Toothache occurs throughout life, most often when you don't expect it. Problems can begin even for those who carefully and constantly care for their teeth. But there is a period of life when teeth are especially vulnerable - pregnancy. Carrying a child is a difficult time for the female body, during which various changes occur. Teeth are no exception. Depletion of calcium, consumed for the needs of the formation and maintenance of the vital functions of the fetus, which during gestation is practically impossible to replenish one hundred percent, leads to dental problems that have no place in a woman’s everyday life.
Tooth extraction during pregnancy
Is it possible to remove teeth in position?
Since many medications are prohibited during pregnancy, expectant mothers refuse to have their teeth treated or removed and endure pain until childbirth. But in many cases such a measure is not justified. It is possible and necessary to carry out treatment or extirpation, the main thing is to do it correctly.
Anesthesia is done using local drugs that have minimal side effects and do not have a negative effect on the fetus. However, the operation is performed only if there is an urgent need.
Indications for extraction:
- pulpitis, periodontitis, in which neighboring tissues become infected;
- deep carious lesion affecting the root;
- cyst or malignant neoplasms;
- growth of a figure eight, complicated by inflammation or if it presses on an adjacent molar;
- tooth root fracture;
- rapid development of periodontal disease, which is not amenable to therapeutic treatment.
If a pregnant woman experiences pain when chewing, she will not be able to eat properly, which leads to a deficiency of nutrients. This situation negatively affects her body, the formation and growth of the fetus.
The doctor considers each case individually. If possible, reschedule the operation for a more convenient time.
When is the best time to treat teeth for pregnant women?
When the problem is critical, you need to consult a dentist at any time, and as soon as possible. But first, a pregnant woman needs to find out from her gynecologist whether there are any restrictions on dental treatment. If you can be patient, it is better to carry out treatment procedures in the second half of the term, since in the first and third the formation and intensive growth of the baby’s internal organs occurs, so there is a possibility that any intervention and medication will have a detrimental effect on the child’s development.
How does the timing of tooth extraction affect pregnancy?
In case of severe inflammation and pain, it is not always possible to postpone surgical intervention. If there are indications for extraction of a dental unit, then the possibility of carrying out the procedure must be agreed with the therapist and gynecologist. In this case, the period of bearing the child is important. Each trimester has certain restrictions and possible complications for the mother and fetus.
Possibility of extirpation according to timing:
- First trimester. The placenta is being formed, the organs and systems of the child are being formed, so any medical manipulations are performed with extreme caution and only according to strict indications. During this period, most drugs are contraindicated, and surgery without them is impossible. Medicines, x-rays, and computed tomography have a negative effect on the fetus, causing various abnormalities. Some medications cause miscarriage. Even treatment of deep caries can be postponed to a later date. However, there are situations that do not allow you to avoid removing a diseased tooth. If there is severe pain and inflammation, this leads to hypertonicity of the uterus, nervous breakdowns, spread of infection to other organs, and infection of the fetus. In this case, the dentist can perform the operation despite contraindications.
- Second trimester. After 3 months, the fetus is formed and the placenta is well protected. During this period, many types of treatment are allowed, including extraction, except for complex cases with a figure eight. Mother's stress and medications do not have such a strong effect on the child and pregnancy. Local anesthetics can be used safely. Before a CT scan or X-ray, a woman puts on a special protective apron.
- Third trimester. Surgical intervention is highly undesirable. Although the fetus has become physically stronger, by this time the placenta is thinning and protects it less well. In addition, the period is dangerous for premature birth. Stress and pain can cause uterine contractions. Starting from the thirty-fourth week, almost any treatment is stopped.
At any time, extraction is carried out for purulent inflammation, which cannot be cured by therapeutic methods. In addition, if a pregnant woman suffers severe pain and is constantly under stress, this can have a bad effect on the child’s psyche.
Why should you consult a gynecologist before dental treatment?
The first reason is that, in principle, dental treatment is a certain stress factor for all patients. In pregnant women, this factor works doubly. Therefore, in this case, the gynecologist must weigh whether this will pose a threat to the normal course of pregnancy.
The second reason is pain. I think that almost all patients experienced some kind of pain during an appointment with the dentist; this must be excluded in pregnant women, so we use local anesthesia. Naturally, approved drugs are used during pregnancy, an individual dose is selected, but in any case, these are medications, and their administration also needs to be discussed with a gynecologist.
And the third reason is the most controversial issue now, this is targeted X-ray diagnostics of teeth. In general, in modern radiology there are no contraindications for taking dental photographs during pregnancy. It is recommended to use radiovisiography methods (visiography produces 90% less radiation). Naturally, in this case, the expectant mother wears a special lead apron, which protects the stomach and pelvic organs from radiation. But I would still recommend using this method with caution and consulting with a gynecologist, because in any case, the expectant mother receives at least a small dose of radiation. Therefore, you need to consult with a specialist as far as necessary.
