Prescription of Medication
When prescribing medication during pregnancy,
the main concern is the risk of teratogenesis,
because drugs cross the placenta by simple diffusion.
Drugs are administered during pregnancy
only when they are essential for the pregnant
woman's well-being, and the drug of choice should
always be the one that is the least toxic. In practice,
dentists mainly prescribe antibiotics to control
infections and painkillers to relieve the pain. Any
drug that is prescribed during pregnancy should
have the fewest possible side effects and it should
aim to improve the health of the mother or the fetus
The FDA has classified drugs into four categories,
according to how dangerous they are for the
mother and the fetus when prescribed during pregnancy
[16]. This classification provides a useful
guide with regard to what drugs should or should
not be prescribed for a pregnant woman.
• Category A includes drugs that have been
tested in humans and there is evidence to
support that they are 100% safe to use (e.g.,
folic acid).
• Category B includes drugs that are relatively
safe to use. Generally these drugs are
considered safe to use during pregnancy
(e.g., paracetamol and amoxicillin) [17].
• Category C includes the majority of drugs,
such as aspirin, which should be used with
caution and certainly according to the treating
doctor's orders.
• Category D includes drugs such as tetracycline,
which should be avoided during
pregnancy [16] (Tables 1 and 2).
As far as antibiotics are concerned, amoxicillin
and penicillin V are the safest and the most common
ones to prescribe [18,19]. Tetracyclines are
contra-indicated during pregnancy because they
accumulate in fetal dental tissue during the calcification
stage, causing discoloration of the teeth [19].
The safest choice among painkillers is paracetamol,
as it is not teratogenic. The absorption of
the usual recommended dose in the body does not
seem to change during pregnancy [18,19].