Is there a danger of dental treatment during pregnancy: myths and reality. What happens to teeth during pregnancy, how to preserve and strengthen them during an “interesting situation”

Pregnancy is a physiological condition characterized, among other things, by hormonal changes in a woman’s body, which can lead to problems with teeth and gums. Each of the three trimesters of pregnancy has its own characteristics, but the capabilities of modern therapeutic dentistry can eliminate any of these problems in each period.

Pregnancy is characterized by a strong hormonal shock, which involves a rather complex set of hormones. In addition, during pregnancy, strong vascular changes occur, in particular in the mucous membranes of the oral cavity, dentoalveolar ligaments (periodontal).

Hormonal and immunological changes

Physiological changes that appear in a pregnant woman occur as a result of the endocrine activity of the placenta, the release of estrogen and progesterone.

The secretion of these hormones increases during pregnancy up to 10 times for progesterone and up to 30 times for estrogens.

Some hormones associated with pregnancy, such as progesterone, have immunosuppressive properties (immune suppression). Also, when levels of sex hormones are high, polymorphonuclear chemotactism, phagocytosis, and antibody response are affected. Therefore, the risk of any infection during pregnancy increases significantly.

Changes in the oral environment

During pregnancy, quantitative and qualitative changes occur in a woman's saliva. During the first three months of pregnancy, salivation increases (until now this phenomenon has not been explained). In subsequent months, this phenomenon of hypersalivation disappears.

The pH value of saliva changes towards increasing acidity (from 6.7 to 6.2) and this decrease in pH reduces the protective function of saliva. In addition, the presence of hormones is observed in saliva, which contribute to the growth of the number of microorganisms in saliva, increased bacterial contamination, and the formation of dental plaque and dental plaques.

Pathologies of the oral cavity during pregnancy

The effect of pregnancy hormones on the oral mucosa has been proven experimentally and clinically.

Inflammation of the gums (gingivitis) is an inflammatory process often observed during pregnancy, aggravated by the formation of dental plaque and plaque caused by an increase in the content of estrogen and progesterone in saliva.

Tumor of the gums (supragingival) pregnant women is a benign tumor. The etiology of its occurrence is still unclear, although trauma, poor oral hygiene and hormonal changes certainly play a role. The tumor disappears spontaneously after childbirth.

Caries. During pregnancy, the development of carious cavities is often observed. It has been established that caries during pregnancy is provoked not only by deterioration of oral hygiene, but also by changes in hormonal levels, changes in the pH of saliva (the acidity of which increases during pregnancy). Increased carbohydrate intake may also influence the incidence of dental caries in pregnant women.

Diffuse toothache. Often pregnant women complain of non-localized, diffuse pain in the teeth. This is probably due to changes in blood circulation inside the dental pulp, which causes contractions of nerve fibers when the walls of the pulp chamber are motionless. This pain is not associated with dental caries. If pain suddenly appears on healthy teeth, it usually disappears after 1-2 weeks (while caries does not disappear spontaneously).

Tooth hypersensitivity. It has been established that pregnancy contributes to changes in tooth sensitivity, reaching the degree of hypersensitivity.

Tooth erosion - demineralization, loss of substance from hard dental tissues under the influence of chemicals. During pregnancy, erosion is observed mainly at the level of the necks of the anterior teeth of the upper jaw. Tooth erosion is caused by increased acidity or gastric juice, especially when vomiting during pregnancy toxicosis. When erosions occur, short-term pain sensations appear, usually after eating, which spontaneously disappear after childbirth.

Treatment of dental and oral diseases in pregnant women

There are no contraindications for dental treatment for pregnant women. On the contrary, if treatment is not carried out, this can further have a detrimental effect on the health of both mother and baby.

However, when treating pregnant women at the dentist, it is necessary to observe some precautions, namely, pay attention to the following factors:

stressful situations during treatment;

use of ionizing (X-ray) radiation;

anesthesia;

filling materials;

medications used;

the presence of other pathologies in the body;

choosing the moment to start treatment.

Stress

Anxiety and stress during dental surgery in a pregnant woman can be reduced by the attentive attitude and patience of the doctor. It is important that the dentist explains in detail to the expectant mother what manipulations he will perform, and that it is absolutely harmless for her unborn child.

Ionizing radiation (X-ray)

Dental x-rays are considered virtually harmless to pregnant women. However, it is recommended to observe the following rules:

short irradiation time;
protection of the pregnant woman’s abdomen and chest with a special apron (personal protective equipment);
the number of x-rays should be kept to a minimum.

All of these precautions reduce the child's risk of exposure to radiation. However, it is still best to avoid X-ray examinations in the first trimester of pregnancy, unless absolutely necessary.

Anesthesia

Local anesthesia used in dentistry is not contraindicated for a pregnant woman. Regarding the drugs used, it is necessary to take into account that:

the toxicity of painkillers increases due to a decrease in proteinemia (the presence of proteins in the blood plasma) of the pregnant woman;
local hyperemia (overflow of blood in the vessels of the circulatory system above normal) when an anesthetic is injected causes acidification of the environment, which favors the cationic form of the anesthetic molecule to the detriment of the main form (namely, the main form acts on the nerve of the tooth, so the degree of pain relief in pregnant women may be reduced);
all drugs have molecular weights of about 250-330, and any molecules with a molecular weight below 600 are retained by the placenta;
the toxic dose of the anesthetic is 400 mg, which is significantly higher than the therapeutic doses used; however, it is desirable to use drugs that are least toxic, least lipid soluble, and most protein bound. The lipid solubility of the drug used determines its effect on the development of the embryo. Bonding with proteins increases the molecular weight and makes it impossible for the drug to cross the placenta.

