Dental treatment during pregnancy. What happens to teeth during pregnancy, how to preserve and strengthen them during an “interesting situation”? Measures to preserve teeth during pregnancy

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While carrying a child, a woman undergoes changes in her body, and the need for microelements increases. On the one hand, there is a developing and growing fetus, on the other, the depletion of one’s own resources. A common problem in pregnant women is deterioration of the condition oral cavity.

Women complain about the loss of calcium, which is supposedly taken by the child, so the teeth are destroyed. This is not a completely correct assumption. There are a sufficient number of reasons that affect the condition of the teeth and gums of the expectant mother.

The oral cavity, containing nutrients, is readily colonized by bacteria. When microbes settle on the teeth and gums, they form plaque that is difficult to clean off. In a hygienically clean cavity, the barrier to infection is bactericidal saliva and immunity.

Infected teeth and gums develop caries, gingivitis and other diseases, including periodontitis. The disease destroys the soft tissue and bone of the jaw. Through damage to the gums, pathogenic microbes enter the bloodstream and spread throughout the body.

Untreated oral cavity causes:

acquired diabetes mellitus,
stroke,
cardiovascular diseases.

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 notify 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 low degree effects 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 pregnant.

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;
incessant sharp pain which 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 compulsory medical insurance policy. A list of all government institutions, as well as private dentistry, can be found on our website.

100 years ago, based on missing teeth, a dentist could calculate how many times a woman gave birth: with each child, the mother lost a tooth. Today, such dental arithmetic does not work. You can save your teeth if you take proper care of them and visit the dentist regularly during pregnancy. We have collected the most common questions that expectant mothers have.

How many times should you visit the dentist during pregnancy?

A preventive examination should be completed at least three times: at 6–8 weeks, 22–24 and 32–34 weeks of pregnancy, even if you have not complained about the disease before and are now fine. And, of course, if you have any problem with your teeth and gums (and many expectant mothers have them), you should immediately visit the dentist. And be sure to immediately notify your doctor that you are pregnant. He will select the appropriate treatment for your situation.

Why do teeth and gums become vulnerable during pregnancy?

First of all, teeth during pregnancy suffer from hormonal changes that the mother’s body experiences. Changes in hormonal levels cause the gums to bleed. The synthesis of estrogen hormones increases the volume of circulating blood and dilates blood vessels, including those in the mucous membranes. They become loose, full of blood, and can be easily injured even with regular tooth brushing. That’s why pregnant women often sin because, for fear of injuring their gums, they brush their teeth somehow, without applying much force to the brush, and thereby leave a plaque on the teeth in which pathogenic bacteria feel free. And immunity, weakened during pregnancy, allows them to multiply intensively. The result is caries, which destroys the hard tissues of the tooth (enamel and dentin), and (gum inflammation). With the latter problem, the tissues surrounding the tooth turn red, swell, bleed, and begin to hurt, the bone tissue around the tooth is destroyed, and the tooth itself is now loose.

Another significant circumstance is that the mother’s body selflessly shares calcium reserves with the child, who needs this mineral for the construction of the skeleton. Calcium deficiency affects not only the mother’s bones, but also her teeth. The enamel is the first to feel the lack of an important element. During pregnancy, teeth become sensitive to sour, cold, and hot. The enamel may be destroyed. Old fillings do not hold well and fall out, causing microbes to rush into the sore spot. Caries has a new testing ground for destructive activity.

The lack of minerals and vitamins leads to the fact that the composition of the saliva of the expectant mother changes. It no longer copes with its responsibilities and does not protect teeth from leaching of minerals. The changed pH balance of saliva also destroys teeth, allowing bacteria that cause caries to rapidly multiply.

When is the best time to treat teeth during pregnancy?

Of course, ideally, it was necessary to take care of teeth at the stage of conceiving the baby. But during pregnancy, it should not be postponed until after childbirth. The optimal period for dental treatment during pregnancy is considered to be the 2nd trimester. But during the 1st trimester it would be better to do only gentle treatment (for example, install a temporary filling rather than a permanent one), since during these weeks the formation of internal organs and fetal systems. And the future baby will react painfully to any stress that the mother experiences. During the 3rd trimester, the likelihood of premature birth is already high. and tooth extraction after the 27th week is carried out only if absolutely necessary. Therefore, you should not skip visiting the dentist during midterm pregnancy.

What dental procedures should not be performed by expectant mothers?

There is a reason to postpone such procedures as removing tartar and teeth whitening with chemical pastes and gels, installing implants and dentures, planned removal of eights - wisdom teeth (this requires an incision, and it is better not to do surgical intervention now). But other dental services for a pregnant woman are not prohibited. If the need arises, treat caries (you will receive fillings made from modern safe materials), periodontitis, inflammation of the teeth and gums, and remove teeth (except for the planned removal of eights). You can even go to the orthodontist to install braces.

Is it permissible to use anesthesia when treating pregnant women?

Toothache is a great stress for mother and baby. Therefore, under no circumstances agree to endure it in the dentist's chair. In addition, there are now effective and safe anesthetics for mother and baby. Before injecting into the gum, the doctor must numb the very place where he will insert the thin needle. So no discomfort during treatment you will not experience, which means you will not be nervous. Particularly worried mothers can take valerian preparations before visiting the dentist.

Is it possible to take dental x-rays during pregnancy?

Doctors try to take dental x-rays during pregnancy only in extreme cases. It is believed that a more suitable option for mom is computer visiography (again, only in case of urgent need). The radiation dose in a study done using this method is an order of magnitude less than with conventional X-rays.

