Dental treatment during pregnancy

Quite often you can hear that you cannot treat your teeth during pregnancy. This is a stereotype that has little to do with reality. During pregnancy, a woman experiences a hormonal storm, which, unfortunately, does not help her teeth. The pH of saliva changes, which promotes the growth of microorganisms in the oral cavity. Morning sickness and vomiting, as well as more frequent meals (including the consumption of sweet or sour foods) have a negative effect and contribute to the acceleration of caries development.

Dental treatment during pregnancy

Professional and regular oral hygiene

A woman should regularly visit a dentist before pregnancy, and during pregnancy - approximately 2-3 times. The doctor will be able to constantly assess the condition of the teeth and decide which procedures should be performed during pregnancy and which can wait. Pregnant women are at risk of gingivitis. This condition is called gestational gingivitis. It is because of pregnancy hormones that the gums swell, bleed more often, hurt and become more prone to infection. Gingivitis during pregnancy is a completely normal phenomenon and disappears completely after the birth of the child. During this phenomenon, it is very important to maintain exemplary oral hygiene.

Which procedures are allowed during pregnancy and which are not:

Caries treatment is safe throughout pregnancy;
Treatment of root canals - not recommended in the first trimester, the decision is taken by the doctor after consultation;
X-ray of the oral cavity is not recommended during the entire period of pregnancy, especially in the first trimester;
Orthodontic treatment is possible throughout pregnancy;
Anesthesia during dental interventions is allowed after the first trimester of pregnancy;
Dentures are best avoided in all trimesters;
Tooth extraction - after the first trimester of pregnancy;
Tartar removal - after the first trimester of pregnancy;
Teeth whitening is not recommended throughout pregnancy.

A pregnant woman needs to visit her dentist more often than usual, both for an examination and for possible dental treatment, as well as for professional oral hygiene. Therefore, if you have a question: "Is it possible to do ultrasonic teeth cleaning during pregnancy?", then know that there are no contraindications for this. When a woman is examined by a gynecologist, an ultrasound of the abdominal cavity is performed using ultrasounds of a much higher intensity than in the dentist's office, and they are safe for the patient and the fetus.

Treatment of dental caries

Caries and tartar are the source of a large number of live and dead bacteria. Despite the fact that they live directly in the oral cavity, these bacteria penetrate through the mucous membrane into the blood vessels and, accordingly, into the entire bloodstream. Circulating in the blood, they reach various organs, such as the heart, kidneys and joints, which can cause disease and, in the case of pregnancy, also affect the fetus. In addition, if tartar is not removed, the gums bleed and cause bad breath.

Teeth should be treated and caries should not be allowed to form. Many pregnant women attribute the sudden development of caries to pregnancy. It is a myth that the baby takes nutrients from the pregnant woman. The fetus, of course, needs all the micro- and macroelements that determine its proper development, so a healthy, balanced diet is recommended during pregnancy. The rapid development of caries in pregnant women is caused by the frequent consumption of large amounts of sugar, insufficient oral hygiene, and the lack of regular tartar removal.

Annoying nausea is an additional threat to the teeth of pregnant women. During vomiting, tooth enamel is softened by stomach acids, more precisely by hydrochloric acid. In this way, the external structure of the tooth is destroyed, which ultimately causes irreversible changes in the enamel and dentin.

Treatment of tooth canals and X-ray of the oral cavity

The need for root canal treatment is a consequence of the development of an advanced carious cavity, in which caries, penetrating deep into the tooth tissue, eventually reaches the dental pulp. Inflammation of the pulp develops, which is most often manifested by severe continuous toothache and swelling of the surrounding tissues.

An invariable element of correctly performed root canal treatment is X-ray. X-ray examinations should be avoided during pregnancy, especially in the first trimester. If an examination is necessary, always wear a protective gown that minimizes the impact of ionizing radiation on the fetus. Without the above diagnosis, the dentist does not know the condition of the surrounding bone of the tooth, whether it is really suitable for root canal treatment, or whether it will need to be removed. The doctor must take a detailed history and ask the patient for old X-rays, if available (panoramic image not older than a year), to check the approximate state of the periodontium and bone tissue. If necessary, after consultation with the obstetrician, a decision will be made about the need for the necessary X-ray.

An alternative to immediate antiseptic treatment of root canals is to carry out the procedure of devitalization of the tooth pulp and postpone the final treatment until the end of pregnancy. This is a method of providing emergency care to the patient, especially in the case of pregnancy in the last stages. In general, unnecessary stressors should be avoided. A few days after the procedure, the pain symptoms usually stop.

Can pregnant women be anesthetized?

If there is a possibility of pain during the procedure, the patient can be anesthetized with an appropriately selected local anesthetic, using up to two ampoules of a preparation with adrenaline (not norepinephrine!) at a dilution of 1:200,000.

indicated: lidocaine, ropivacaine, articaine, and procaine
contraindicated: prilocaine, mepivacaine and bupivacaine

Sedation and general anesthesia should be avoided during pregnancy. Painkillers should be used only as needed, for as short a time as possible, and in the lowest effective dose.

allowed: paracetamol (throughout pregnancy), ibuprofen, naproxen, diclofenac (allowed only in the 1st and 2nd trimesters)
contraindicated: aspirin, opioids.

Taking antibiotics

In the case of severe pain and swelling, the patient may be prescribed an appropriate antibiotic to eliminate ongoing inflammation.

acceptable: amoxicillin, penicillin G, cephalosporins (eg, cefuroxime), and clindamycin
inadmissible: clamromycin, tetracyclines, aminoglycosides, sulfonamides, and metronidazole

Surgical treatment

Scheduled procedures (agreed in advance - not related to acute or emergency care) should be postponed no earlier than 6 weeks after the end of pregnancy. Emergency (urgent) surgery is preferably performed in the 2nd trimester of pregnancy. Procedures for pregnant women should be carried out in a sitting position. Contraindications to surgical operations are multiple emissions, anemia in pregnant women or hemophilia.

Why are the first and last trimesters so important?

In the first trimester of pregnancy, organogenesis occurs, that is, the formation of organs in the fetus. Any interventions in the pregnant woman's body during this period are contraindicated. In the last trimester, there is a high risk of contractions and premature birth due to taking certain medications, their excessive amount or additional stress.