Therefore, it is better to avoid the use of anesthesia drugs such as Prilocaine, Lidocaine and Mepivacaine. It is preferable to use Articaine (Alfacaine, Ultracaine, Primacaine, Septanest, Bucanest, Deltazin, Ubistezin).

Filling materials

No studies have shown that materials used for conservative dental treatment (composites, glass ionomer cements, etc.) or their components can penetrate the placenta or act as cellular poisons. But you should avoid using any materials containing mercury.

Medicines

If the dentist determines the presence of an infection in the oral cavity (teeth, gums), it will likely be necessary to resort to additional drug therapy. During pregnancy, you should avoid some antibiotics, some anti-inflammatory drugs, and some pain relievers.

Antibiotics

It is best to use penicillin antibiotics. First generation cephalosporins and erythromycin may sometimes be used as they have been shown to be safe. Tetracyclines should not be used because, in addition to causing dyschromia (staining) of the newborn's teeth, they are also responsible for clouding of the lens (cataracts) and congenital abnormalities of the limbs of newborns. Tetracycline can also cause fatty degeneration of liver cells and pancreatic necrosis in a pregnant woman.

Anti-inflammatory drugs

The dentist can prescribe anti-inflammatory therapy, however, the use of these drugs in pregnant women should still be avoided, both steroidal and non-steroidal. Steroid drugs can cause embryonic growth retardation, as well as affect the formation of lung tissue and tissue of some parts of the brain. Such drugs can only be used in case of a life threat, for example, in case of anaphylactic shock.

Non-steroidal anti-inflammatory drugs may be responsible for premature closure of the arterial canal, which can lead to heart problems in the newborn. Such drugs are prohibited for use in the 2nd and 3rd trimesters of pregnancy.

Painkillers

The most recommended painkiller is paracetamol. It is not toxic and teratogenic (contributing to the appearance of deformities in the unborn child). The use of acetylsalicylic acid (aspirin) should be prohibited. Aspirin has been shown to contribute to the formation of palatal clefts, intrauterine death of the child and growth retardation. Dextropropoxyphene is contraindicated in the first trimester due to the potential for respiratory depression in the infant. Codeine-containing drugs should not be used as they can cause congenital deformities and cardiac abnormalities.

When should a pregnant woman be examined by a dentist?

A woman must, first of all, register with a gynecologist in order to know exactly the duration of her pregnancy and the general condition of her body. Pregnancy is divided into three main periods (trimesters), during which the risks vary.

1-3 month

During the first trimester, the risk of deformities in the development of the fetus is greatest, and the likelihood of spontaneous miscarriage is high (up to 75% of miscarriages occur in the 1st trimester). During this time, dental intervention (endodontics and tooth extraction) is only necessary in urgent cases to avoid stress, pain and the risk of infection. In addition, during this period, women often experience toxicosis, irritability, and increased salivation, which interferes with normal dental treatment.

4-7 month

This is the best time for treatment at the dentist, because... The period of organogenesis (development of the child’s organs) has ended. During this period, it is desirable to eliminate all pathologies associated with the teeth and oral cavity, accompanied by pain or inflammation.

8-9 month

In the last months of pregnancy, a woman is already constrained by her obesity, her movements are limited, and her due date is close. During this period, the dentist should be contacted only in emergency cases, and visits to the doctor should not be long and should take place in a semi-sitting position.

Treatment of oral pathologies associated with pregnancy

Tumor of the gums (supragingival)

The tumor disappears immediately after birth. Surgery is only necessary if the tumor interferes with the process of chewing food. In this case, the dentist can only give recommendations on oral hygiene.

Primary periodontal lesions

In case of gum disease associated with pregnancy, the first step is to remove plaque, plaque and tartar. After removing plaque, rinse your mouth with a 0.12% chlorhexidine solution. In cases of periodontal damage, only minimal treatment of the affected areas is carried out. The main therapy is postponed until after childbirth.

Caries and damage to dental tissues

To prevent caries, it is necessary to remove dental plaque and seal defects using glass ionomer cements or liquid composites. To consolidate the effect, the teeth are coated with chlorhexidine varnish. You can coat your teeth with fluoride varnish, which will help avoid the appearance of new foci of caries and prevent the occurrence of dental hypersensitivity. It is better to postpone full treatment of carious cavities with permanent filling materials until after childbirth.

In the case of pulpitis, placing calcium hydroxide into the canal will temporarily soothe the pain and have an antibacterial effect. Complete canal treatment is performed only in the second trimester or after childbirth.

Erosion of teeth

In case of erosion of dental tissues, it is recommended to rinse with a solution of baking soda (especially after vomiting); brushing your teeth with a hard brush is not recommended. It is necessary to follow a diet and exclude acidic foods from the diet (lemons, oranges, sauces made from vinegar, oil and salt).

Observation and treatment of pregnant women at the dentist is not much different from that for ordinary patients. Only a few precautions are necessary. You need to be especially careful in the first trimester of pregnancy, when dental intervention is allowed only in critical cases. All other treatment should be postponed to the second trimester. In the third trimester, treatment is indicated only if there is particular urgency.

Popular wisdom says that for each child a mother must pay with one tooth. Fortunately, this is not always the case.

