Going to the dentist while pregnant

Can I go to the dentist when I’m pregnant? | Your Pregnancy Matters

For the vast majority of women, going to the dentist for routine care is safe during pregnancy.

It’s an old wives’ tale that going to the dentist while pregnant is risky for developing babies and moms-to-be. In fact, just the opposite is true – good dental hygiene is part of a healthy lifestyle for everyone. The mouth is a major gateway to the blood vessels and digestive system. As such, your oral health can be a good indicator of your overall health.

Still, many pregnant women have questions about whether dental care during pregnancy is safe. It’s understandable – moms want to do everything right for their babies, and there’s a lot of misinformation out there. In fact, our office gets so many questions that, with input from local dentists, we put together a standard letter that addresses patients’ concerns.

With the help of guest contributor Wandana Mistry, D.D.S. (a dentist and a UT Southwestern Ob/Gyn patient), I’ve answered seven of the most common questions we get about dental care during pregnancy. Take a look – we hope it helps you feel confident in getting the care you need.

1. Why is dental care important during pregnancy?

Hormone changes and certain medications can increase the risk of periodontal disease and dry mouth, so we advise patients to brush and floss twice daily during pregnancy. That might sound like a lot, but it can prevent cavities after eating craved sweets and reduce the risk of gum erosion. Also, vomiting related to severe morning sickness can cause acid erosion of the teeth and, rarely, pregnancy hormones can cause benign growths in the mouth that are not necessarily dangerous but can be annoying.

Additionally, a baby's teeth start to develop during the third to sixth month of pregnancy. It is important that pregnant women monitor their diets to support healthy teeth in their babies. Pregnant patients might have a hard time brushing due to a strong gag reflex. Patients can try using a smaller toothbrush or using different flavors of toothpaste to make brushing easier.

2. I’m in my second trimester of pregnancy. Can I get my teeth cleaned?

Treatment during every trimester is safe. However, the second trimester is the safest trimester in which to get dental treatment. The third trimester is safe, but the patient might have a hard time laying back for extended period of time.

For the most part, there is no medical need to defer most common dental treatments until after pregnancy. In fact, some experts believe there might be an association between periodontal disease and poor pregnancy outcomes, such as preterm birth and preeclampsia. Some providers will encourage women to wait for dental care until after the first trimester to reduce the risk of miscarriage. In our opinion, there is no increased risk for miscarriage with dental care and we don’t recommend delaying needed treatment.

If major dental work or elective orthodontics is planned, patients might wish to consider waiting until after delivery. This is our general recommendation with most medical procedures. If it’s necessary for your health, have the procedure. If it’s elective or it can wait, that’s often the safest choice.

3. If I need oral surgery or a procedure, what types of anesthetic are safe?

Local anesthetics such as bupivacaine, lidocaine, and mepivacaine are safe during pregnancy. If your dental provider feels something stronger is necessary, discuss it in advance with your Ob/Gyn or certified nurse midwife.

4. Are dental X-rays safe during pregnancy?

Modern digital radiography has made radiation concerns almost negligible. X-rays for the diagnosis of dental disease during pregnancy are of very little risk to the developing fetus – especially when you consider the infections and pain that can develop if you don’t have them. However, it’s important that you tell your dentist you are pregnant before X-rays are done so the staff can provide a special garment or device to shield your pelvis and abdomen from exposure.

It’s an old wives’ tale that going to the dentist while pregnant is risky for developing babies and moms-to-be. In fact, just the opposite is true – good dental hygiene is part of a healthy lifestyle for everyone.

5. Which antibiotics can I take to prevent or treat a tooth infection?

Penicillin and amoxicillin are safe choices during pregnancy, as are cephalosporins, such as cephalexin. Avoid tetracycline because it can cause tooth staining in the fetus.

6. What can I take for pain control after a dental procedure?

Acetaminophen in combination with a narcotic drug, such as codeine or hydrocodone, is commonly prescribed and is safe during pregnancy. We encourage patients to use as short a course of such drugs as possible following procedures to reduce the risk of opioid dependency. Patients should be counseled to transition to non-narcotic pain relievers, such as plain acetaminophen, as soon as possible. As such, dentists should not prescribe a 30-day supply of any opioid drug. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are not recommended during pregnancy.

