Breastfeeding and Dental Health

Breastfeeding and Dental Health

When a mother breastfeeds her child, the emphasis is often on your child’s teeth development. But your own dental health while breastfeeding is just as important. If you’re wondering about how breastfeeding can impact your own dental wellness, here are some of the most important things to know.

Breastfeeding does not have a direct impact on a mothers dental health. However, during this busy time looking after and breastfeeding your baby, proper care of your teeth may not always take priority, and therefore dental health of the mother can suffer. Calcium loss during pregnancy and breastfeeding usually comes from from the bones rather than the teeth. The popular OTC analgesics and antibiotics are safe to take while breastfeeding. It is generally considered safe to receive dental fillings and a local anesthetic such as lidocaine when breastfeeding. Speak with your dentist first regarding what is suitable for you.

Is There Any Connection Between Breastfeeding And The Dental Health Of The Mother? 

Self Care

The American Dental Association (ADA) suggests that what is most commonly observed among new mothers, whether breastfeeding or not, is lack of self-care. Often, new mothers struggle to find the time to take care of themselves compared to before their baby arrived, This includes oral hygiene practices. Neglecting your oral health, for example brushing teeth only once a day or not brushing at all can lead to gum disease and cavities. 

Sufficient Calcium Intake

Some mothers may also question if breastfeeding can lead to the depletion of calcium in their body and therefore, affect the condition of their teeth. There is an increase in demand for calcium from pregnancy up to when a mom is breastfeeding. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIH) studies have shown that women often lose 3% to 5% of their bone mass during breastfeeding. The good news is that this loss will be recovered quickly once weaning has begun. If there are insufficient calcium levels in the body, experts suggest that it is the bones, and not the teeth, that will first provide the required calcium for her baby’s needs. However, it is important to get adequate calcium intake when breastfeeding to maintain your dental health.

Therefore, breastfeeding does not have a direct impact on a mother’s dental health. but what’s most likely to happen is the change in her oral hygiene practices after giving birth. As a natural concern, many breastfeeding moms will think twice about whether to undergo a dental procedure or treatment. I have looked a little deeper to see how safe is it to go ahead with breastfeeding while also undergoing a dental procedure and the medications that go with it.

What Can I Take For A Toothache While Breastfeeding?

Most mothers prefer to use over-the-counter (OTC) analgesics to provide short-term relief for toothache. However, while breastfeeding, you must be extra careful about what and how much to take. Some OTC drugs can pass into breast milk. However, scientific studies have shown that if taken correctly, the amount is too little to pose a risk to the breastfed infant. 

According to one study, paracetamol (acetaminophen), low dose aspirin (up to 100 mg a day) and short-term treatment with Non-steroidal anti-inflammatory drugs (NSAIDs) are considered compatible with breastfeeding. The researchers have suggested that there are plenty of safe analgesics to take while breastfeeding. Mothers should not experience pain and don’t need to choose between nursing and pain relief.

For a quick guide, here are some medications that can be taken by breastfeeding mothers for toothache:

  • Paracetamol/ acetaminophen (Tylenol). Often the drug of choice where breastfeeding mothers can take up to the maximum daily recommended dose.
  • Ibuprofen (Advil, Motrin, Proprinal). Breastfeeding mothers can also take up to the maximum recommended daily dose.

Don’t take these if you have a peptic ulcer or asthma

  • Naproxen (Aleve, Midol, Flanax). Can be taken in the maximum daily dose but for short-term use only.
  • Aspirin. A low dose only of up to 100 mg/day

Aspirin should be used with caution as overdosage can pose an increased risk for Reye Syndrome. This is a rare but serious condition involving brain and liver inflammation among babies

These OTC medications HAVE proven compatible with breastfeeding provided that you take them within the safe limits. However, bear in mind that most medications can have side effects if not used properly. It is always safer to ask your doctor if you want to start a new medicine or if you need some help with the appropriate dosage for your toothache.