Good nutrition, personal hygiene and proper preparation for pregnancy will help avoid this problem. However, dental diseases also occur in pregnant women. Is it necessary to treat teeth during this period, and what treatment methods are acceptable?

It is a known fact that a carious cavity is an open gate for infection and pathogenic bacteria. During pregnancy, we try to protect the unborn baby from any harmful effects. So why expose him to unnecessary risk?!

It is important to visit a dentist and, if necessary, cure caries, or remove teeth that can no longer be saved.

In addition to the open threat of infection, there are additional problems associated with diseased teeth:

Psychological discomfort for the mother, which may intensify against the background of deteriorating health, especially in the first trimester and the period of toxicosis.
A tooth that reacts sharply to sweets or cold, or aches when eating solid foods, does not provide adequate nutrition to the mother.

Bad teeth interfere with chewing food or force a woman to refuse certain dishes (for example, fresh vegetables and fruits). Insufficient nutrition of the expectant mother can affect the development of the fetus.

Do all dental diseases need to be treated for pregnant women?

The first and most important rule: any dental disease is a reason to visit the dentist! And only the doctor will be able to decide whether the problem requires an immediate solution or whether you can wait for a more favorable stage of fetal development or the end of pregnancy.

Open cavities or a missing filling usually require treatment.

The extent of medical intervention depends on how quickly it is carried out, so you should not delay treatment.

But depulpation or tooth extraction during pregnancy is not recommended, as it can lead to an inflammatory process, an increase in temperature and a general deterioration in the condition of the expectant mother. In case of emergency, of course, removal is also carried out for pregnant women. But it is better, if possible, to limit yourself to herbal rinses and “soothe the tooth” before childbirth.

Gum cysts, if they do not bother the woman, also do not need to be treated during pregnancy. You just need to be more careful about oral hygiene. Antiseptic rinses based on herbs or miramistin will prevent the development of gingivitis and periodontitis. Local remedies practically do not enter the bloodstream and are usually safe for the fetus.

Negative impact of a diseased tooth on the fetus: consequences if treatment is refused

The influence of infections developing in a carious cavity on fetal growth is not purely theoretical.

Research by scientists in a number of countries proves a clear relationship between the presence of bacteria with cariogenic effects and the number or.

In response to the inflammatory process in the oral cavity, the body produces substances designed to suppress inflammation. And, if in the area of the diseased tooth their influence is beneficial, then the decrease in mucus in the area of the cervical canal sometimes turns out to be detrimental to the fetus. The cervix becomes thinner, and its obturator functions decrease.

Untreated caries leads to the spread of inflammation to the gums and increased pain. General intoxication affects not only the mother’s body, it will also affect the fetus.

In this case, there is a threat of delayed fetal development or appearance.

Pain in the teeth, and especially the involvement of the gums in the process, complicates eating. The woman refuses many dishes. In this case, the fetus suffers from a lack of nutrients and microelements. Depending on the stage of fetal development, this may subsequently affect the proper functioning of the endocrine system or the formation of muscle tissue, brain, etc.

In what trimesters of pregnancy can teeth be treated: the use of anesthesia and anesthesia

Pregnant women do not have their teeth treated under general anesthesia. And there is no need to be afraid of dental treatment under local anesthesia. If the expectant mother, afraid of harming the baby, refuses pain relief, during treatment she experiences excessive tension and adrenaline is released into the blood. Maternal tension and stress can negatively affect the pregnancy. Doctors recommend agreeing to anesthesia.

Lidocaine (a drug that is more often used for pain relief during dental treatment) is not recommended for pregnant women, but there are modern drugs approved for use in pregnant women (for example, anesthesia based on artecaine, Ultracaine or Ubistezin).

Dentists consider the 2nd trimester to be the most appropriate time for dental treatment. What is this connected with?

In the first trimester, when the fertilized egg is implanted and the baby’s main organs are formed, it is the most dangerous in terms of the possible influence of the materials and drugs used on the development of the fetus.

Even though the safety of many materials has been confirmed through research, no one excludes possible individual reactions during early dental treatment. Therefore, it is extremely important to treat all carious teeth before conception.

Accompanying many women in the first trimester, it is also an obstacle to comfortable dental treatment. This is another reason why dental treatment is usually not performed in the first trimester (except in emergency cases!)

In the second trimester, when the woman is no longer tormented by vomiting, but the stomach is still small enough and does not interfere with sitting comfortably in the dental chair, treatment can be performed at the dentist.

It is by this period that teeth may already be noticeable, the destruction of which occurred due to a lack of calcium for the growing fetus. Another reason for tooth decay in pregnant women is contact of tooth enamel with the acidic contents of vomit during toxicosis.

By noticing changes in tooth enamel in the early stages, they can be easily treated without causing serious complications. Otherwise, in the third trimester, a period of rapid growth of the fetus, the tooth will decay more actively and there is a risk of losing it altogether.

In the third trimester, the uterus becomes more sensitive to any external influences. Therefore, even anxiety before a dental examination can or even threaten premature birth.

The increased pressure of the uterus on large blood vessels and frequent discomfort in the lumbar region do not allow a woman to remain motionless in the dental chair for a long time, which also complicates treatment.

But if treatment is still necessary, dentists may recommend a special position for the pregnant woman during treatment, with support on her left side. This practice exists and allows you to perform all the necessary manipulations.

Dental X-ray during pregnancy

Doctors try not to prescribe X-ray examinations for pregnant women unless absolutely necessary. But if treatment tactics depend on the condition of the tooth root, an x-ray will have to be taken.