7. What about dental care after the baby is born?

After childbirth, continuing with your own dental care and your baby’s is very important. Continue brushing your teeth regularly and purchase an infant toothbrush and infant toothpaste without fluoride to keep the baby’s gums and budding teeth healthy. We also advise new parents to avoid putting babies to bed with bottles because it can lead to tooth decay.

Schedule your baby’s first dentist appointment at six months or when the first tooth comes in. The dentist will check for tongue-tie and other oral issues that can delay speech and other functions. Also, seeing a dentist regularly will help the baby get used to it and potentially reduce the fear of seeing a dentist later in life. Remember, good dental health is key to overall wellness, and pregnancy is an optimal time to establish healthy habits. If you’re concerned about an upcoming trip to the dentist during pregnancy, call your Ob/Gyn for recommendations and clarification.

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Dental Concerns During Pregnancy - American Dental Association

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In between trips to the doctor, hospital tours and setting up the nursery, don’t let visiting the dentist fall off your pregnancy to-do list before your baby comes. Getting a checkup during pregnancy is safe and important for your dental health. Not only can you take care of cleanings and procedures like cavity fillings before your baby is born, but your dentist can help you with any pregnancy-related dental symptoms you might be experiencing.

The American Dental Association, the American Congress of Obstetricians and Gynecologists and the American Academy of Pediatrics all encourage women to get dental care while pregnant. “It is a crucial period of time in a woman’s life and maintaining oral health is directly related to good overall health,” says Aharon Hagai, D.M.D.

Here are some common concerns women have about going to the dentist during pregnancy.

When to Tell Your Dentist You Are Pregnant

Even if you only think you might be pregnant, let your dental office know. Tell them how far along you are when you make your appointment. Also let your dentist know about the medications you are taking or if you have received any special advice from your physician. If your pregnancy is high-risk or if you have certain medical conditions, your dentist and your physician may recommend that some treatments be postponed.

How Pregnancy Will Affect Your Mouth?

Although many women make it nine months with no dental discomfort, pregnancy can make some conditions worse – or create new ones. Regular checkups and good dental health habits can help keep you and your baby healthy.

Pregnancy Gingivitis
Your mouth can be affected by the hormonal changes you will experience during pregnancy. For example, some women develop a condition known as “pregnancy gingivitis,” an inflammation of the gums that can cause swelling and tenderness. Your gums also may bleed a little when you brush or floss. Left untreated, gingivitis can lead to more serious forms of gum disease. Your dentist may recommend more frequent cleanings to prevent this.

Increased Risk of Tooth Decay
Pregnant women may be more prone to cavities for a number of reasons. If you’re eating more carbohydrates than usual, this can cause decay. Morning sickness can increase the amount of acid your mouth is exposed to, which can eat away at the outer covering of your tooth (enamel).

Brushing twice a day and flossing once can also fall by the wayside during pregnancy for many reasons, including morning sickness, a more sensitive gag reflex, tender gums and exhaustion. It’s especially important to keep up your routine, as poor habits during pregnancy have been associated with premature delivery, intrauterine growth restriction, gestational diabetes and preeclampsia.

Pregnancy Tumors
In some women, overgrowths of tissue called “pregnancy tumors” appear on the gums, most often during the second trimester. It is not cancer but rather just swelling that happens most often between teeth. They may be related to excess plaque. They bleed easily and have a red, raw-looking raspberry-like appearance. They usually disappear after your baby is born, but if you are concerned, talk to your dentist about removing them.

Medications

Be sure your dentist knows what, if any, prescription medications and over-the-counter drugs you are taking. This information will help your dentist determine what type of prescription, if any, to write for you. Your dentist can consult with your physician to choose medications—such as pain relievers or antibiotics—you may safely take during the pregnancy. Both your dentist and physician are concerned about you and your baby, so ask them any questions you have about medications they recommend.

