Pregnancy and breastfeeding are periods that consume “resources” from the mother.
It is known that the second trimester of pregnancy is optimal for dental treatments. The other two trimesters require precautions in case of emergencies.
It is advisable not to wait in case of possible dental problems, firstly, because they worsen and secondly, because an infection in the body harms the breastfed baby more than the possibility of eliminating some substances in the breast milk.
Local dental anesthetics
In general, mothers are advised not to resort to anesthesia during breastfeeding or not to breastfeed 24h after local anesthesia.
The following substances are currently used in anesthesia: lidocaine, articaine, bupivacaine, mepivacaine.
Sometimes they are associated or not with vasoconstrictors such as epinephrine. (This is not contraindicated either)
Injection is near the nerve block, not directly into the bloodstream, in the smallest amount possible.
It stabilizes the neuronal membrane by inhibiting the ionic flows responsible for initiating and conducting the nerve impulse, thus it has a local anesthetic effect which disappears through slow diffusion of the substance and its absorption into the bloodstream.
It is slow to maintain the anesthetic effect. So, we have a first slow dilution in maternal blood (1ml anesthetic dilutes in about 4.5l maternal blood).
The substance is then rapidly metabolized in the liver, and from there it leaves as metabolites.
In the end, only a tiny amount (<0.1% of the initial substance) reaches the cells that produce breast milk.
The same anesthetic substances are also used for general anesthesia during pregnancy, in larger quantities. So, in the first days of life, more of these substances pass into breast milk and no one contraindicates breastfeeding.
Similarly, antibiotic treatment should not be avoided in case of infections; anti-inflammatory and analgesic treatment is a prerequisite during breastfeeding: ibuprofen, paracetamol, metamizole sodium, ketoprofen.
Conclusion
Do not postpone treatments! Do not postpone breastfeeding! You can take antibiotics and anti-inflammatory if necessary.