Modern equipment allows you to direct the beam pointwise, using a minimum dose of radiation. In addition, the patient is given a protective lead apron.

It is better to avoid such studies in the first trimester, but in the second and third they are quite acceptable.

Dental procedures prohibited during pregnancy

Pregnant women undergo only emergency dental treatment or preventive procedures. And you should refrain from such manipulations as prosthetics and implantation.

Implantation, as well as tooth extraction, require large doses of anesthesia, are accompanied by prolonged pain, blood loss, and there is a threat of wound infection and inflammatory processes. All this poses a risk for pregnancy.

And even seemingly “non-contact” prosthetics (for example, making a partial removable denture) are best done after the baby is born. Firstly, the gums of pregnant women are often swollen, the impression will be inaccurate and you will not be able to use the denture after pregnancy. In addition, a new denture (even a minimal “butterfly” for 1 tooth) can rub at first, leading to inflammation in the gums.

Teeth whitening should also not be performed on pregnant women. The chemical composition used for this procedure may have a negative effect on the fetus. And the tooth enamel of pregnant women already suffers from a lack of microelements, so you should not expose it to unnecessary aggressive influences.

Prevention of dental diseases

The best prevention is hygiene procedures and timely dental treatment. During the period of toxicosis, when even the smell of toothpaste or the presence of a toothbrush in the mouth can cause vomiting, some women do not pay due attention to hygiene. Meanwhile, it is important to use a rinse, herbal or alkaline solution after each vomiting. This will preserve your tooth enamel.

If morning sickness prevents you from brushing your teeth in the morning, you can reschedule this procedure to another time of day when the symptoms of toxicosis are not so strong.

It will provide the growing fetus with calcium and protect mother’s teeth from destruction.

The normal growth and development of the fetus during pregnancy depends on the health of the expectant mother's teeth. The threat posed by untreated caries should not be underestimated. It is important to visit a dentist when planning a pregnancy to treat foci of infection. And during pregnancy, pay more attention to oral hygiene and proper nutrition for the expectant mother.

Dental treatment for pregnant women is not only possible, but necessary. You cannot tolerate toothache; it is a huge stress for both the woman’s body and the baby. In addition, hidden foci of infection in the mouth can lead to infection of the fetus. Therefore, you should not put off visiting the dentist.

Features of dental treatment for pregnant women

Pregnancy is not an absolute contraindication to any dental procedures. However, the patient must warn the doctor about her situation, and also indicate the exact duration of pregnancy.

Main nuances of therapy:

while carrying a child, caries, pulpitis, periodontitis and inflammatory gum diseases (gingivitis, periodontitis, stomatitis) can be treated;
To fill a tooth, you can use both chemically curing materials and light-curing composites; photopolymer lamps are safe for the fetus;
enamel bleaching is prohibited;
Dental treatment is carried out under local anesthesia (injection of Ultracaine, Articaine), the expectant mother must not be allowed to endure terrible pain in the dentist’s office;
General anesthesia is strictly contraindicated.

Early and late dental treatment

The entire period of pregnancy is conventionally divided into 3 periods (trimesters).

First trimester (up to 12 weeks)

In the 1st trimester (the earliest period), all the vital organs of the child are formed. The placenta is just beginning to form; it cannot yet protect the fetus from negative influences. Therefore, it is undesirable to carry out any medical intervention during this period. However, the dentist can prescribe local drugs to relieve inflammation (Chlorhexidine, Miramistin, Cholisal).

Second trimester (from approximately 13 to 24 weeks)

In the second trimester, the risk of dangers decreases significantly. The placenta serves as a reliable protective barrier for the baby. This is the optimal period for dental treatment and other dental procedures.

Third trimester (from 25 weeks to delivery)

In the 3rd trimester, increased sensitivity of the uterus to drug effects occurs. In addition, during this period the woman’s body is quite weakened. Therefore, “extra” stress in the dentist’s office is extremely undesirable. If possible, it is better to postpone dental treatment during lactation. However, this does not apply to emergency cases, such as acute toothache.

Dental diagnostics during pregnancy

Treatment of pulpitis and tooth extraction during pregnancy cannot be done without diagnosis. Traditional radiography (sighted x-ray) is not the best option for pregnant women. Fetal cells are in the process of dividing, so they are especially sensitive to radiation.

But if there is a need for such diagnostics, it is better to carry it out in the second trimester. Be sure to cover your stomach and pelvic area with a protective lead apron.

The safest option for women during pregnancy is digital radiovisiography. This method is characterized by minimal radiation exposure - 90% less compared to film X-rays.

Local anesthetics are used that do not cross the placental barrier. Another requirement for painkillers is a low degree of impact on blood vessels.

Lidocaine is not suitable for expectant mothers, as this drug can cause muscle weakness, cramps and a sharp decrease in blood pressure.

The best option is anesthetics based on anticaine:

These drugs do not harm the baby because they act locally. They also have a reduced concentration of vasoconstrictor components (adrenaline, etc.), which is safe for the mother.

Tooth extraction during pregnancy

Tooth extraction is a surgical operation that is always accompanied by psycho-emotional stress. Of course, it is undesirable for women while carrying a child.

Therefore, tooth extraction is carried out only in extreme cases:

crown or root fracture;
deep carious lesion, which causes purulent inflammation;
formation of a cyst whose diameter exceeds 1 cm;
persistent acute pain that cannot be eliminated with conservative therapy.

