By Dr. Randall LeDuke, DDS
Pregnancy can be a difficult and uncomfortable experience for women. Discomfort from dental problems, however, is one that can usually be avoided with minimal maintenance help from your dental professionals.
Although all elective medical or dental procedures during pregnancy should probably be deferred until after delivery, preventive dental care and dental infection control can and should be accomplished. The American Congress of Obstetricians and Gynecologists says that emergency dental treatments, such as extractions, root canals or restorations can be safely performed during pregnancy and that delaying treatment may result in more complex problems. If dental procedures for treatment of ongoing oral pathologic conditions are warranted, it’s always a good idea for the dental office to reach out to the obstetrician to inform him/her of the conditions and intended therapeutics. Questions that should be discussed are:
• When is the expected delivery date?
• Is this a high-risk pregnancy? If so, are there any special concerns or contraindications?
• Is there a recommended medication for pain control?
Oral Hygiene is Critical
During pregnancy, oral hygiene is particularly critical. Gingivitis often becomes more of a problem since exaggerated response to oral irritants and bacteria accompany the hormonal changes that are part of pregnancy.
The gum tissue of pregnant women often becomes red, swollen and tender. Dental decay may be more likely due to changes in diet due to cravings and oral acidity levels may elevate due to vomiting, dry mouth or poor oral hygiene stemming from nausea. A gum tissue tumor called pyogenic granuloma that is frequently associated with altered hormone levels is often seen in pregnant females. And dental erosion stemming from vomiting as a result of morning sickness may be detected around the roots of teeth.
Due to the increased risk of gingivitis and caries, the importance of good daily oral hygiene should be emphasized to these patients. Brushing twice a day with a soft-bristled brush for two minutes, using a fluoride-containing toothpaste, and cleaning between the teeth once a day is encouraged. If it is determined that a topical fluoride treatment is needed to minimize the effects of erosion, fluoride varnish may be preferred over gel treatments due to nausea.
Relationship Between Chronic Gum Disease and Pregnancy
Much research has been established in recent years regarding the relationship between chronic gum disease and pregnancy outcomes. While findings of individual studies have been mixed, a systematic review of research published through 2012 concluded that associations exist between gum disease (periodontitis) and pre-term birth, low birthweight babies and the development of dangerously high blood pressure (preeclampsia).
Questions about Local Anesthetics or Antibiotics
Questions often arise about the use of local anesthetics or antibiotics. Options considered safe for anesthesia in these situations include Lidocaine or Prilocaine. Antibiotic options include Penicillin, Amoxicillin, Cephalosporins, Clindamycin or Metronidazole. Use of other medications would call for consultation with the patient’s obstetrician to weigh risks and benefits. Decisions about medications for pain relief should be arrived at after consultation with the obstetrician, although, emergencies call for immediate implementation of standard emergency protocols.
The commonly used sedative gas Nitrous oxide is classified as a pregnancy risk, meaning that there is a risk of fetal harm if administered during pregnancy. It is recommended that pregnant women, both patients and staff, avoid exposure to nitrous oxide.
Safety of X-rays
X-rays during pregnancy are deferred unless determined to be a necessary part of competent diagnosis and treatment planning of an ongoing pathology that requires immediate attention and cannot be postponed until after delivery. Necessary x-rays are considered safe for the pregnant patient at any stage during the pregnancy when proper abdominal and thyroid shielding is used.
Regular Preventive Dental Hygiene
During pregnancy, women may be at increased risk for oral conditions such as gingivitis and dental caries, and should be counseled by both their obstetrician and dentist on the importance of good oral hygiene throughout the pregnancy. Necessary dental care, including the use of local anesthetics, antibiotics and radiographs, is safe at any stage during pregnancy. And, as always, regular preventive dental hygiene attention is important.
If you have questions, please contact our office for a consultation. We are always happy to answer your questions. 731-885-0497
214 West Church
Union City, TN 38261