Dental Treatment While Breastfeeding

 

Many times we come across mothers who are concerned if having dental work (i.e. fillings, root canals, etc) will affect breastfeeding. Sometimes they are told they must temporarily suspend nursing in order to take pain medications or antibiotics, or they need to wait until the anesthesia clears from their system. This, however, is not always necessary; in fact, it’s almost never necessary. The following guidelines are for mothers who are nursing healthy, full term babies. Babies with health problems need special considerations.

Dental Procedures

Numbing agents such as lidocaine, or any of its derivatives commonly used as local anesthetics for dental procedures, do not affect mother’s milk. Bupivacaine lasts longer than carbocaine or lidocaine, but its milk levels are still “zero” according to Dr. Thomas Hale, author of Medications & Mother’s Milk. All dental material used during procedures are safe for during and post treatment for breast feeding and will not affect mother’s breast milk. Some dentists use different types of anesthesia for during pregnancy and while breastfeeding.

A nursing mother who has a tooth removed should not need to interrupt breastfeeding at all (except during the surgery, of course). To minimize baby’s exposure (and increase mom’s comfort), mom can nurse just before she goes in for the procedure. There is no need to wait on breastfeeding afterwards or to pump and dump — mom can nurse as soon as she feels alert enough to hold baby. dental-exam

Sedation and Nitrous Oxide

If the mother is given valium for sedation, as soon as mom is awake and non-sedated she can safely resume nursing. There is rarely ever a need to pump and dump. According to Dr. Hale, the amount of anesthetic in a mom’s milk after one dose would be minimal to zero.  Most medications used for oral and IV sedation are considered safe with breastfeeding.

Nitrous oxide (laughing gas) sedation is also considered to be compatible with breastfeeding. It is virtually insoluble in the bloodstream, which means it goes from your brain to your lungs to the room air immediately after you stop breathing it in. According to Dr. Hale, “it is rapidly eliminated from the body due to rapid exchange with nitrogen via the pulmonary alveoli (within minutes). A rapid recovery generally occurs within 3-5 minutes… Ingestion of nitrous oxide orally via milk is unlikely.”

Diagnostic Tests 

X-rays, ultrasounds, mammograms and fine-needle aspirations do not affect mother’s milk. Any x-rays that need to be done can be completed.  They have no effect on breast milk.

Other Dental Products

Antiseptic mouthwashes should not pose a problem for the breastfeeding infant, as its absorption is virtually zero.

As for whitening teeth, the substance used for that is a peroxide compound. Peroxides are absorbed into the tissues but then are instantly destroyed, so none ever reach mother’s milk.

Mothers should also keep in mind that all dental procedures and treatment can be refused if the mother does not feel comfortable and would like to postpone to a later date or when they can prepare breast milk ahead of time. Just remember that sometimes waiting for treatment can risk the health of the tooth (i.e. a cavity can may need a root canal if the cavity has grown into the root).

 

Reference: The Breastfeeding Answer Book, LLL

Reference: Medications and Mother’s Milk, 1999, Thomas Hale, Ph.D., Eigth Edition

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