Local Anesthetics During Pregnancy

If you’re pregnant and need a filling, root canal or tooth pulled, one thing you don’t have to worry about is the safety of the numbing medications your dentist may use during the procedure. They are, in fact, safe for both you and your baby.

A study in the August 2015 issue of the Journal of the American Dental Association followed a group of pregnant women who had procedures that used anesthetics like lidocaine shots and a group that did not. The study showed these treatments were safe during pregnancy, as they cause no difference in the rate of miscarriages, birth defects, prematurity or weight of the baby. “Our study identified no evidence to show that dental treatment with anesthetics is harmful during pregnancy,” said study author Dr. Hagai. “We aimed to determine if there was a significant risk associated with dental treatment with anesthesia and pregnancy outcomes. We did not find any such risk.”

Dental X-Rays During Pregnancy

Yes, it's safe to get an X-ray during pregnancy. Although radiation from dental X-rays is extremely low, your dentist or hygienist will cover you with a leaded apron that minimizes exposure to the abdomen. Your dental office will also cover your throat with a leaded collar to protect your thyroid from radiation.

Dental treatment during pregnancy - is it possible to treat teeth in the 1st, 2nd, 3rd trimester

It is possible and even necessary to treat teeth during pregnancy. Tolerate a toothache is not worth it, it is stressful for the expectant mother and baby. In addition, sanitation of the oral cavity is also indicated for other reasons: to remove foci of chronic infections and reduce the risk of complications. There is no need to postpone a visit to the doctor, and an examination by a dentist during pregnancy is included in the examination plan.

Visits to the dentist in good oral health are necessary twice - in the first trimester at registration and immediately before childbirth. If a disease requiring treatment is identified, the doctor will tell you about further actions.

Features of dental treatment during pregnancy

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

Caries, pulpitis, periodontitis, inflammatory diseases of the gums and soft tissues are subject to urgent treatment: stomatitis, gingivitis, periodontitis, glossitis, cheilitis. Also, urgent care is indicated for injuries such as a fracture of the tooth root, chips, cracks, and the need for surgical intervention for abscesses, periostitis, etc. In some cases, orthodontic, orthopedic treatment, as well as whitening, can be postponed. For example, the installation of braces or one dental implant can be postponed to a more favorable time, after the birth of the baby. In the absence of a large number of teeth, you can resort to removable dentures, they do not provide for preparation in the form of tooth preparation and other difficulties.

When filling, the doctor can use any materials according to indications. The lamps that are used for curing are not harmful to the fetus.
Dental treatment during pregnancy can be accompanied by high-quality pain relief. The expectant mother should not endure discomfort, there are drugs approved for use. The only limitation is anesthesia.

Contraindications and limitations

A contraindication to any dental intervention may be the threat of termination of pregnancy or premature birth. Of course, if a woman is in a hospital and is being treated to maintain her pregnancy, oral problems may recede into the background. But if the condition allows you to visit the dentist, it is better to do so and discuss the appropriateness of treatment.

Some procedures will have to be postponed until the end of pregnancy:

Implantation: the surgical stage may be contraindicated due to the use of drugs during the recovery period, the need for several x-rays. However, in some cases, for example, when installing a permanent prosthesis on already implanted implants, it is allowed to carry out the procedure in agreement with the gynecologist leading the pregnancy.

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

Professional whitening: Pregnancy is a contraindication for whitening as teeth enamel can be weakened due to pregnancy and results are more difficult to predict.
Installation of fixed prostheses: in the absence of a large number of teeth, it is better to prefer removable prosthetics, it involves a smaller amount of intervention.

In all cases where the extraction of a tooth can be delayed, it must be done. We are talking about the removal of impacted, dystopic teeth that do not cause severe pain and do not carry the risk of serious consequences in the near future. If the tooth cannot be restored and causes severe pain, is a potentially dangerous focus of infection, extraction is recommended.

