Dental Treatment in Pregnancy

Toothache is not uncommon for women during pregnancy. Learn how to get proper and safe dental care while pregnant.

It is possible and even necessary to treat teeth during pregnancy. You should not tolerate toothache, it is stressful for the expectant mother and the baby. In addition, oral hygiene is also indicated for other reasons: to remove chronic infections and reduce the risk of complications. A visit to the dentist is not to be put off, and examination by the dentist during pregnancy is part of the examination plan.

If your oral health is good, you should visit the dentist twice – in the first trimester, when you are registered and immediately before delivery. If diseases requiring treatment are detected, the doctor will tell you about further actions.

Peculiarities of Dental Treatment in Pregnancy

Pregnancy is not a contraindication to dental procedures. However, it is important to take into account both the duration of pregnancy and the peculiarities of its course, as well as the overall health of the woman. There are a few peculiarities of treatment:

Dental Treatment in Pregnancy

Caries, pulpitis, periodontitis, inflammatory diseases of the gums and soft tissues: stomatitis, gingivitis, periodontitis, glossitis, cheilitis are subject to urgent treatment. Urgent care is also indicated for injuries such as broken tooth roots, chips, cracks, and the need for surgery for abscesses, periostitis, etc. In some cases, orthodontic, orthopedic, and whitening treatments can be postponed. For example, the installation of braces or a single dental implant may be postponed until a more favorable time after the birth of the baby. If you are missing a large number of teeth, you can resort to removable dentures, they do not require preparation in the form of tooth preparation and other complications.

When filling, the doctor can use any materials as indicated. The lamps that are used for curing are not harmful to the fetus.

Dental treatment during pregnancy can be accompanied by quality anesthesia. It is not necessary to endure unpleasant feelings for the future mother, there are drugs that are approved for use. The only limitation is anesthesia.

Dental Treatment in Pregnancy: Contraindications and Restrictions

A contraindication to any dental intervention can be the threat of pregnancy termination or premature delivery. Of course, if a woman is hospitalized and undergoing treatment to preserve pregnancy, oral problems can recede into the background. But if the condition allows for a visit to the dentist, it is better to do so and discuss the advisability of treatment.

Some procedures may have to be postponed until after the pregnancy is over:

Implantation: the surgical phase may be contraindicated due to the use of medications during recovery, the need for multiple X-rays. However, in some cases, such as the placement of a permanent prosthesis on implants that are already engrafted, the procedure is allowed by agreement with the gynecologist in charge of the pregnancy.

Implantation requires serious preparation. During pregnancy, all the body’s forces are directed towards the development of the baby. The work of immune forces, the blood supply to organs and tissues, metabolic processes change. This can lead to unpredictable results of artificial root engraftment. In addition, the recovery period after installation may include taking medications that are contraindicated when carrying a baby.

Professional whitening: pregnancy is a contraindication to whitening, as tooth enamel may be weakened due to pregnancy and the outcome is more difficult to predict.

Fixed dentures: if a large number of teeth are missing, removable dentures are preferable, as they require less intervention.

In all cases where tooth extraction can be postponed, it should be done. We are talking about the removal of retained, dystopian teeth that do not cause severe pain and do not carry the risk of serious consequences in the near future. If, however, the tooth is irreparable and causes severe pain, and is a potentially dangerous focus of infection, extraction is recommended.

Antibacterial therapy as well as x-rays are not advisable during pregnancy, but they can be prescribed by the doctor in case of strict indications. It is important to protect the abdominal area with a lead apron when taking x-rays. Antibiotics are selected by a specialist taking into account the duration of pregnancy, carefully weighing the potential danger in the absence of treatment and the possible harm to the fetus. There are antibacterial agents that are allowed during pregnancy and do not have teratogenic effects.

Dental Treatment in Different Trimesters of Pregnancy

The specifics of treatment may depend on the specific gestational age.