Do dentists allow you to use an electric toothbrush?

This device is safe and will not harm mother or baby. It would be nice to buy another device - an irrigator. The strong stream of water it delivers perfectly cleans the spaces between the teeth and at the edge of the gums.

How dangerous is toxicosis for teeth? Should you brush your teeth after every vomiting?

Nausea and vomiting cause an imbalance in the pH balance in the oral cavity, demineralization of teeth and the development of caries. But you shouldn’t grab a toothbrush every time after an attack of toxicosis. It is enough to brush your teeth twice a day - morning and evening. More frequent brushing wears away tooth enamel.

It is better to rinse your mouth with a soda solution after attacks of nausea and vomiting (1 teaspoon of soda per glass of water). Baking soda neutralizes the aggressive effects of stomach acid on enamel. Chewing sugar-free gum will also help you.

Our expert

Edgar Gigolyan, chief physician of the Med-Light rehabilitation dentistry clinic on Ostozhenka

To prevent the expectant mother from feeling calcium deficiency, she needs to include dairy and fermented milk products in her diet and additionally take calcium complexes with vitamin D. Often, calcium deficiency occurs against the background of gastrointestinal diseases that interfere with the natural process of absorption of the required element. In this case, menus and vitamins will not help - you need to be treated by a gastroenterologist.

The initial signs of a dental disease common among expectant mothers, which is called pregnancy gingivitis (inflammation of the gum tissue), may appear already in the first trimester. But this state reaches its apogee in the last two trimesters. To cleanse the oral cavity of harmful bacteria and prevent the risk of developing chronic forms of gingivitis and periodontitis, it is necessary to regularly carry out complete professional oral hygiene in the dentist's chair. It includes removing hard supragingival and subgingival dental plaque (tartar), cleaning the surface of the teeth from soft plaque, polishing the surface of the teeth and applying special compounds to their surface to prevent caries. It is advisable to undergo this procedure 2 times during pregnancy, and after childbirth - at least 2 times a year.

There is a popular wisdom that every child takes one tooth from its mother. Most people think this is stupid, but there is some truth here. If a woman is pregnant, she consults a gynecologist to ensure the baby has a healthy start. Your next visit should be to the dentist. A growing child takes the necessary substances from the bloodstream, mainly microelements and vitamins, so the teeth suffer. Therefore, the question arises, how to preserve teeth during pregnancy?

Saving teeth during pregnancy

To preserve teeth during pregnancy, you should adhere to the following rules:

Visit the dentist. Everyone knows about caries, but not everyone knows that teeth need to be treated before the baby is born. Because carious cavities are a storehouse for various microorganisms. The infection from there spreads into the blood and can cause complications for both mother and baby.
The most acceptable dates for dental treatment:
First visit – 6-9 weeks of pregnancy,
The second - at 16-18,
The third - at 26-28 weeks,
The fourth is at 36-38 weeks.
Tooth extraction during pregnancy is carried out no earlier than 14 weeks, when the placental barrier is formed. There is no need to remove teeth before the birth itself, since an open wound after tooth extraction can become a source of infection.
Dental x-rays should not be taken during pregnancy. If there is an urgent need, it is better to go for computer visiography.
If there is toxicosis in the first trimester of pregnancy, namely frequent vomiting, you need to tell the dentist about it. Acidic pH values of vomit masses destroy the balance of the oral cavity. This leads to rapid proliferation of microflora and tooth enamel is destroyed. The dentist will find the necessary means to preserve the enamel.
If you need anesthesia for dental treatment, you should definitely tell your doctor about your pregnancy. He will select an approved anesthetic that will not harm the unborn baby.
The filling is always chosen by the doctor. There is no need to give up fluoride-containing filling material. The lamp used for this is harmless to the fetus.
You need to learn how to brush your teeth properly. Everyone remembers that tooth sensitivity increases during pregnancy. You can use a paste marked “sensitive”, which is used for sensitive teeth. Professional teeth cleaning is carried out at least once every 4 months, it is better to do it after childbirth.
If blood stains remain on the toothbrush when brushing your teeth, then gingivitis may have developed, that is, inflammation of the mucous membrane of the gums. This disease occurs quite often. The teeth are not necessarily out of order. In pregnant women, increased bleeding of the gums is the result of hormones and goes away on its own after childbirth. But it's better to see a dentist. Treating gingivitis will prevent a more severe disease called periodontitis.
Difficulty coping with drooling is a reason to visit the dentist. This type of toxicosis is not dangerous. If you are salivating excessively, you can rinse your mouth with infusions of chamomile or sage.
If you experience leg cramps, you should tell your dentist about it. Most common cause Lack of calcium causes leg cramps. If calcium deficiency is not corrected in due time, tooth decay will begin, since the growing baby will still take from the mother’s bones as much calcium as he needs for full development. Sources of calcium are dairy products - milk, yogurt, kefir, cheese, cottage cheese and fish. Calcium from vegetables and fruits is poorly absorbed.
It is also better to send your partner to the dentist. No matter how much a pregnant woman tries to ensure the “sterility” of the oral cavity, it is useless, because the very first kiss will return “harmful” microflora.

Dental hygiene of a pregnant woman

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 yourself, 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 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 be at 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 smell from mouth. 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 falling blood pressure, the woman needs to position herself 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! Protect teeth during pregnancy early stages careful hygiene using fluoride-containing toothpastes without the effect of bleaching will help.

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 wobbly 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 has a negative effect on heartbeat 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.