Wisdom teeth removal is generally not performed during pregnancy. This operation often ends with alveolitis (inflammation of the socket) and other complications requiring antibiotics.

Implantation and dental prosthetics during pregnancy

During pregnancy, you can have any type of prosthesis, including crowns and bridges. The exception is dental implants.

Implanting a dental implant often requires a lot of vital energy. But during pregnancy, all resources are aimed at developing a healthy baby.

In addition, after implantation, anti-inflammatory and painkillers are required, which are contraindicated for the expectant mother.

Dental treatment during pregnancy can be done absolutely free if you use the compulsory medical insurance policy. A list of all government institutions, as well as private dentistry, can be found on our website.

The pregnancy period always prepares many unwanted surprises for expectant mothers. Month after month, women's hormonal levels change, mineral reserves are depleted, and their immunity weakens. And these are just a few possible reasons for problems in the oral cavity. But this is not the end of the world, as most pregnant women claim, citing the ban on painkillers. This is just a reason to devote a few free hours to your loved one and your health. Moreover, treating teeth is now a pleasure compared to the level of dentistry 10 years ago. True, pregnant women need an individual approach to dental treatment, but everything is not as scary as it seems. Let's look together for answers to the question: “Are teeth treated during pregnancy?”

For some reason, pregnant women consider visiting the dentist as something superfluous and unimportant. For the entire 9 months, they run around the clinic offices and take many tests for the well-being of their child, and put off taking care of their health until later. What's the end result? Even a small problem that could take 15 minutes to solve at the dentist can lead to tooth extraction and chronic periodontal disease by the end of pregnancy.

A woman should clearly understand that there are three good reasons why she needs to see a doctor:

Hormonal changes in the body contribute to pathological processes in the oral cavity.
A lack of calcium, especially in the 2nd and 3rd trimester, can easily destroy even the healthiest teeth. Modern dental technologies help many women in this situation to keep their teeth in excellent condition.
During pregnancy, the properties of saliva change: it loses its disinfecting abilities, and pathogenic microbes begin to multiply in the mouth. Also, the pH level of saliva changes and the enamel is destroyed.

Advice! Don’t consider bad teeth during pregnancy to be a small problem that will resolve itself. It is better to do a preventive examination rather than get lost in guesswork and worries. Contact only specialists who have experience in treating teeth for pregnant women. Will they know when, how and with what treatment can be carried out?

Is it possible to treat teeth during pregnancy?

Many women, when going to the dentist, ask the same question: “Are teeth treated during pregnancy?” Everyone would like to hear the word “no” and postpone this procedure as far as possible. But dental treatment during pregnancy is the responsibility of every expectant mother who takes care of herself and her baby. You, of course, ask, what does the fruit have to do with it? The fact is that inflammatory processes in the oral cavity may not affect the development of the fetus in the best way. Even a simple carious tooth, which does not bother a woman, serves as a source of microorganisms that enter the stomach and provoke late toxicosis. Just imagine how quickly the infection will spread throughout the mother’s body if the purulent focus is in the root area of the tooth? Or will severe gingivitis be passed on to an already born child through a mother’s kiss? There are many options here, and not all of them are harmless.

Normally, a woman has 2% calcium in her body. Very often during pregnancy she does not receive enough of this mineral from her diet or she has problems with metabolism and calcium is not absorbed. In this case, the holes in the teeth will be accompanied by night cramps in the limbs, and the risk of postpartum hemorrhage will double. In addition, the newborn baby will have a risk of allergic reactions and rickets. Therefore, a preventive examination by the dentist should be carried out every trimester.

Some statistics...

45% of pregnant women come into contact with a problem such as gingivitis. Their gums swell and bleed, discomfort and bad breath appear. For most of them, these problems go away on their own after childbirth if they followed the recommendations of specialists.

Suitable pregnancy strings for dental treatment

We are already convinced that it is possible to treat teeth during pregnancy. But when is the best time to do this? If a critical moment comes, then you need to go to the dentist immediately for help. If time permits, then treatment is carried out in the period from 14 to 20 weeks of pregnancy, that is, in the second trimester. Starting from 14-15 weeks, the fetus is already protected by the placental barrier. At this stage of pregnancy, the use of anesthetics with minimal adrenaline or radiography (in extreme cases) is allowed. In the first trimester, the embryo is just forming and organs and systems are being laid down, so the use of anesthesia and any drugs is contraindicated. After 20-24 weeks, it is physically quite difficult for a woman to undergo such an event as dental treatment.

On a note! In the 3rd trimester, the fetus puts strong pressure on the aorta. If a woman has to undergo dental treatment, then her position in the chair should be special. To prevent fainting or a drop in blood pressure, a woman needs to lie on her left side.

Diseases that can and should be treated during pregnancy

If it so happens that you need dental treatment during pregnancy, firstly, don’t worry, and secondly, tell the doctor what week of pregnancy you are, about its progress and about taking medications, if you are taking them. This will help the doctor choose the optimal and safe treatment tactics.

Advice! Careful hygiene using fluoride-containing toothpastes without the effect of whitening will help protect teeth during early pregnancy.

If you have caries...

Caries is a common hole in a tooth. At the stage of its occurrence, caries can be easily treated and does not require pain medication. If the process is started, the destruction of dental tissue will reach the pulp and removal of the nerve and more stringent treatment will be required. The only limitation is arsenic. Its use is unacceptable. And there are no restrictions in the choice of fillings. You can fill your teeth with both chemical fillings and light-curing fillings using ultraviolet lamps.

