27.11.2019
Tooth extraction is an unpleasant and painful procedure, especially during pregnancy. Unfortunately, toothache is a problem that often occurs in pregnant women. As a rule, it occurs due to numerous changes in the hormonal background and in all organs and systems that the body undergoes during this period. Teeth and gums become especially vulnerable to pathogenic bacteria. This is due both to a lack of calcium and phosphorus, and to changes in acidity in the oral cavity. As a result, tooth enamel begins to deteriorate, which can lead to the development of caries and its complications.
Tooth extraction is a last resort resorted to by a dentist during a woman’s pregnancy. During the procedure, a woman may experience severe stress, which negatively affects the baby’s health. Therefore, it is recommended that pregnant women postpone tooth extraction until after pregnancy.
When the process of tooth decay has just begun, therapeutic treatment of caries can be carried out. If you follow certain recommendations, this procedure is safe for the health of the woman and child. However, there are cases when the only way out of the situation is tooth extraction.
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.
Why you shouldn’t delay tooth extraction
Despite the recommendations that visiting a dentist during pregnancy is not very advisable for both the mother and the baby, we immediately note that the problem cannot be ignored. If the situation is urgent, the tooth is damaged or hurts, you must consult a specialist. The visit cannot be delayed.
Firstly, the risk of inflammation increases and the problem worsens to such an extent that you will have to resort to surgery. Secondly, a timely visit to the dentist may help avoid removal during pregnancy. It is not always necessary to pull out a wisdom tooth right away. If the situation is not critical, then the doctor will carry out sanitation and use therapeutic agents, for example, filling a molar so that its removal can be postponed until the birth of the child.
If removal surgery is indicated, you should not ignore going to the dentist. It is prescribed in extreme cases when there is a risk to the woman’s health (for example, possible tissue infection or infection in the blood). There is no need to push yourself to extremes; it is better to act in accordance with the recommendations of a specialist.
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.
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Is it possible to treat “eights”?
The eruption of wisdom teeth during pregnancy may be accompanied by:
- general weakness;
- swelling of the gums;
- severe pain;
- increased temperature;
- enlarged lymph nodes.
Impacted and semi-impacted (not fully erupted) teeth often cause pericoronitis, an inflammation of the soft tissues. Under the “hood” (soft tissues covering the erupting tooth), food debris accumulates, bacteria multiply intensively, and a pathological infiltrate is formed. This is a serious complication that requires immediate surgical treatment.
As a rule, the problem is solved by excision of the gum and release of the tooth from under the soft tissue hood. This is a simple intervention that is performed on an outpatient basis in the first and second trimester of pregnancy. In advanced cases, additional antibacterial therapy may be prescribed. In mild forms, conservative therapy is possible.
In the presence of caries or pulpitis, correctly positioned “eights” are treated in the same way as other teeth, provided that the doctor has sufficient access to carry out quality treatment.
However, in some cases, tooth extraction during pregnancy is indicated. As a rule, this is necessary if the tooth is severely damaged, positioned incorrectly, partially erupted, or is not in the bite (does not participate in the act of chewing).
You need to understand that doctors resort to surgery only when other treatment methods are impossible. Each situation is assessed individually.
Indications for wisdom tooth removal during pregnancy
Removal of “eights” is carried out either plannedly or according to urgent indications. Planned extractions are cases when the tooth does not hurt, there is no acute inflammation, purulent discharge, or soft tissue swelling. The tooth may be destroyed, but if it does not bother you, then the surgeon will recommend removing such a tooth after childbirth.
Removal of figure eights for orthodontic reasons is not performed during pregnancy. The procedure is postponed until the postpartum period.
Wisdom tooth removal for pregnant women is possible only for urgent indications, for example:
- the tooth hurts, but it is impossible to cure it due to lack of normal access;
- treatment is inappropriate (the carious tooth is not in the bite and does not bear the chewing load);
- The “eight” is dystopic (grows incorrectly: at an angle, in the cheek, horizontally), which causes anxiety, injures soft tissues or destroys neighboring teeth.
If the “eight” causes even the slightest concern, you should immediately go to the dentist: the sooner you see a doctor, the greater the chance of avoiding surgical intervention.
Photos of the dental offices of the clinic Our Dentist in Krasnogorsk
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Features of wisdom tooth removal for pregnant women
Removal of a wisdom tooth during pregnancy has a number of features, in particular:
- X-rays are not taken. Any types of X-ray examinations (including orthopantomogram, digital visiography, computed tomography) are prohibited during pregnancy. Doctors use alternative diagnostic and monitoring methods. If necessary, X-ray examinations are carried out after birth.
- Local anesthesia with special drugs is used. In such situations, the dentists of the “Our Dentist” clinic use drugs without adrenaline (in exceptional cases - with its minimum content). The appropriateness of using a particular drug is determined by the doctor in accordance with the clinical situation.
