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There is little enquiry on the rubber of dental handling during breastfeeding but many mothers undertake treatments without impairment on a daily basis. The chance of interrupting breastfeeding and substitution of formula appears greater (Dorea 2004).

Fillings

There is no reason to avoid inserting or replacing fillings during breastfeeding. One report suggests that it is prudent to avert unnecessary removal of fillings during pregnancy or lactation (Barreguard 1995). Notwithstanding at that place are occasions when a new mother may need a filling inserted or replaced. When mercury is removed some will be vaporised by the high-speed drill and a very small amount may be swallowed or inhaled. These amounts are infinitesimal and passage into breastmilk is insignificant compared to the background levels of mercury in the environment. The limitation of the consumption of tuna in line with the FSA guidance is more of import on limiting the body burden of mercury and information technology is very hard to prove any link betwixt mercury fillings and long term health bug (Lawson). Preventative dental health to minimise the risk of decay is perhaps the bulletin which is of paramount importance.

White fillings

In some parts of the UK white fillings are recommended in pregnancy and lactation following an EU Directive (July 2022) merely have to be paid for past the patient rather than being part of free NHS treatment. The information states that "These restrictions on the use of dental constructing aim to help reduce environmental mercury pollution and are not a upshot of any safe concerns about amalgam fillings for dental patients." (https://www.sdcep.org.u.k./wp-content/uploads/2018/06/SDCEP-Dental-Constructing-Data-for-Significant-or-Breastfeeding-Patients.pdf)

Local anaesthetic

There is no evidence to interrupt breastfeeding after the employ of local anaesthetics. Local anaesthetics work past boring awareness of the nerve endings around the tooth. In that location is no bear witness of passage into breastmilk and therefore no reason not to continue breastfeeding. The improver of adrenaline to the anaesthetic to reduce bleeding may possibly make a sensitive baby jumpy and irritable so information technology may be worth asking the dentist to limit employ if possible.

For information on the use of Local anaesthetics whilst breastfeeding delight run across https://www.breastfeedingnetwork.org.united kingdom of great britain and northern ireland/local-anaesthetics/

Molar extraction

There is no bear witness to interrupt breastfeeding after molar extraction. If a tooth is to exist removed the mother is likely to be offered a local anaesthetic injection or sedation. She may too need pain killers and/or antibiotics.

Sedation/general anaesthetic

At that place is no testify to interrupt breastfeeding after sedation or general anaesthesia. The anaesthetics used for dental extractions take a very brusque half-life (time they act in the body).

Past the time the female parent is awake nearly of the drug has been metabolised by the body or exhaled. Similarly sedation with drugs such as midazolam will act for simply a short time and by the time the mother is aware of the demand to breastfeed once at home, the infant is at worst probable to sleep for a longer than expected period. It may be advisable for another adult to be available to intendance for the baby until the mother feels totally alert. Meet fact sheet dental sedation and breastfeeding

Analgesics (pain killers)

Breastfeeding mothers may take paracetamol and/or ibuprofen in normal doses afterwards dental treatment. Run across factsheet on analgesics https://www.breastfeedingnetwork.org.united kingdom of great britain and northern ireland/analgesics/

Antibiotics

Breastfeeding mothers may have antibiotics in normal doses afterwards dental handling and keep to breastfeed. Babies may have looser bowel motions and may be windy. Run across factsheet on antibiotics https://www.breastfeedingnetwork.org.great britain/antibiotics/

Other dental agents

  • Mouthwashes – tin can be used by a breastfeeding mother as they will not be captivated into the bloodstream e.yard. Oraldene®, Corsodyl®, Chlorhexidine mouthwash, Difflam®, Benzydamine mouthwash
  • Gels and liquids for oral fissure ulcers e.g. Anbesol®, Bonjela®, Adcoryl in Orabase®, Medijel®, Rinstead® pastilles tin all be used
  • Fluoride toothpastes can be used during breastfeeding. Although there is no inquiry the assimilation from the teeth would be minimal and swallowing of backlog is unlikely
    g. Durophat®

Tooth whitening

There appears to be no information bachelor on the use of tooth whitening agents during lactation. Whilst information technology is unlikely that whatsoever significant transfer of the agents used into breastmilk will take place, information technology is unlikely that urgent treatment is necessary and tin be delayed until breastfeeding has finished naturally. Unless the products spill from the bath in which the liquid is placed, absorption is unlikely.

Breastfeeding and Dental Health of the Baby

  • BDA Breastfeeding – what are the benefits?: Nutrient Fact Sheet https://www.bda.u.k..com/resource/breastfeeding.html
  • PHE Breastfeeding and dental health https://www.gov.uk/regime/publications/breastfeeding-and-dental-wellness/breastfeeding-and-dental-health
  • New communication issued on breastfeeding and dental disuse.Br Paring J 226,248 (2019).
  • Public Health England. 'Delivering Amend Oral Health: An Evidence-Based Toolkit for Prevention' 2022 (viewed on 3 August 2022)
  • Public Wellness England. 'Health Matters: Child Oral Health' 2022 (viewed on nineteen September 2022)
  • Tham R and others. 'Breastfeeding and the risk of dental caries: a systematic review and meta‐analysis' Acta Paediatrica 2022: volume 104(S467):62-84
  • Peres K and others. 'Breastfeeding and Oral Health: Prove and Methodological Challenges' Journal of Dental Research 2022: volume 97(3): 251-8
  • Peres K and others. 'Impact of Prolonged Breastfeeding on Dental Caries: A Population-Based Birth Cohort Study' Pediatrics 2022: volume 140(ane): 2022-2943,

References

  • Barreguard et al 1995 Occupational and Environmental Medicines
  • Dorea JG. Mercury and lead during breast-feeding. Br J Nutr. 2004 Jul;92(1):21-40
  • Grandjean et al. Cognitive Deficit in 7 yr old children and prenatal mercury exposure 1997 Neurotoxicol Teratol. 1997 Nov-Dec;19(six):417-28 1997
  • Peter Lawson BDS, FDS, FRCPS Amalgam and mercury.

©Dr Wendy Jones MBE, MRPharmS and the Breastfeeding Network March 2022