The first trimester is the period up to the 12th week. At this time, the baby’s organs are laid, and the unformed placenta does not yet provide reliable protection for the fetus from negative factors. In addition, the probability of spontaneous abortion is higher until the 8th or 9th week. It is also important to remember that many women in the first trimester have toxemia, characterized by nausea, vomiting, excess salivation, dizziness. Therefore, interventions in this period are tried to be avoided, and if it is possible to postpone the treatment, the doctor will recommend doing so. Remineralizing therapy, professional tooth cleaning without ultrasound are allowed.

Dental treatment in the 2nd trimester of pregnancy, from the 13th week to the 24th week, is the safest. The formed placenta acts as a reliable protection for the baby. Periods of high risk of termination are behind us, and the well-being of the mother allows enough time in the dental chair. It is recommended that all routine procedures be performed at this time. These include professional cleanings, treatment of diseases that may worsen over time.

Dental treatment during pregnancy in the 3rd trimester – from the 25th week until the end of the term – also has several limitations. A woman’s body may be weakened by the end of her pregnancy. Shortness of breath, tachycardia, and low blood pressure may occur. In addition, in a half-lying position, symptoms may increase due to compression of the inferior vena cava by the uterus. A slightly left-sided position is allowed, in order to reduce the load on the aorta and inferior vena cava.

The uterus becomes more sensitive to adverse factors, including medications. The woman herself may become more anxious and fatigued more quickly. Therefore, treatment is carried out only on strict indications, if it is impossible to wait for delivery and the woman’s condition may worsen sharply.

Diagnosis

Accurate diagnosis determines the results of treatment, so it should not be neglected. Targeted dental X-rays may be contraindicated, especially in the first trimester of pregnancy, when cells are susceptible to radiation. But if other diagnostic methods are not available, and without an X-ray it is impossible to develop a proper treatment plan, it can be used. Digital radiovisiography is the safest method. Compared to the film image, the load is several times less, so you can resort to such diagnostics. Radiological protection is observed during the examination.

Safe Pain Management During Pregnancy

Dental treatment during pregnancy involves quality anesthesia. For this purpose, the latest generation local anesthetics are used, which do not cross the placental barrier. Many formulations include a vasoconstrictor component, which increases the effectiveness of the anesthetic. In preparations for pregnant women, the concentration of such a component is somewhat lower. It does not affect blood flow in the placenta and uterus.

There are several local anesthetics approved for use in pregnant women:

  • Ultracaine,
  • Lidocaine,
  • Mepivacaine (Scandoneast).

They have no systemic effect and are harmless to the baby and the pregnant woman.

Peculiarities of Procedures

Tooth extraction is a surgical procedure. It is accompanied by a small amount of blood loss, as well as stress. Increased psycho-emotional stress is undesirable during pregnancy, so there must be strict indications for tooth extraction. To the extreme cases when you cannot do without intervention, include the following:

  • Fracture of the crown, root;
  • Root caries,
  • Third molar pulpitis, causing an acute purulent inflammation,
  • Periodontitis with the formation of cysts;
  • Destruction of the tooth, accompanied by severe pain.

Planned extraction of wisdom teeth is not carried out. This is due to the high risk of alveolitis and other possible complications, in which repeated intervention and powerful antibacterial therapy will be required.

Your doctor will explain in detail how to treat teeth during pregnancy. If the treatment of superficial and medium caries during this period is practically the same as the standard procedure, then the treatment of pulpitis will require a special approach. The doctor will choose an arsenic-free remedy to devitalize the pulp. There is a need for at least two radiographs – before the procedure to determine the structure, number and size of root canals and after the procedure to monitor the effectiveness of treatment. Therefore, the digital radiovisiography method is used.

Treatment of periodontal disease is mandatory. In addition, pregnancy significantly increases the risk of their development. For example, gingivitis in pregnant women is relatively common. The doctor will choose the tactics of treatment taking into account individual characteristics, prescribe medication therapy approved for use.

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