Pregnancy outcome after in utero exposure to local anesthetics as part of dental treatment: A prospective comparative cohort study

Abstract

Background: Dental treatment and use of local anesthetics during pregnancy generally are considered harmless because of lack of evidence of adverse pregnancy effects. Data on the safety of dental treatment and local anesthetics during pregnancy are scant. Dental care is often a reason for concern both among women and their health care providers. The primary objective of this study was to evaluate the rate of major anomalies after exposure to local anesthetics as part of dental care during pregnancy.

Methods: The authors performed a prospective, comparative observational study at the Israeli Teratology Information Services between 1999 and 2005.

Results: The authors followed 210 pregnancies exposed to dental local anesthetics (112 [53%] in the first trimester) and compared them with 794 pregnancies not exposed to teratogens. The rate of major anomalies was not significantly different between the groups (4.8% versus 3.3%, P = .300). There was no difference in the rate of miscarriages, gestational age at delivery, or birth weight. The most common types of dental treatment were endodontic treatment (43%), tooth extraction (31%), and tooth restoration (21%). Most women (63%) were not exposed to additional medications. Approximately one-half (51%) of the women were not exposed to dental radiography, and 44% were exposed to radiation, mostly bite-wing radiography.

Conclusions: This study's results suggest that use of dental local anesthetics, as well as dental treatment during pregnancy, do not represent a major teratogenic risk.

Practical implications: There seems to be no reason to prevent pregnant women from receiving dental treatment and local anesthetics during pregnancy.

Keywords: Dental care; local anesthetics; major congenital anomalies; pregnancy.