Important! Toothpastes with fragrances and flavoring additives can provoke attacks of toxicosis. Repeated vomiting increases the acidity of saliva and causes destruction of enamel.

If you have gingivitis or stomatitis...

Gingivitis in pregnant women is a hypertrophied enlargement of the gums under the influence of hormonal imbalances in preparation for childbirth. The gum tissue becomes easily inflamed and can completely cover the dental crowns. With this condition of the oral cavity, a woman is simply unable to maintain hygiene and needs professional help. Self-medication with home remedies will only worsen the disease and it will end in a complex form of periodontitis. According to the results of recent studies, women with exacerbation of severe forms of periodontitis during pregnancy experienced premature birth and some pathological conditions in newborns.

A timely visit to the doctor will ease your painful condition with gingivitis and protect your baby from exposure to toxins. The doctor will prescribe treatment of the gums with an antiseptic, rinses and applications to relieve inflammation, and conduct professional oral hygiene.

Due to weakened immunity, women often experience stomatitis in the oral cavity. Small ulcerative lesions cause severe pain and swelling. This disease does not pose any particular danger, but it won’t hurt to go to the doctor. He will advise you on a spray that is appropriate during pregnancy.

If you have periodontitis or pulpitis...

Inflammation of the nerve (pulpitis) and around the root dental tissues (periodontitis) is a consequence of untreated caries. The treatment of such diseases already requires the use of an anesthetic, and in order to properly fill the dental canals, you will have to take an x-ray. Modern radiovisiographic devices irradiate 10-15 times less than their ancestors. In addition, a lead apron will protect the baby from radiation.

If you suffer from tartar...

During pregnancy, both teeth and tartar create many difficulties. Plaque and tartar can cause gums to bleed and encourage the proliferation of “bad” microorganisms. This procedure does not involve pain and is performed using ultrasound or special instruments.

What anesthesia can be used during pregnancy?

There is still a myth circulating among pregnant women that if a tooth hurts during pregnancy, it will have to be treated without anesthesia. This forces frightened women to go to the dentist on weak legs, expecting terrible pain in the dental chair. And only when they see a doctor, they learn that a new generation of painkillers is actively used in practice to treat pregnant women.

Anesthetics based on articaine and mepivacaine (“Ultracaine”) contain a minimal amount of vasoconstrictor components and have a purely local effect, without passing through the placenta to the child. Therefore, suffering from toothache causes much more severe damage to your child than dental anesthesia during pregnancy.

On a note! General anesthesia is contraindicated during pregnancy.

X-ray during pregnancy: is it acceptable?

Not every doctor will be able to “blindly” fill a crooked canal or diagnose a cyst or hidden caries. This will require an x-ray. It is allowed only after the 12th week of pregnancy.

How to do X-rays for pregnant women:

She is covered with a lead blanket.
Determine the appropriate exposure and use Class E film.
All necessary photographs are taken simultaneously.

It is important to know!

It is preferable to go to a clinic where there are modern devices with microdoses close to the normal background radiation.

Removal and prosthetics of teeth during pregnancy

The need for tooth extraction during pregnancy is rare, but it does occur if you have neglected your tooth and caries has completely affected it. The process is absolutely safe for pregnancy, except for the patient’s anxiety. After tooth extraction during pregnancy, you should avoid hypothermia or overheating of the damaged area of the gum.

Prosthetics are considered acceptable during pregnancy, especially if the woman feels great and initiates it herself. If necessary, it is allowed to install braces.

Interesting!

Dental caries is diagnosed in 91.4% of women with normal pregnancy.

Severe tooth sensitivity (enamel hyperesthesia) is observed in 79% of pregnant women.

Which procedures are best postponed?

Implantation. Engraftment of new implants involves the use of medications, antibiotics and additional forces of the female body. This procedure is not recommended for pregnant women.
Removal of wisdom teeth during pregnancy. This is a complex surgical procedure, after which it is possible to increase the temperature and take antibiotics. If the situation is not critical, then you can remove the tooth after pregnancy.
Teeth whitening. The chemical components in the bleaching liquid penetrate the placental barrier and have a toxic effect on the fetus. In addition, whitening destroys enamel and increases the risk of dental diseases.

What are the dangers for a baby from a mother’s bad teeth?

Psychotraumatic factor. Toothache negatively affects the female body and at the same time the condition of the child.
Infection. Various pathogenic microorganisms can cause all sorts of complications in a child.
Intoxication and inflammation. Periodontal damage causes poor health, high fever, toxicosis, and digestive system disorders. This threatens late gestosis for the mother and hypoxia for the fetus.

What drugs should not be used during pregnancy?

Before you are given an anesthetic injection and asked to make an application, ask what drug will be used.

Lidocaine is a chemical for local anesthesia. Causes convulsions, dizziness, weakness and decreased blood pressure.
Sodium fluoride is a remedy for the treatment of caries. Used to strengthen tooth enamel. In high concentrations, it negatively affects the heart rate and fetal development.
Imudon is a drug for the treatment of inflammatory diseases of the oral cavity. The negative factor is unknown since no studies have been conducted.