Antibacterial therapy, as well as x-rays, are undesirable during pregnancy, but they can be prescribed by a doctor if there are strict indications. When taking an x-ray, it is important to protect the abdomen with a lead apron. The specialist selects antibiotics taking into account the duration of pregnancy, carefully weighing the potential danger in the absence of treatment and possible harm to the fetus. There are antibacterial agents that are allowed during pregnancy and do not have a teratogenic effect.

Treatment in different trimesters of pregnancy

Treatment may depend on the specific stage of pregnancy.

The first trimester is the period up to the 12th week. At this time, the laying of the child's organs occurs, and the unformed placenta does not yet provide reliable protection for the fetus from negative factors. In addition, before the 8-9th week, the probability of spontaneous interruption is higher. It is also important to remember that many women experience toxicosis in the first trimester, characterized by nausea, vomiting, increased salivation, and dizziness. Therefore, they try to avoid interventions in this period, and if treatment can be postponed, the doctor will recommend doing so. Remineralizing therapy, professional teeth cleaning without ultrasonic exposure are allowed.

Dental treatment in the 2nd trimester of pregnancy - from the 13th to the 24th week - is the safest. The formed placenta acts as a reliable protection for the child. The periods of high interruption risks are over, and the mother's well-being allows her to spend a lot of time in the dental chair. All planned procedures are recommended to be carried out at this time. These include professional cleaning, treatment of diseases that can 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 gestation. Shortness of breath, tachycardia, low blood pressure may be observed. In addition, in a reclining position, symptoms may be aggravated due to compression of the inferior vena cava by the uterus. Slightly on the left side is allowed 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, get tired faster. Therefore, treatment is carried out only according to strict indications, if it is impossible to wait for delivery and the woman's condition may deteriorate sharply.

Features of diagnosis

Accurate diagnosis determines the results of treatment, so it should not be neglected. A targeted x-ray of a tooth may be contraindicated, especially in the first trimester of pregnancy when the cells are susceptible to radiation. But if other diagnostic methods are not available, and without a picture it is impossible to correctly develop a treatment regimen, you can resort to it. The safest method is digital radiovisiography. In comparison with a film image, the load is several times less, so you can resort to such a diagnosis. During the examination, radiological protection is observed.

Safe pain relief

Dental care during pregnancy provides quality pain relief. For this, local anesthetics of the latest generation 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 slightly lower. It does not affect blood flow in the placenta and uterus.

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

They do not have a systemic effect and are harmless to the baby and the pregnant woman.

Features of procedures

Tooth extraction is a surgical procedure. It is accompanied by a small blood loss, as well as stress. Increased psycho-emotional stress is undesirable during pregnancy, so there must be strict indications for tooth extraction. Extreme cases where intervention is indispensable include the following:

fracture of the crown, root;
root caries,
pulpitis of the third molars, which are the cause of acute purulent inflammation,
cystic periodontitis;
tooth decay accompanied by acute pain.

Elective extraction of wisdom teeth is not performed. This is due to high risks of alveolitis and other possible complications, which require repeated intervention and powerful antibiotic therapy.

How to treat teeth during pregnancy, the doctor will tell you in detail. If the therapy of superficial and medium caries during this period practically does not differ from the standard procedure, then the treatment of pulpitis will require a special approach. The doctor will select an agent without arsenic for pulp devitalization. There is a need to conduct at least two radiographic images - before the procedure to determine the structure, number and size of the root canals and after it to monitor the effectiveness of the treatment. Therefore, the method of digital radiovisiography is used.

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

Dental treatment during pregnancy is successfully carried out by the doctors of the STOMA clinics. We have everything you need to provide urgent assistance and carry out planned activities. In the clinics of the network, you can undergo regular dental examinations or apply for the treatment of caries, gingivitis of pregnant women, periodontitis, pulpitis, etc. We guarantee the use of only approved anesthetics and high-quality equipment, safe diagnostics. You can make an appointment by phone or through a special form on the website.

Is it possible to treat teeth during pregnancy

How often should I go to the dentist?

Visits are required every trimester. Immunity during pregnancy decreases. And this is not surprising: a woman bears in herself a new organism, different from herself. What is changing from the point of view of the dentist?