Dental Antibiotics While Breastfeeding

In some cases, you’ll need to take some antibacterial medications to treat a specific dental concern. There are a number of antibiotics commonly used in dentistry which the American Academy of Pediatrics considers compatible with breastfeeding. These include:

  • Amoxicillin
  • Azithromycin
  • Cephalexin
  • Clindamycin
  • Penicillin

Depending on the treatment, other antibiotics may also be prescribed by your dentist with some special precautions. For example, if you’ll be needing a single dose of the antibiotic metronidazole, your dentist may advise to temporarily stop breastfeeding for 12 to 24 hours. This will allow your body time to eliminate the drug before you can breastfeed again.

When antibiotics are required for dental treatment it’s important to inform your dentist or healthcare provider that you are currently breastfeeding. By doing so, you will be appropriately assessed. This will enable your dentist to prescribe an antibacterial treatment that will best suit your current condition without compromising your current breastfeeding routine.

Breastfeeding After A Dental Filling

breastfeeding mother holding her baby about to undergo a dental procedure

A dental filling is often the most common procedure to deal with tooth decay. Basically, there are 3 options when it comes to filling a cavity. These include:

  • Composite resins. These are tooth-colored fillings derived from a mixture of glass or quartz filler. Composites are becoming more popular because of aesthetic concerns.  This is also the material of choice if the cavity is located on the front teeth.
  • Dental Amalgams. These silver-colored fillings are made from a mixture of metals including silver, copper, tin, and mercury. Liquid mercury is mixed with the powdered metal alloy to form a “putty” that is then placed to fill the cavity.  Amalgam is known for its durability and is often used in large cavities, particularly the back teeth which require more force when chewing. 
  • Gold fillings. These are made from gold alloy and are sometimes referred to as inlays or onlays. These are long-lasting and durable but are more costly than the other varieties.

According to the ADA, all of these 3 options have been proven safe and have long been used as dental fillings. However, what concerns many mothers, particularly those breastfeeding, is the mercury content of dental amalgams. 

Fillings That Contain Mercury When Breastfeeding

Mercury exposure can be a concern for pregnant mothers and young babies. Sources from our diet include fish such as tuna, mackerel, and swordfish. This can also make us question whether it is safe to breastfeed after a mother may have had this type of dental filling. 

According to the ADA’s statement, “the elemental mercury forms a stable material when combined with other metals”. Moreover, the elemental mercury which is used in amalgams is different from the methyl mercury found in water that accumulates in fish and can cause toxicity when consumed in high doses. 

The FDA suggests that dental amalgams are proven safe for adults and children 6 years old and above. However, they noted that there is currently a lack of clinical studies examining the effects of dental amalgams on babies in the womb and young children who may be more sensitive to neurotoxic substances. Amalgam releases low levels of mercury in the form of a vapor that can be inhaled. Should it enter the mother’s body, the estimated levels that can be found in her breast milk is significantly lower when compared to the levels of oral intake that the Environmental Protection Agency suggests as safe. 

In view to these available resources, the FDA considers that infants are not at risk for adverse health effects from the mercury that may be found in the breast milk of mothers who inhaled it from a dental amalgam. Nevertheless, if you’re still concerned of its minute effects to your baby, then you can talk to your dentist about other options when getting a dental filling. Alternatives can include the tooth-colored composite, which is also durable and affordable. If you want to replace or refill your dental amalgam, it would be prudent to delay the procedure until you’ve ceased breastfeeding unless it is extremely necessary during this time.

Breastfeeding Your Baby or Toddler After Tooth Extraction

Tooth extraction is often a minor procedure that involves the use of a local anesthetic. Some clients who feel anxious about this procedure may also choose to be sedated. Since tooth extraction involves the use of anesthetics, breastfeeding mothers will want to know whether they can breastfeed their baby or toddler after the procedure. Let’s take a look at what experts have to say about the safe use of anesthetics while also breastfeeding.