But, I want to note that the exception to all of the above cases is the provision of emergency dental care, because if there is some acute disease in the oral cavity or some kind of severe pain syndrome, then in any case, assistance will be provided to the required extent, regardless of the period, because this may already threaten the health of the expectant mother.
CHECK LIST - EXERCISES FOR PREGNANT WOMEN
RULES AND TRAININGS FOR EACH TRIMESTER
I want a checklist
Exercising allows the body to better adapt to the increasing load associated with fetal growth, changes in the body, and a shift in the center of gravity.
Wisdom tooth removal during pregnancy: risks and complications
Surgery on the third molar is the most difficult. The procedure itself has a high probability of developing complications, especially in the lower jaw. Extracting the root of a lower extreme molar requires cutting into the gum and removing part of the bone, which is a more traumatic surgical procedure than a simple procedure.
After extirpation of the figure eight, body temperature may rise, severe pain in the jaws, head, neck, throat, swelling of the face and other negative phenomena may occur. The recovery period is long and painful. For these reasons, surgery is performed only in extreme cases: if there is a risk of infection spreading, or if there is severe, ongoing pain.
If it is possible to wait until childbirth or at least until the 2nd trimester, then the extraction of the figure eight is postponed.
How does the extraction take place?
To begin with, the doctor and the patient choose the appropriate time for treatment. It is also very important to choose a mild anesthetic so that it works well, but is also allowed for use by pregnant women (the medicine should not cross the placenta).
It is imperative to carry out preventive procedures at home - rinsing with herbal decoctions and a solution with soda. If there is severe pain, it is allowed to take Paracetamol or Tempalgin, but in a strict dosage.
When a third molar needs to be removed, the dentist will cut through the gum, drill into the bone, and then use forceps to pull it out. After this, the doctor applies stitches to speed up the healing of the wound.
Removal of tooth nerve during pregnancy
Depulpation is done for deep caries, when pathogenic microflora has penetrated the root canal and affected the pulp. Treatment requires local anesthesia, so the procedure is not recommended in the 1st trimester.
In order to leave the dental unit alive, they try to cure the nerve. If most of the pulp is affected, it is completely removed. If the nerve is treated with a therapeutic method, then the pregnant woman should regularly visit the dentist, as a relapse of the disease is possible.
Modern clinics do not use arsenic, which is absolutely contraindicated for pregnant women. For treatment, safe drugs with natural ingredients are used.
How is the procedure performed?
The procedure will be performed by a dental surgeon. Before this, he needs to study the results of the X-ray examination. However, if the patient is in position and the clinical picture is obvious, this stage can be avoided so as not to further jeopardize the process of fetal formation. But you shouldn’t worry if you can’t do without an image - today clinics and diagnostic centers use modern high-precision equipment to minimize the negative impact of x-rays on the human body.
An examination is required before the procedure.
Extractions are carried out in any case with the use of painkillers. Currently, for this purpose, the most gentle drugs are used that are safe for the health of both mother and baby. After administering the anesthetic, the surgeon carries out the procedure according to the standard protocol - he grabs the causative element with special forceps, sharply twists it and carefully removes it. After treatment, the patient will be given detailed recommendations for oral care.
Tooth extraction during pregnancy: anesthesia and medications
Anesthesia is required for surgery. General anesthesia is not acceptable. Anesthesia with lidocaine and similar anesthetics with adrenaline is also not carried out for pregnant women. The drugs can cause cramps, muscle weakness, severe allergic reactions, and lower blood pressure.
Modern painkillers contain a minimum of adrenaline and do not contain vasoconstrictor components that cause uterine hypertonicity. When applied topically, they are practically not absorbed into the blood, therefore they are safe for the fetus.
Among the acceptable medications, the safest ones can be identified:
- Ultracaine;
- Alfacaine;
- Artifrin;
- Primacaine;
- Ubistezin.
During forced surgery, you do not have to endure pain, as happened several decades ago. Today, extraction is done absolutely painlessly.
If gum tissue is cut during surgery, antibiotic therapy is necessary. Pregnant women are usually prescribed Amoxiclav, which has an antibacterial and bactericidal effect. To reduce fever, a minimum dosage of Paracetamol may be prescribed.
Chlorhexidine, Miramistin, Romazulan - safe antiseptics - are used for mouth rinsing.
Means for healing the hole, approved for pregnant women
It is recommended to refrain from eating for about 3 hours. Immediately after treatment, you should not heat the sore spot - this can only intensify postoperative symptoms and even provoke inflammation. Rinsing your mouth is also contraindicated, since this can damage the blood clot, which is a kind of barrier that protects the open wound from infection.
As for medications, pregnant patients are usually prescribed Paracetamol for pain (0.5 g is the maximum single dosage) and the antiseptic Amoxiclav. A chamomile decoction for mouth rinsing will help relieve signs of inflammation and provide additional disinfection. Before using it, be sure to consult a specialist.
