1. Dental pain originating from infections or extensive carious lesions can be severe. Definitive dental care should be arranged as soon as possible but short term interim pain management may be needed. Clinicians can use the following analgesics with several caveats.
Acetaminophen
Category B
Ibuprofen
Category B prior to 30 weeks gestation, Category D at greater than or equal to 30 weeks gestation
Avoid in third trimester because of the risk of premature closure of the ductus arteriosus and oligohydramnios
Oxycodone
Category B in 1st and 2nd trimester; category D in 3rd trimester
In the third trimester, there is risk of fetal dependency/withdrawal with codeine, hydrocodone and oxycodone if continuous use and also respiratory suppression if given near delivery.
Hydrocodone and Codeine
Category C in 1st and 2nd trimester; category D in 3rd trimester.
Opioid analgesics should be used for moderate to severe pain for the shortest period of time possible.
References Oral Health During Pregnancy and Early Childhood: Evidence Guidelines for Health Professionals. California Dental Association Foundation
Motherisk. Toronto, Ontario, Canada at (which included referencing National Collaborative Perinatal Project, , Record Group 443, National Institutes of Health.)
Hilgers KK, Douglass JM, Mathieu GP. Adolescent Pregnancy: A Review of Dental Treatment Guidelines. Pediatr Dent 2003;25:
Care During Pregnancy and Early Childhood Practice Guidelines. New York Public Health Department
Oral Health During Pregnancy and Early Childhood: Evidence Guidelines for Health Professionals. California Dental Association Foundation. February 2010.
US Food and Drug Administration Pregnancy and Lactation Labeling: Accessed 3/31/14.
Oral Health Care During Pregnancy Expert Workgroup Oral Health Care During Pregnancy: A National Consensus Statement—Summary of an Expert Workgroup Meeting. Washington, DC: National Maternal and Child Oral Health Resource Center.
Briggs GC, Freeman RK, Yaffe SJ. Drugs in Pregnancy and Lactation, Ninth Edition. Lippincott Williams and Wilkins, Philadelphia, PA 2011.