- In the third trimester, wisdom teeth are removed only in a hospital setting. According to the law, all surgical interventions (including opening of abscesses, periosteotomy, tooth extraction) for a period of 27-28 weeks are performed only in a hospital. If the doctor believes that surgery is indicated, the pregnant woman is sent to maxillofacial surgery, or in emergency cases by ambulance.
Ideally, they try to postpone the treatment and removal of teeth (including “eights”) to the second trimester of pregnancy. But the presence of a source of infection and pain is an indication for treatment and removal of teeth at any time.
If your wisdom tooth becomes ill or begins to cause trouble during pregnancy, you should not self-medicate or expect everything to go away on its own.
Come for a free consultation at the “Our Dentist” clinic: timely and professional dental care is a guarantee that problems with wisdom teeth will not affect the health of the mother and baby.
Your calls are always welcome! 8 915-367-04-47 - call, make an appointment, come for a free initial consultation, and Our Dentist will become yours!
Dear patients! All prices on the site are valid only at the time of publication. The specialist will inform you about the exact cost and scope of necessary procedures after consultation.
Author of the material: dental surgeon, implantologist Alexey Alekseevich Kashtanov.
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.
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.
Features of wisdom tooth removal in pregnant women: answers to basic questions
One of the important recommendations for those planning a pregnancy is early treatment and solution of all problems associated with the oral cavity. However, there are times when the expectant mother begins to be bothered by her wisdom teeth and requires their removal. The situation is unpleasant, since such manipulations are not very desirable for pregnant patients. Let's take a closer look at when removal is really required and how to perform it with the least risk to pregnancy.
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.
Nuances and features of the procedure during pregnancy
If, after carrying out all the necessary diagnostic measures, the dentist nevertheless comes to the conclusion that urgent extraction is necessary, then the procedure will be carried out with local anesthesia. The operation usually proceeds quickly and without complications. In this case, the expectant mother must strictly follow all the instructions of the attending physician and carefully monitor her condition after the procedure.
How safe is X-ray diagnostics?
Usually, before removal, the doctor prescribes x-ray diagnostics. Pregnant patients most often have to undergo this procedure using a visiograph - this is a modern device that is characterized by a targeted effect and minimal negative impact of x-rays on the body. As a result, the doctor receives an informative image, on the basis of which he can make a final verdict regarding the need for removal.
A visiograph will help you take a targeted photo with minimal health risks
Anesthesia and medications
Many expectant mothers are concerned about the question of what kind of anesthesia pregnant women can use. In this case, teeth should be removed with an injection of local anesthesia only - the procedure is not performed under anesthesia. Modern pharmacology offers effective and safe drugs for this category of patients with the following properties:
- the products do not cross the placental barrier, which means that their active ingredients cannot affect the fetus in any way,
- do not contain vasoconstrictors (to be more precise, epiniphrine).
Teeth should be removed with an injection of local anesthesia only.
For this purpose, today drugs such as Ultracain, Ubistezin and Novocain are used - the latter is used exclusively in the form of a spray and requires mandatory spitting of saliva. With such an injection, pulling out a tooth does not hurt at all, so there is nothing to be afraid of.
Possible complications
In any case, the procedure is fraught with certain complications, which, however, usually develop against the background of mistakes made by the doctor or the patient’s failure to comply with the dentist’s instructions. Such negative manifestations can be divided into early and late. The first category includes complications that occur during or immediately after the procedure:
- jaw injury,
- fainting,
- injury to the maxillary sinuses,
- leaving fragments in the gum tissues,
- damage to neighboring units,
- bleeding, hematoma formation.
This is what inflammation of the socket looks like after tooth extraction.
However, certain problems may arise some time after extraction. These manifestations include alveolitis, expressed by inflammation of the socket, as well as neuritis, which is characterized by the development of inflammatory processes in peripheral nerve cells. The sooner you contact a specialist if such phenomena develop, the easier and faster they can be eliminated without consequences.
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.
Why do dental problems often occur during pregnancy?
Pregnant women are a special category of patients at the dentist. Their body undergoes serious hormonal changes. As a result, existing chronic diseases may worsen or acute ones may develop.
When the musculoskeletal system of the fetus is actively developing, the expectant mother may experience calcium deficiency. First of all, it always affects the condition of the teeth. They crumble, existing caries progresses quickly, and previously placed fillings often fall out.
Also, in an “interesting” position, the pathogenicity of the oral flora increases. Because of this, the intensity of the spread of caries increases. Therefore, during this period you need to monitor your health very carefully. If caries appears, you cannot wait. After all, if you can remove teeth during pregnancy, then put fillings - even more so.