Lidocaine injection and breastfeeding

Lidocaine is a local anesthetic used in tooth extraction. It is injected into the gums and works by blocking the sensation on the nerve endings around the tooth. Studies show that lidocaine concentrations in breast milk are low and this substance is poorly absorbed by the infant. Therefore, lidocaine is not expected to cause adverse health effects to a breastfed baby and no special precautions are required. There is no reason to delay breastfeeding after having received a lidocaine injection. This article discusses local anesthetic more in-depth when you are also breastfeeding.

Sedation and breastfeeding

Most of the sedating medications used in dentistry are compatible with breastfeeding.  Basically, there are 3 types of sedation used for dental procedures:

Oral sedation

This medication will be given orally with a sip of water one hour prior to the procedure. Triazolam (Halcion) and Diazepam (Valium) are the two most common drugs administered orally before a dental procedure. If the client is breastfeeding, the drug of choice is Triazolam which stays in the body for a much shorter duration when compared to the other variety.

Inhalation

This makes use of nitrous oxide inhalation, also called the laughing gas, to help relieve the client’s anxiety and work as a sedative. Experts suggest that nitrous oxide inhalation is compatible with breastfeeding and is a good option for breastfeeding mothers. Minimal amounts enter the bloodstream as it travels directly from the lungs to the brain then back to room air immediately after you stop breathing the gas. It is very unlikely for the baby to ingest the medication through breast milk.

Intravenous (IV) sedation

Sedating agents may also be administered intravenously through an IV line. Most of the IV sedating drugs used in dentistry are compatible with breastfeeding and have a short half-life. This means they stay in the body for a much shorter period of time.

However, some experts advise extra caution when using certain IV sedating medications such as Diazepam (Valium) and Morphine which generally have a longer half-life and higher concentrations in breast milk when compared to the other IV sedating agents. Mothers who had Midazolam for IV sedation also need to take a special precaution to delay breastfeeding for at least 4 hours if their baby is under 2 months of age

Tips For Breastfeeding Mothers Undergoing A Tooth Extraction

Talk to your dentist beforehand 

Don’t be shy to verbalize your concerns including the type of anesthetic that you will be most comfortable with. Many dentists will happily address the special needs of a breastfeeding mother so that tooth extraction can be more convenient for the client. 

Breastfeed prior to the procedure

Most mothers find it helpful to breastfeed right before the procedure or before the administration of the anesthetic to maximize the time before their next breastfeeding session. This allows more time to rest until you are conscious and comfortable enough to breastfeed again.

Express your breast milk

It is also wise to hand express or pump some breast milk beforehand so that your baby will have enough breastmilk while you are still undergoing the procedure or if you need some extra time for recovery from the anesthetic. Nevertheless, many mothers can manage to breastfeed their baby right after their tooth is extracted.

Overall, dental procedures and the necessary medications are often compatible with breastfeeding. A breastfeeding mother should communicate her concerns so that she and her dentist can choose the best one to suit her needs. Finally, the ADA encourages all mothers to take care of their oral health. Simple oral hygiene practices like tooth brushing, flossing and using a mouthwash are vital to maintaining your oral health.  

References:

https://www.mouthhealthy.org/en/az-topics/b/breastfeeding

https://www.betterhealth.vic.gov.au/health/healthyliving/pregnancy-and-teeth

https://www.ncbi.nlm.nih.gov/pubmed/14583068

https://www.researchgate.net/publication/230600131_Pregnancy_breast-feeding_and_drugs_used_in_dentistry

https://www.mouthhealthy.org/en/az-topics/d/dental-filling-options

https://www.fda.gov/medical-devices/dental-amalgam/about-dental-amalgam-fillings

https://www.ncbi.nlm.nih.gov/books/NBK501230/

https://www.ncbi.nlm.nih.gov/books/NBK501235/

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