Endodontics · patient case question
Articaine carries which FDA pregnancy category?
Patient case: Endodontic Emergency in Pregnancy
demo: 29-year-old female, 32 weeks pregnant
chief: “The lower left tooth has been keeping me awake for three nights.”
history: Uncomplicated pregnancy, third trimester. Obstetrician cleared for necessary dental care.
meds: Prenatal vitamins
findings: Tooth #19 with a deep distal carious lesion, lingering pain to cold, tender to percussion. Vital pulp on access.
Show answer and explanation
Correct answer: A. Category C
- A. Correct. Articaine is Category C, meaning animal studies show adverse effects or data are lacking. Lidocaine and prilocaine are Category B and are conventionally preferred in pregnancy.
- B. No local anesthetic used in dentistry carries Category A.
- C. Category B applies to lidocaine, prilocaine, and etidocaine — not articaine.
- D. Category X is reserved for agents with proven fetal risk that outweighs any benefit, such as isotretinoin.
Note: The FDA replaced the letter categories with the Pregnancy and Lactation Labeling Rule in 2015, but board recalls still use the old system.