vessels). Additional components: sodium chloride, distilled water, sodium pyrosulfate, etc. d. The drug has a pronounced anesthetic effect, which manifests itself quite quickly and lasts for at least 60 minutes.

Ultracaine is presented in 3 forms, which have their own trade name:

• Ultracaine DS forte with adrenaline concentration – 1:100000. The drug helps to achieve a pronounced anesthetic effect during dental treatment. This form of medication is contraindicated for hypertension, severe diseases of the heart and blood vessels, thyroid gland, and asthma.
• Ultracaine D does not contain adrenaline. The dosage form contains no preservatives that stabilize anesthetics containing epinephrine. Therefore, it is recommended for patients prone to allergies and asthmatics. In addition, the medication is allowed to be used for diseases of the thyroid gland, serious illnesses of the heart and blood vessels. However, the anesthetic effect of Ultracaine without adrenaline lasts about 20 minutes.
• The drug marked DS has an epinephrine concentration of 1:200,000. This is the optimal dosage form for pregnant and lactating patients, people with heart disease in the compensated stage. It is not recommended to use the drug for asthmatics and people with a diseased thyroid gland.

In addition, it should be noted that after using Ultracaine it is not recommended to perform activities related to reaction speed and concentration for 5 hours.

A local anesthetic drug is used in dentistry for the following procedures:

• Dental filling.
• Removing a nerve from a tooth.
• Surgical operation to remove a tooth without complications.
• Orthopedic work (installation of crowns, veneers, removable dentures, etc.).
• Treatment of wounds, abscesses on the oral mucosa, suturing.
• Dental work of any complexity for patients with severe pain tolerance.

Ultracaine is used for the treatment and removal of teeth during pregnancy, breastfeeding, and also in patients of a younger age category.

Local anesthesia. Ultracaine

When carrying out medical manipulations, patients want it to happen as comfortably and painlessly as possible, since many, for fear of discomfort during the procedure, put off solving skin problems for a long time. Anesthesia is used to reduce pain during the procedure.

When carrying out medical manipulations, patients want it to happen as comfortably and painlessly as possible, since many, for fear of discomfort during the procedure, put off solving skin problems for a long time. Anesthesia is used to reduce pain during the procedure.

Anesthesia is a decrease in the sensitivity of tissues to various irritants, which is achieved by briefly blocking the transmission of signals along nerve endings with the help of painkillers. Anesthesia is divided into general and local. General anesthesia (anesthesia) is most often used in surgery, and types of local anesthesia such as infiltration and application are widely used in dermatology.

Infiltration anesthesia is usually used for the removal of skin lesions, such as papillomas, moles, viral warts, keratomas and others, as well as for skin biopsy. The drug is injected directly into the site of the upcoming procedure to make the procedure as comfortable as possible. For pain relief, the drugs most often used are lidocaine or ultracaine.

Local anesthesia with ultracaine and lidocaine is quite safe due to the administration of small doses of the drug and short-term blocking of the transmission of pain impulses along nerve fibers.

The choice of drug for local infiltration anesthesia is determined by the attending physician during a consultation, taking into account all contraindications and drug intolerance.

The advantages of infiltration anesthesia are a long-lasting analgesic effect, the safety of the method, harmlessness to the body, simplicity and relative cheapness.

Contraindications include:

— the presence of an inflammatory process at the injection site;

- diseases of the nervous system;

- hemorrhagic syndrome;

- intolerance to local anesthetic, allergic reactions in the past to the active substance of the anesthetic;

- lack of proper contact with the patient (deaf-mute, intoxicated).

Also, before the procedure, you must inform the doctor about the presence of pregnancy or lactation.

Stalmakov Alexander Lvovich

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Blokhina Yulia Vladimirovna

Dermatovenerologist, cosmetologist, trichologist
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Aibulatova Valentina Anatolevna

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Bogdanova Irina Sergeevna

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Rodina Ekaterina Vladimirovna

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Application of anesthetic

A large number of modern dental clinics use Ultracain for pain relief. This is due to the fact that this drug is more effective than classical anesthetics (Lidocaine, Novocaine). In addition, the drug is safe and practically does not cause negative effects.

The dose of the medication depends on the depth and duration of the procedure. The dentist determines the required dose of medication for each patient separately. However, when making a decision, the doctor is guided by the following rules regarding the dose of the drug:

• To remove 1 or several teeth located nearby, 1.7 ml of solution is injected. To remove several teeth located far away, 2 injections (1.7 ml each) are given near each one. If after administration of the solution the therapeutic effect does not appear, then the same dose is administered, but into one tooth. In the absence of anesthesia, Ultracaine is abandoned and a complete blockade is carried out.
• When grinding teeth, 1 ml of solution is injected under the crown near the damaged tooth.
• When cutting or suturing the palate, 0.1 ml of the drug is injected near the damaged area.

Adults are prohibited from administering more than 7 mg/1 kg of the drug during treatment procedures. The normal dosage of the drug, which is well tolerated by patients, is about 12.5 ml. The child is prohibited from administering more than 5 mg/1 kg. Ultracaine is approved for use in children over 4 years of age.

Tooth extraction and lactation

If the tooth decay is so severe that there is no way to save and cure it, the doctor performs an extraction. For this, local anesthesia is used. Breastfeeding is not a reason to refuse this procedure, since in this situation there is often severe inflammation and pain. Therefore, we cannot wait. It is necessary to inform the dentist in advance about lactation so that he can select the right anesthesia and antibiotics.