Patients are often prescribed Amoxiclav
What to do after tooth extraction during pregnancy
Even if the procedure was successful, without pain, complications may develop during the recovery period. It is very important that after extirpation a blood clot is formed and firmly attached. It protects the resulting cavity with exposed bone and nerve endings from infection by bacteria and food.
The natural “plug” may come off in the following cases:
- sticking to a cotton swab (placed after surgery) if held for too long;
- licking the hole with the tongue;
- using a drinking straw;
- newly opened bleeding.
If the blood clot falls out, a new surgical intervention will be required. Otherwise, an inflammatory process will occur, which can lead to complications.
It is not recommended to get tired on the day of surgery. After the procedure, you need to go home and rest. You can eat after 3 - 4 hours. Food should be at a comfortable temperature, soft or liquid. Spicy, rough foods that injure soft tissues should be excluded. You should not smoke, as nicotine constricts blood vessels and interferes with healing.
You can rinse your mouth on the second day. As an antiseptic, pharmaceutical preparations, decoctions of medicinal plants, and an aqueous solution with salt and soda are used. Medicines will prevent the development of infection and speed up wound healing. Rinsing should be gentle and not intense, otherwise the blood clot will come off.
When brushing teeth, the surgical site is bypassed. You should use a toothbrush with soft bristles.
Until the wound heals, you should not overheat the body or exert physical stress. Otherwise, bleeding may resume.
What is the safest time for removal?
As we have already explained above, in fact, there is no safe period for tooth extraction. Because even if anesthesia can be used in the second trimester, then after this operation you will need to rinse the mouth with antiseptic solutions (not all of them are allowed), and you will need to take certain medications. What if a complication develops? After all, then even stronger therapy will be required! So it’s better to hold off on deleting it. But if the indications are urgent, then any period will not be a limitation, because a bad tooth means pain, stress and, of course, an acute inflammatory process, which is also dangerous for the fetus.
How to prevent tooth extraction during pregnancy
A full examination and treatment by a dentist should be done at the planning stage of conception. But even in this case, there is no guarantee that dental problems will not appear during pregnancy. After registration, a pregnant woman should regularly visit the dentist. If diseases are detected early, they can be treated safely and painlessly.
It is necessary to remember and carefully follow all the doctor’s recommendations for the prevention of diseases of the dental system. After conception, the composition of saliva and hormonal levels change, causing a deficiency of macro- and microelements and vitamins. Gingivitis is often diagnosed, which develops against the background of loose gums and reduced immunity. At this time, it is very important to eat right and maintain good oral hygiene.
In the second trimester, identified problems can be safely eliminated. After professional hygiene at the dentist, dental protection improves significantly, so do not neglect this procedure.
Common diseases in pregnant women
Pregnant women can and should visit the dentist, and it is better to do this once every trimester. This frequency allows you to understand how much the condition of your teeth has changed, whether urgent problems have arisen, or whether additional care is required.
- Caries
One of the most common problems for expectant mothers is tooth decay. Superficial caries, which does not affect tissue, is treated without anesthesia; the procedure is painless and therefore allowed for pregnant women. In case of serious spread of caries, when the integrity of the tooth is damaged, removal of the nerve is required, treatment is postponed to a period that is safer for women’s and children’s health.
- Pulpitis, periodontitis
Untreated caries often leads to inflammation of the nerve and dental tissues. And then pregnant women are diagnosed with pulpitis and periodontitis. Full treatment is impossible without x-rays and anesthetics. Therefore, the appropriateness of medical intervention is determined together with the attending physician.
- Stomatitis, gingivitis
Often, pregnant women experience stomatitis (damage to the oral mucosa) and gingivitis (enlargement of the gums due to hormonal changes). It is impossible to cope with these ailments at home - treatment and prevention require the help of a specialist. The dentist will determine the extent of the damage, clean the mouth, and prescribe products for treating the gums, rinsing, and relieving inflammation.
- Tartars
Poor oral hygiene leads to the formation of tartar, which provokes bleeding from the gums and the development of serious diseases. Since the modern method of brushing teeth does not require anesthesia (with rare exceptions) and is carried out using ultrasound, it is allowed for pregnant women. But! for certain periods and in the absence of contraindications.
The best time for dental treatment is the second trimester
Precautionary measures
If possible, a woman should not have x-rays throughout her pregnancy. But if it is impossible to do without this type of diagnosis to clarify the situation and make a correct diagnosis, preference should be given to radiovisiography. During it, a radiovisiograph is used - modern electronic equipment, which makes it possible to see a clear x-ray image of the area under study on a computer monitor in real time. The radiation coming from this device is much lower than that of an X-ray machine. To minimize radiation exposure, the patient's chest, abdomen and pelvis are protected with special aprons that block the passage of X-rays.
If you are pregnant and suffering from toothache, and don’t know whether it’s worth removing a tooth now or whether it’s better to postpone the procedure until the cherished “X” day, make an appointment at the Line of Smile dental clinic. Our doctors have extensive experience and will tell you how best to proceed in your situation.
