Pregnancy and Dental Care

Question:

What special considerations should be given to the pregnant patient when they undergo dental care?

Answer:

The goal of dental care during pregnancy is to provide the necessary services without causing any adverse effects to the mother or the developing baby. Any extensive or elective treatment should be postponed whenever possible. However, avoiding necessary treatment would be unwise, and potentially carry greater risk than the risk associated with the procedure. For example, if there is a large area of decay present close to the nerve, and this cavity can potentially cause an infection that could be harmful to you or your baby, it would make sense to address this problem as soon as possible (with clearance from your OBGYN). It is recommended that the pregnant patient have at least one cleaning during their pregnancy to minimize the chance of developing Pregnancy Gingivitis (inflammation, bleeding and swelling of the gums that are heightened in response to the plaque due to the hormones associated with pregnancy). Fluoride supplementation is recommended starting around the third month of pregnancy, since this is when the baby teeth start to mineralize.

It is recommended that X-rays are avoided during pregnancy, unless it is essential that one be taken to help address a dental emergency. If an x-ray needs to be taken, a second lead vest should be used to help cover the abdominal area. Additionally, the dentist should take care to avoid using local anesthetics containing epinephrine (a vasoconstrictor) and drugs that can cross the placental barrier. Tylenol is usually considered to be fine by most OBGYNs for controlling discomfort. Penicillin and Erythromycin are usually considered acceptable antibiotics when the risk of an infection outweighs the risk of taking these medications. Check with your OBGYN first before starting any type of medication. Anxious patients should avoid taking barbiturates, anti-anxiety medications (such as valium) and Nitrous Oxide when pregnant.

Question:

How should you stage dental care when pregnant?

Answer:

Except for emergency care, only preventative dental treatment and hygiene appointments should be carried out during the first trimester. The best time to provide dental care is during the second trimester, since most of critical systems of their body have matured to the point where the risk to the fetus is less likely. Dental treatment can proceed into the third trimester if the patient is comfortable.