Tooth extraction during pregnancy

Pregnant women often complain of dental problems. And at the same time, they are afraid to go to the dentist, since anesthesia can harm the child. In fact, it is not anesthesia that causes the greatest harm, but the reluctance to resort to competent treatment. After all, untreated teeth are a source of infection, which has a detrimental effect on both the mother and the fetus.

A bad tooth provokes pressure surges, which already threatens termination of pregnancy. And taking painkillers during pregnancy leads to congenital defects in the newborn, miscarriages, and stillborn babies.

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.

Is it possible to have wisdom teeth pulled out during pregnancy?

Third molars have a very large and extensive root system. Because of this, the roots, which are deep, may also be positioned incorrectly - affecting the “neighbor”, going too far to the sides. Therefore, their removal is more complex, mainly requiring an x-ray, an incision in the gum, and then sutures.

But there is a second problem - when the massive figure eight erupts, it often causes suppuration, and neighboring tissues become inflamed. In such cases, it is impossible to delay and not treat the area; emergency measures must be taken.

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.

Indications for the procedure

We found out whether teeth are removed during pregnancy and whether it is even possible to carry out such a procedure at this time. Obviously, there needs to be a compelling reason for its appointment. This is a surgical operation, which in the situation under consideration is performed only if there are strict indications:

infection of surrounding tissues: usually this phenomenon is observed with the rapid development of carious lesions and its complications - pulpitis, periodontitis. That is, when it is not possible to maintain one, and inflammation progresses very quickly,
severe damage down to the root,
malignant neoplasms or cysts: in this case, not only removal, but also surgical intervention to remove the tumor may be required,
unexpected growth of wisdom teeth, which causes damage to its “neighbors” and leads to acute inflammatory processes,
advanced gum disease: the presence of a serious pathology, which again progresses very quickly, while drug therapy does not produce positive results.

Pulpitis may be an indication for tooth extraction
. Due to painful sensations in the oral cavity, a pregnant woman begins to become very nervous and worried. In addition, this inevitably affects the diet of the expectant mother, which is why the baby involuntarily suffers. Therefore, the issue of dental treatment during pregnancy must be resolved.

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.

Treatment and removal during pregnancy - pros and cons

If the diseased tooth does not bother you much, then it is better to postpone its extraction until after childbirth. But when the question arises about severe discomfort or even pain, there can be only one solution - to immediately remove the causative element. It is worth immediately indicating that the most preferable period for treatment and removal is the second trimester of pregnancy. Today, the procedure is carried out with maximum comfort and safety for the patient, using modern harmless anesthetics and gentle extraction methods, for example, using a laser.

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.

Dental procedures during pregnancy

X-ray.

Treatment of pulpitis and periodontitis is impossible without x-rays.
If an x-ray is prescribed for a pregnant woman, all precautions are taken.

X-ray examination is carried out using a digital radiovisiograph. The radiation doses of this equipment are 90% lower than with film X-rays.
During the procedure, the abdominal area is covered with a lead apron and the woman’s stay in the X-ray room is limited.

X-ray diagnostics, especially an orthopantomogram, cannot be performed in the 1st trimester of pregnancy (from 1 to 12 weeks).

Treatment of caries.

It is possible to treat caries in pregnant women, especially at the initial stage, with virtually no restrictions. If anesthesia is required, it is better to wait until the second trimester.

Tooth extraction.

Tooth extraction under local anesthesia is not contraindicated for the expectant mother. However, complex removal, such as a wisdom tooth, is best done after the birth of the child.

Anesthesia for dental treatment while expecting a child

Modern anesthetic drugs based on articaine have an exclusively local effect and do not penetrate the placental barrier. Anesthesia is absolutely safe for mother and baby.

Recommendation:

in the first 3 months, while the placenta has not yet fully formed, it is better for a pregnant woman to refrain from using anesthetics. Dental treatment with anesthesia is best done in the second trimester.

What dental procedures should not be done during pregnancy?

Teeth whitening.

Professional whitening preparations penetrate the placenta and are dangerous for the fetus at any stage.

General anesthesia and sedation.

General anesthesia drugs are prohibited for use by pregnant women.

Implantation.

During implantation, antibiotics and anti-inflammatory drugs are prescribed. Moreover, the hormonal background of a pregnant woman increases the risk of implant rejection.

Expert of the article you are reading: Bukengolts Anna Aleksandrovna Dentist-Therapist, Candidate of Medical Sciences, leading specialist of the NovaDent network

15 years
Clinical experience

Skhodnenskaya

Khimki Boulevard, 14, bldg. 2

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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.

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.

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.