We carry out doctor's orders

Even if all the teeth are healthy and there is no hint of even the most harmless gingivitis, all pregnant women are simply obliged to visit the dentist when registering to receive valuable recommendations:

The ideal option is to treat your teeth at the stage of pregnancy planning.
Get regular check-ups with your dentist.
Maintain oral hygiene: dental floss, mouthwash, soft toothbrushes and high-quality toothpastes.
Adjust the menu so that it contains a sufficient amount of calcium.
If you suffer from toxicosis, be sure to rinse your mouth with soda solution after vomiting.
To prevent gingivitis, rinse your mouth with a herbal decoction of chamomile, oregano, mint and St. John's wort.

Women must responsibly prepare for such a happy period in their lives as pregnancy. But, if for some reason it was not possible to prepare your teeth and health in general in advance, then come to the dentist for help as early as possible and remember that treatment should be carried out at 4, 5 and 6 months of pregnancy.

Caries during pregnancy generally occurs more often than in other periods of a woman’s life, and often occurs very actively at this time, sometimes even in an acute form. It is quite understandable for expectant mothers to be concerned about the possible impact of caries on the fetus, as well as fears about whether it is even possible to treat teeth during such a crucial period.

In some cases, during pregnancy, caries is just beginning its destructive work (and many try to wait out this time), and the most noticeable and sensitive consequences of dental damage await the woman after childbirth.

On a note

The statistics are eloquent:

Caries is found in 91.4% of women with a normal pregnancy and in 94% of women with toxicosis.

The average intensity of dental damage in pregnant women is from 5.4 to 6.5 (this is a high level);

Enamel hyperesthesia (increased sensitivity) is observed in 79% of women during pregnancy.

It is believed that caries itself during pregnancy does not have such a negative effect on the fetus as its treatment can have. Taking advantage of this popular belief, many pregnant women are wary of visiting the dentist, and the reason for this is that expectant mothers do not understand the nature of caries and the very dangers it poses.

Let's figure out what is actually more dangerous and can have a stronger effect on the fetus - and also see how you can carry a healthy baby and at the same time keep your teeth in excellent condition.

Does tooth decay affect the fetus?

To begin with, it is useful to remember that caries is a disease caused by pathogenic bacteria in the oral cavity. It is believed that through microdamage to soft tissues, these bacteria can penetrate the bloodstream, enter the fetus’s body and cause various pathologies.

However, the likelihood of this is extremely low: bacteria manage to penetrate the placental barrier only in extremely rare cases, and the inhabitants of the oral cavity have practically no chance of surviving in the tissues of the embryo and having any effect on it. Viruses mostly have these abilities. But, as with any infectious disease, the presence of caries in pregnant women requires a number of hygiene procedures and careful oral care.

Caries and pregnancy are more closely related precisely through the physical condition of the mother. For example, constant pain in a tooth affected by caries (which, by the way, is not uncommon during pregnancy) leads to a woman’s inability to eat normally and a general deterioration in her emotional state. All this together can really have some negative impact on the development of the fetus.

In addition, complicated caries also affects pregnancy in that with lesions, for example, periodontal disease, an inflammatory process occurs, which can affect the general physical condition of the expectant mother: lead to an increase in body temperature and the need to take antipyretic drugs, exacerbation of toxicosis, and disruptions in work digestive system.

But still, the main and most real danger of caries during pregnancy is the possibility of its transition to an acute form, severe damage to many teeth at once and the woman losing them in a fairly short time. In other words, tooth decay is usually more dangerous for the mother than for the fetus.

The same is true in the case of caries in a nursing mother. The only differences here are the reasons for refusing to visit the dentist: if a pregnant woman is often afraid that caries treatment will harm the unborn baby, then a nursing mother simply does not have 2-3 hours of time to go to the clinic.

Causes of caries development in pregnant women

Caries during pregnancy is largely due to the same reasons as in cases with other categories of patients: poor oral hygiene, an abundance of snacks during the day, a passion for sweets.

But for many women, additional reasons due to gestation come to the fore:

A decrease in the concentration of calcium and fluorine compounds both in saliva and in the blood due to some consumption of them for the needs of the developing embryo. Calcium is not consumed from the teeth themselves, as many people incorrectly believe. But the remineralization of enamel and its strengthening, which always occurs in other periods due to the action of saliva, can slow down or even stop during pregnancy. As a result, the enamel becomes weakly mineralized and is more easily damaged by acidic waste products of bacteria.
Hormonal changes in the body and, again, corresponding changes in the composition of saliva, which leads to a decrease in its bactericidal properties. Simply put, the saliva of pregnant women is in some cases less effective at destroying cariogenic bacteria.
Changes in diet – pregnant women can go to different extremes; they often develop strong cravings for sweets and starchy foods.
Improper dental care - due to fatigue, toxicosis, worries and fuss, some expectant mothers regularly forget to brush their teeth or do not do it thoroughly.

In addition, many pregnant women manage to hear a lot of statements from friends and relatives that it is impossible to treat teeth during pregnancy, and simply do not go for preventive examinations. And as a result, they miss the moment when the tooth could actually still be cured absolutely safely for the fetus.

Treatment of caries at different stages of pregnancy: is it dangerous and how is it carried out?

Caries during pregnancy is not only possible, but also absolutely necessary. Sometimes, due to the risk of acute development of the disease, timely treatment for some pregnant women is the only way to prevent it. Of course, the management of the disease itself must take into account the patient’s situation.

The main danger that arises when treating caries during pregnancy is the risk of exposure of anesthesia drugs to the fetus. All anesthetics are absorbed into the blood and can pass through the placenta, and some of them are quite capable of having an adverse effect on the developing embryo.

