Dental treatments can often be needed during pregnancy. Dentists generally recommend having elective treatments done before conceiving or after giving birth. But if you are a soon to be mother, you might have many questions concerning your overall oral health, and whether it’s safe or not to do emergency treatments, or any other dental procedures.
Bleeding gums is considered as being a secondary reaction to pregnancy. Gingivitis (inflammation of the gums) is caused by a hormonal change that increases blood flow towards the gums. Gum disease can be controlled with thorough oral hygiene which includes brushing and flossing. Sometimes rinsing with water and salt is recommended in some extremes cases of bleeding gums. If gingivitis is not taken care of, it can affect the health of your baby. It is not clear if gum disease can lead to premature birth, but physicians consider it.
Brush your teeth regularly with a soft-bristled toothbrush after every meal to help prevent gingivitis and tooth decay. Make sure to also floss after each meal. Dental floss should all the way down (or up) around each tooth to clear gums from all plaque. Do not worry if your gums bleed as you floss; bleeding should be reduced as the health of your gums improve. Do not delay your regular dental cleanings. When your dental hygienist removes hidden plaque and tartar, it helps keeping your gums healthy. Dentists recommend a cleaning every six months. A pregnant woman may want to get cleanings done more frequently if she has trouble controlling gingivitis.
Most dental procedures can and should be done when the dentist diagnoses a problem, because anything that would promote your oral health, would also improve your baby’s health as well. There are however some elective treatments that should wait to be done after the birth of your baby.
Routine X-rays, such as the ones taken during a dental exam, should be avoided during pregnancy. If however you have a dental emergency, or are suffering from extreme pain in your mouth, your dentist would rely on X-rays to find out what the problem is. When X-rays are necessary, your dentist will use extreme caution to keep you and your baby safe. A blanket made out of lead is used to protect the uterus. The actual amount of radiation that passes through lead is insignificant.
Having dental fillings does not harm your health or your babies. Your dentist can safely repair your cavity under local anesthesia (novocaine or lidocaine). Many dentists do not however recommend replacing old amalgam-containing grey fillings with new ones. Some studies say that the amalgam vapour created from drilling into a grey filling might be toxic.
Some procedures, like tooth extraction or root canal therapy, can be done during pregnancy, under local anesthesia, without causing risk to your baby. Sometimes your dentist can start a root canal and finish it after you give birth, delaying the need to take many X-rays. General anesthesia should be avoided during pregnancy.
The first trimester of pregnancy is the period of greatest risk for the baby because during this stage the baby’s organs are developing. Some medicines taken during this time have the potential to affect this development, which could result in malformations or birth defects. Some other medicines are however considered safe.
Local anaesthetics such as novocaine and lidocaine are considered safe for pregnant women and their babies. They are preferred over intravenous or inhaled agents which may increase the risk of miscarriage if used during the first trimester. The anaesthetic solution does cross the placenta, it is therefore recommended not to use excess anaesthesia during dental treatments.
Antibiotics often need to be prescribed by dentists to either treat or prevent an infection. If we don’t consider allergies, the penicillin and cephalosporin families are safe to take. Erythromycin, which is prescribed for people who are allergic to penicillin, is also acceptable. Metronidazole, which is sometimes used for serious abscesses, can be taken during pregnancy as well. Tetracycline should be avoided because it can affect the colour of the teeth and bones of a developing foetus.
The safest pain medication is Acetaminophen (Tylenol) which is believed to be harmless throughout pregnancy. Non-steroidal anti-inflammatory drugs like ibuprofen (Motrin or Advil) are generally considered safe, but only until around 32 weeks of pregnancy; after that, they can interfere with childbirth. If stronger pain medications are needed, narcotics such as Codeine or Percocet can be used, but for a period of less than a few weeks.
Fluoride protects developing teeth from cavities, but it’s not known whether it poses any risk to the foetus. The use of supplemental fluoride in pregnancy is controversial among dentists. Some studies have concluded that babies whose mothers received fluoride during their pregnancies developed fewer cavities; other studies found no benefit to fluoride use. As a general rule, it is advised not to take fluoride more than the amount contained in city water.
Dental treatments during pregnancy