Increased risk of bone destruction
There are changes in the work of the glands that produce saliva. The rate of saliva secretion decreases, its viscosity increases, the pH shifts to the acid side
Calcium and magnesium deficiency occurs - this reduces the mineralizing ability of saliva. It ceases to perform a very important function: to wash the teeth, remove food debris, supply tooth enamel with minerals
Increased risk of gum disease and caries

Therefore, a pregnant woman needs to visit the dentist regularly for professional cleaning, as well as prevention and treatment at the earliest stages.

When can pregnant women be treated?

Try to get your teeth fixed before pregnancy. Any dental interventions (except professional hygiene) in the first and third trimesters are undesirable: in the first - all organs and systems of the child are laid, in the third - any irritants are undesirable.

It is possible in the second trimester (this is about 14-20 weeks), when all the baby's systems are developing smoothly. This is the safest time for dental treatment.

But, if you are tormented by a toothache, you can treat it in the first and even in the third trimester (the exception is only complex surgical operations).

What can be treated and what can not?

Caries and pulpitis - possible. Treatment at Belgravia Dental Studio is performed under a microscope - precise and gentle removal of only affected tissues. The therapy is comfortable - with safe local anesthesia, the patient sits in a comfortable chair on a special soft mattress.

And we treat caries in the initial stage with an absolutely comfortable and non-invasive Icon method - without drilling and fillings.

Gingivitis - you can. The treatment of gum disease in Belgravia Dental Studio consists in the removal of tartar and plaque, in anti-inflammatory therapy.

Surgical interventions are highly undesirable! They are carried out in pregnant women (regardless of the term) only for urgent indications. What are these indications? Injuries of the teeth and purulent-inflammatory processes in the oral cavity. All other operations, including implantation, can be considered planned and postponed until the postpartum period.

Is anesthesia allowed?

Only anesthesia with a high content of adrenaline is prohibited. Such drugs have been used in clinics before, they could provoke muscle spasms. This is what both obstetrician-gynecologists and pregnant women themselves are afraid of, completely refusing any pain relief.

In Belgravia Dental Studio, such compositions have not been used for a long time - only the most modern and safe anesthetics are used. If treatment is still necessary for the expectant mother, we use hypoallergenic products that are well tolerated by the body. Such anesthetic injections do not penetrate the placental barrier and will not harm the baby.

Should I endure a toothache?

In no case! Many women still refuse any pain relief and endure pain. “So harmless to the baby,” they say. And it’s good if they still go to see a doctor - many simply suffer at home, use the most unimaginable home remedies, but never go to the dentist! Such women consider themselves almost heroines, because they endured severe pain, not wanting to harm their unborn child.

But in fact, it only gets worse: pain, especially severe and prolonged, disrupts the functions of internal organs and metabolism. And even that's not all! Pain has another aspect - psychological. A woman can be afraid of pain, worry about it, lose her temper, and commit rash acts. All this is not at all useful for the pregnant woman and the child. Excruciating pain is actually out of control of the central nervous system and can cause serious harm to the body.

Is X-ray acceptable during pregnancy?

Only by strict indications! We quote the sanitary rules and norms (SanPiN): “The appointment of pregnant women for X-ray examination is carried out only according to clinical indications. Studies should, if possible, be carried out in the second half of pregnancy. This means that the dentist will send you for an x-ray only if there is a serious threat to the patient's health.

Belgravia Dental Studio uses DIAGNOcam to diagnose initial caries in pregnant women, a modern device that allows you to take pictures of the crown (visible) part of the tooth without X-ray irradiation. This will not replace X-ray 100%, but in many cases it will help to cure a pregnant patient. With DIAGNOcam, for example, you can recognize caries at an early stage and perform minimally invasive treatment.

Prevention of diseases of the teeth and gums

We have prepared a special program of dental pregnancy management - "Healthy Mom". It has everything you need to keep your teeth healthy while you're expecting a baby.

Home care is also important. It includes the selection of the right toothpaste with a minimum content of lauryl sulfate (or without it at all), and the composition of the paste should also not contain mint oils.