Oral numbing gels are over-the-counter topical anesthetics designed to provide temporary relief from mouth pain caused by issues such as canker sores, gum irritation, or toothaches. These products are applied directly to the affected area to numb the tissue. For pregnant individuals, the central concern is whether the active ingredients are absorbed into the body and could potentially affect the developing fetus.
Active Ingredients in Oral Numbing Gels
The primary active ingredient in most over-the-counter oral numbing gels is Benzocaine, a local anesthetic found in products like Orajel and Anbesol. Benzocaine works by temporarily stopping the transmission of pain signals along nerve fibers near the application site. These gels are available in various concentrations, with adult formulations often containing 10% to 20% Benzocaine. Lidocaine is another local anesthetic sometimes found in prescription-strength topical oral products, though it is less common in standard OTC gels.
Safety Assessment of Topical Anesthetics During Pregnancy
Medical guidance for using topical anesthetics during pregnancy leans toward caution due to a lack of extensive, controlled studies involving pregnant humans. Benzocaine is typically categorized as a Pregnancy Category C drug, meaning human safety data is insufficient, although animal studies have sometimes shown adverse effects. When used correctly and sparingly, very little Benzocaine is expected to be absorbed systemically, suggesting a low likelihood of reaching the fetus.
However, the U.S. Food and Drug Administration (FDA) has warned about the risk of methemoglobinemia, a rare but serious condition that reduces the amount of oxygen carried through the blood. While this risk is more common with sprays and overuse, the potential for reduced oxygen is a concern for any pregnant individual. Medical professionals advise using these topical products minimally and only after discussion with a healthcare provider. Prescription local anesthetics like Lidocaine, commonly used by dentists, are generally considered safer for dental work during pregnancy because the injected dose is precisely controlled.
Safer Options for Managing Oral Discomfort
If a pregnant person chooses to avoid topical numbing gels, several non-pharmacological methods can help manage oral discomfort. Rinsing the mouth with a warm salt water solution can soothe irritated gums and reduce inflammation. Applying a cold compress to the outside of the cheek over the painful area can also help to dull nerve signals and reduce swelling.
For systemic pain relief, Acetaminophen (Tylenol) is the first-line medication of choice for mild to moderate pain throughout all trimesters of pregnancy. This medication has the best safety profile compared to other over-the-counter pain relievers. Always use the lowest effective dose for the shortest duration, and consult with a doctor or OB/GYN before taking any systemic medication. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are generally avoided, especially after the second trimester, due to risks of fetal complications.
When to Consult Your Dentist or OB/GYN
Self-treatment with gels or other home remedies should only be a temporary measure while waiting to see a professional. Any persistent, severe pain that does not resolve quickly is a signal to seek professional care immediately. Urgent symptoms include visible swelling in the mouth or face, which can indicate a serious infection or abscess, or the presence of a fever alongside oral pain. Untreated dental infections during pregnancy should not be ignored, as they can pose risks to the pregnancy itself. Promptly consulting a dentist or OB/GYN ensures the underlying cause is properly diagnosed and treated with methods safe for the pregnancy.