Message in a Bottle Mailbag: Should dental professionals avoid nitrous oxide exposure during pregnancy?
THE MESSAGE IN A BOTTLE MAILBAG is a monthly feature of the Product Navigator e-newsletter. Each month, we answer reader-submitted questions to help you navigate your dental and dental hygiene product decisions (and more!).
This month, Colleen M. Olson, RDH, BBA, responds to a question about whether dental professionals should avoid nitrous oxide exposure during pregnancy.
Question
The article about dental x-ray radiation exposure to pregnant dental office employees reminded me that nitrous oxide exposure isn't good during pregnancy. Correct? Thanks!
Answer
Thanks for the question! You’re right: nitrous oxide should be avoided during pregnancy. According to the American Dental Association, “Nitrous oxide is classified as a pregnancy risk group Category C medication, meaning that there is a risk of fetal harm if administered during pregnancy. It is recommended that pregnant women, both patients and staff, avoid exposure to nitrous oxide.” (1)
In a 2006 article in the Journal of the Canadian Dental Association, Sandra M. Olfert, PhD, MSc, reviewed literature on the reproductive outcomes among dental personnel. (2) She notes that, although nitrous oxide exposure in dental offices is small, it can be continuous and occur over a long period of time, which may be more dangerous than short-term exposure to a higher concentration. However, much of the available research on nitrous oxide and spontaneous abortion, or miscarriage, and infertility was published before the widespread use of scavenger systems. Dr. Olfert concludes, “There is some evidence to support a direct link to N2O and spontaneous abortion and infertility; however, this evidence is limited.” She notes that the use of scavenging systems reduces occupational exposure and thereby may “help to reduce the risk of adverse reproductive outcomes.” (2)
It is important to make sure your office’s nitrous scavenging system is working properly. To be cautious, dental office personnel can wear monitoring badges. Until more studies can confirm or deny the risk of adverse pregnancy outcomes in dental staff exposed to nitrous oxide, the most prudent course of action would be to limit exposure. As a dental hygienist, I would not work on patients requiring nitrous oxide sedation if I were pregnant or planning to become pregnant.
More reading
December 2017 | Fluoride-free product recommendations for patients who refuse to use fluoride
November 2017 | Should pregnant dental hygienists continue to take x-rays?
October 2017 | Posttreatment mouth rinses for periodontal patients
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References
1. Pregnancy. American Dental Association website. http://www.ada.org/en/member-center/oral-health-topics/pregnancy. Updated November 22, 2017. Accessed January 8, 2017.
2. Olfert S. Reproductive outcomes among dental personnel: a review of selected exposures. J Can Dent Assoc. 2006;72(9):821-825.
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