This is why, by the way, it is so important to see a dentist throughout pregnancy - if caries is detected at the earliest stages of its development, treatment can be carried out using remineralization methods without anesthesia, without a drill and without discomfort. But already advanced caries without anesthesia will be really painful to treat.

Often it is impossible to do without anesthesia when treating complications of caries: with pulpitis or periodontitis, this approach is unacceptable, since a pregnant woman may experience painful shock.

As a rule, dentists prefer not to treat moderate caries during pregnancy, especially if the pathology is chronic, until the beginning of the second trimester. It is in the first 12-13 weeks that the formation of all organ systems in the fetus occurs, and the risk of negative effects of medications on it during this period is maximum, although still small. Already starting from 14-15 weeks, the use of special anesthetic drugs allows for safe sanitation.

On a note

Dental X-rays are strictly not used during pregnancy. If the cavity is hidden from view, they try to resort to other methods. They even try not to study the quality of canal filling using x-rays.

Modern radiography using a visiograph has several times less radiation exposure. If there is an urgent need, it can only be done from the second trimester of pregnancy on this device.

Using local anesthesia, regardless of the stage of pregnancy, acute pulpitis, purulent periodontitis and periostitis are treated. When treating caries, even deep ones, the doctor begins treatment without the use of anesthesia and gives an injection only if the patient begins to feel pain when excision of carious areas of dentin.

Specially adapted drugs are used as painkillers for the treatment of pregnant women in dentistry, for example, Septanest and Scandonest at a dilution of 1:200,000. Pregnancy is not a contraindication for their use, and already 3 hours after the injection they are not detected in the blood.

Dentist's opinion:

Pregnancy is not a contraindication for other medications, judging by the instructions. The fact is that reducing the concentration of adrenaline, and in Scandonest - also preservatives, minimizes risks, but does not eliminate them. In any case, I observed on popular portals the position that articaine-type drugs are positioned as relatively safe for local anesthesia with relative risks, therefore they are taken in case of emergency, one of which is pain!

Towards the end of pregnancy, therapy is further complicated by the fact that when sitting in a dental chair, due to the specific position of the fetus, the load on the inferior vena cava and aorta increases, which leads to a decrease in pressure and possible loss of consciousness in the patient. To avoid this, the pregnant woman lies down in the chair slightly on her side, which reduces the load on the fetus. At the same time, the risk of teratogenic effects of anesthetics on the fetus becomes minimal by the end of pregnancy.

You can take painkillers yourself at home only if the pain is completely unbearable and it is impossible to see a doctor at the moment. If it comes to this, the doctor should see the tooth as early as possible. A good dentist will do everything possible to cure the mother’s tooth and not harm the unborn baby.

If you decide to take a painkiller yourself, then keep in mind that taking almost any drug in some cases may well have negative consequences. You can select “self-medication” in an individual case so that even a single dose of a strong painkiller will affect the health of the mother and fetus. Do not forget about individual intolerance and side effects for each drug, especially since painkillers have a whole range of them.

“At one time I went to a clinic where pregnant women did not have their teeth treated at all until the 20th week. Before pregnancy, I didn’t think about it, but when I came in the third month with initial caries, I was turned around. They said that I needed to walk around for another two months, and then they would treat me. This is a disgrace! At the spot stage, caries is treated without anesthesia and without any medications; nothing affects the fetus at all. And in two months they will open my tooth and put a filling, God forbid the nerves will be removed. I had to change the clinic, the tooth was cured, without a filling and without anesthesia. Now I’m already playing with my little one, but my tooth remains healthy.”

Anna, St. Petersburg

Prevention of caries and proper preparation for pregnancy

Prevention of caries in pregnant women should begin even before pregnancy. At the planning stage, the expectant mother should check with a dentist, heal all diseased teeth, and remove plaque and tartar. At this time, the doctor will draw up a schedule of preventive visits that will need to be followed (it is not known what the cariogenic situation in the mouth will be with the onset of pregnancy and fetal development).

On a note

The question is often asked: “Can pregnant women undergo professional hygiene?” There is a list of diseases for which ultrasonic (US) teeth cleaning and the Air Flow device are prohibited or not recommended: epilepsy, the presence of a pacemaker, nasal breathing disorders, asthma, acute chronic lung diseases, HIV and hepatitis, sexually transmitted diseases, high blood sugar or diabetes mellitus, acute respiratory viral infections, herpes and airborne diseases, malignant neoplasms.

Most often this is due to the aerosol that rises when brushing teeth from plaque and tartar. A cloud of wet dust and infection can cause respiratory failure in a pregnant woman, and high blood sugar can lead to the risk of prolonged bleeding from the gums during traumatic manipulation. In some cases, the possibility of carrying out manipulations in a pregnant woman can be determined with a related specialist (gynecologist, endocrinologist, therapist, ENT doctor, oncologist).

Directly during pregnancy, caries prevention requires:

Compliance with the rules of oral hygiene: teeth are brushed after each meal, preferably with pastes selected by the dentist; after random acts of vomiting due to toxicosis, the mouth is rinsed with a soda solution to neutralize acids from the vomit.
Compliance with the diet, restriction in the diet of sweet flour and chocolate products.
Compliance with all the dentist’s instructions - the use of systemic preventive measures, professional teeth cleaning, visiting the dentist for routine examinations, etc.

Practice shows that the correct one during pregnancy, although it should be systematic and regular, it usually does not present any difficulties. At the same time, it is the main guarantee that a woman will keep all her teeth in good condition during pregnancy and breastfeeding.