There is no need to wean the baby from the breast during the period of removal and recovery. The only recommendation is for the mother to stop eating solid food.

It is impossible to delay treatment, since a decayed tooth is a source of infection that will spread throughout the body and be passed on to the child.

Precautionary measures

The anesthetic is contraindicated under the following conditions:

• Hypersensitivity of Ultracaine components. Sometimes patients are allergic to articaine, adrenaline, etc. To avoid negative effects, allergy tests are done before using the drug. The safest solution in ampoules without adrenaline.
• Diseases of the heart and blood vessels. The drug is contraindicated in patients with tachycardia, tachyarrhythmia, hypertension, acute functional heart failure.
• Taking β-blockers. Ultracaine should not be used in combination with non-selective beta-blockers.
• Patients under 4 years of age. The solution is contraindicated in children, as it has not been tested in this age category.

During pregnancy and lactation, the drug is not contraindicated.

Sometimes the medicine provokes negative reactions:

• hypertension (in response to adrenaline);
• breathing disorders, consciousness, muscle spasms;
• decreased visual acuity, diplopia (split objects), blindness;
• nausea, vomiting;
• hypotension, increased heart rate;
• skin rash, itching, nettle fever, inflammation of the conjunctival membrane of an allergic nature, swelling, etc.;
• with bronchial asthma, attacks of vomiting, diarrhea, asthmatic attack, etc. occur.

With an excessive increase in the dose of the solution, the likelihood of psychomotor agitation, disorders of consciousness, and vertigo (dizziness) increases. If such signs appear, you should discard Ultracaine and ventilate the room where the victim is located. If you have difficulty breathing, you must use an oxygen mask.

Dental treatment at different stages of pregnancy

The period of bearing a child is usually divided into three main stages (trimesters), each of which is 13-14 weeks. This is due to changes in the development of the fetus and the barrier function of the placenta, which protects against negative influences from the outside.

1st trimester

- the most dangerous period for any medical interventions. Until the implantation of a fertilized egg (usually on the 17th day), the embryo is critically susceptible to any stress and toxins, and dental treatment at this time can lead to spontaneous abortion. Then the formation of tissues and organs of the embryo begins, and taking drugs can cause severe disruption of these processes. In the first trimester, only acute diseases that are accompanied by pain and purulent discharge can be treated: the solution to any other problems must be postponed until the 14th week.

2nd trimester

- a relatively favorable period for treatment. The main stage of organ laying has ended, and the placenta has formed and reliably protects the fetus. During these periods, professional hygiene can be carried out, as well as dental therapy, the condition of which may worsen in the third trimester. But it is still better to postpone any non-urgent procedures until the postpartum period.

Dental treatment in the 3rd trimester

complicated by the high weight of the fetus, which puts pressure on the mother’s inferior vena cava and aorta, causing her to experience discomfort while lying in the dentist’s chair. In addition, in late pregnancy, the placenta becomes thinner and no longer performs its barrier function so well. Dental treatment at 34 weeks of pregnancy is still possible, but later only emergency intervention can be performed. Dental treatment at 38 weeks of pregnancy is completely prohibited: the risk of labor is high.

Ultracaine for breastfeeding

According to doctors, Ultracain is allowed to be used during breastfeeding. This is due to the fact that modern anesthetic is completely eliminated from the body after 4–5 hours. After administration of the solution, the concentration of articaine in milk is minimal, from this doctors concluded that the drug will not harm the baby during feeding. The amount of adrenaline in Ultracaine DS is also low, and therefore the mother and newborn are safe.

If the mother is still worried, then she can feed the baby before visiting the dentist. Then after 4–5 hours the drug will be completely eliminated from the body. During this period of time, you can feed the baby with formula.

Thus, Ultracaine is a safe drug that is approved for nursing mothers during the treatment of dental diseases.
The dentist will determine whether the woman is allergic to the components of the drug and select the dose of the medication depending on the depth of penetration and duration of the procedure. If there are contraindications, the doctor will select a more suitable anesthetic. Subscribe to our VKontakte group

Prevention of caries

Dental treatment during lactation is a necessary but unpleasant procedure. It is recommended to carry out preventive measures to prevent problems with the oral cavity.

You should start taking care of your teeth at the stage of pregnancy planning. Regular visits to the dentist, professional cleaning, removal of stones - all this will prevent many dental diseases that await a mother during the period of waiting for a child and lactation. If there are old fillings, it is necessary to assess their condition, replacing them with new ones if necessary. Remineralization or fluoridation procedure will help strengthen your teeth.

During pregnancy, dental treatment is allowed from the second trimester. As a preventive measure, it is recommended to use toothpastes with a high fluoride content, and you should brush your teeth every time after eating. It is necessary to remove plaque from the tongue, where a large number of bacteria are present. It will not be superfluous to rinse the mouth with solutions that have an anti-inflammatory and preventive effect.

The nutrition of pregnant and lactating women is of great importance. It is important to get the right amount of vitamins and minerals, especially calcium, which has a strengthening effect on teeth. It is necessary to consume as many fruits and vegetables and dairy products as possible. Additionally, it is worth buying a multivitamin complex at the pharmacy, but only after consulting a doctor.