Bad teeth in a pregnant woman. Caries during pregnancy: can it be treated and how does it affect the fetus. Anesthesia in dental treatment. Is it possible or not

Pregnancy is often overshadowed by health and well-being problems. In particular, many women are forced to think about how to keep their teeth during pregnancy and after childbirth. This is far from an idle question: according to the results of a number of studies, in the normal course of pregnancy, the incidence of caries reaches 91%, diseases - 90%, destruction of previously healthy dental units - 38%.

Of course, the expectant mother wants nothing to overshadow her joy from the upcoming meeting with her baby, and she does not always pay attention to such a “trifle” as her teeth. However, oral health is an important component of well-being and the absence of complications during childbearing.

What happens to teeth during pregnancy?

According to many women, the child "sucks" all kinds of nutrient substrates from the mother, including calcium from the dental tissue, causing its rapid destruction. This is not entirely true. Calcium in the tooth and bone tissue remains in its place. The baby has enough calcium contained in the mother's blood, but it may be in short supply to meet the needs of her own body.

The main causes of dental diseases in pregnant women:

The most common dental problems that a pregnant woman may encounter are:

caries, first appeared (on healthy dental units) or secondary (previously treated);
(inflammation of the gums) of pregnant women, caused by increased formation of tartar under the influence of estrogens and progesterone;
(pregnant supragingival) - a benign neoplasm of an unknown nature in the gum area, which spontaneously resolves after delivery;
under the influence of increased acidity, the anterior upper incisors in the cervical region are more often affected;
diffuse toothache - painful sensations that do not have a clear localization, not associated with a load on dental tissues, spontaneously appear and disappear; presumably associated with increased blood flow and stimulation of nerve endings in the pulp;
that goes away after childbirth.

Is there an effect on the baby?

Maintaining dental health during pregnancy is important not only directly for the expectant mother, but also for the child. Any infectious foci in the body of a pregnant woman pose a potential danger to the fetus. Microbes and the toxic substances they release are able to be absorbed into the bloodstream and, together with the blood, enter the placenta, causing infection of the child.

The risks are especially high in the first trimester of gestation due to the processes of laying the internal organs and systems. If infection occurs at this stage, there is a risk of fetal malformations. With later infection, premature birth, hypoxia and fetal hypotrophy are possible. In addition, some microorganisms can cause an increase in the tone of the uterus, the opening of the cervical canal and damage to the membranes of the fetus, which greatly increases the likelihood of miscarriage.

Do I need to visit a dentist?

Many women ignore the need for dental treatment, believing that dental procedures can harm the child. This is not entirely true. There are procedures that do not pose any danger to the mother and baby, you just need to choose the right time for a visit to the doctor.

The optimal period for treatment by a dentist during the period of bearing a child is the II trimester: 14–26 weeks. At this stage, almost all therapeutic procedures are allowed, it is only desirable to limit the use of medications and x-rays.

If this is not possible, then the dentist will choose the safest agent for anesthesia (ubistezin, septanest), and you can take pictures of the jaws on a dental CT scanner: this is the safest (due to the low dose of radiation) and informative option.

Manipulations allowed in the II trimester:

caries treatment;
treatment of periodontal diseases;
therapy of inflammatory processes in the oral cavity;
non-surgical extraction of teeth;

In the I and III trimesters, only emergency procedures are usually performed (treatment of pulpitis, periodontitis), trying as much as possible to do without anesthesia.

Dental procedures contraindicated for pregnant women:

implantation;
prosthetics;
any surgical treatment options;
removal of tartar.

How to take care of your teeth?

Twice daily followed by fluoride toothpaste. In case of inflammation of the gums, it is recommended to use pastes with herbal ingredients (chamomile, sage). In case of increased tooth sensitivity, it is advisable to use special pastes of the “sensitive” category.
Don't forget to use mouthwash between meals.
After episodes of vomiting, you can chew sugar-free xylitol gum or rinse your mouth with a soda solution to neutralize the acid - 1 teaspoon of baking soda dissolved in a glass of water.
It is advisable to limit the consumption of sweets, carbonated drinks, fruit juices as much as possible.

Video: dental health during pregnancy.

10 steps to healthy teeth

Preventive visit to the dentist. When planning a pregnancy, this must be done, even if subjectively there are no unpleasant sensations: in the initial stages, many diseases of the oral cavity are asymptomatic. If the doctor does not find any pathology, then perhaps he will simply conduct it.
Balanced diet. Food should be primarily balanced in terms of the content of proteins, carbohydrates, lipids, vitamins, micro and macro elements. Vitamin D, fluorine and calcium, which are found in dairy products, eggs, fish, fruits and vegetables, are especially important for dental tissue. You should limit the intake of acidic and carbohydrate foods.
Eating healthy food. It is not recommended to eat too cold and hot food, especially at the same time or in alternation. Try to avoid chewing on hard foods: nuts, hard candy, shellfish. Give up the bad habit of chewing on pens, pencils, cutlery, etc. During pregnancy, the risk of mechanical trauma to the teeth increases especially.
Reception of special vitamin complexes. Not always all the necessary vitamins and minerals can be obtained from food in sufficient quantities, especially with an increased need for them. In the winter-spring season, special multivitamin preparations will come to the rescue. In addition, calcium preparations are prescribed from the 16th week of pregnancy and canceled only a month before the expected birth. And it is recommended to resume taking after the birth of a child, after 3-4 months.
Refusal of strict diets. This advice is especially relevant for women who, from the first weeks after giving birth, go on strict diets in order to quickly get in shape. At this time, the body is very vulnerable to nutritional deficiencies, especially when breastfeeding. Nutrition should be balanced, but complete, you can not limit calories.
Proper oral hygiene. Brushing your teeth twice a day, using flosses, and mouth rinses will help you fight bacteria and plaque as effectively as possible.
Rejection of bad habits. For pregnant women, this is a must in any case, even without taking into account the negative effects of smoking and drinking alcohol on dental health.
Emotional peace. Studies show that prolonged emotional stress has a negative impact on the teeth of not only a pregnant woman, but also her unborn baby. Therefore, it is important to learn how to remain calm in unpleasant situations and not get upset over trifles. You need to be able to maintain a positive attitude.
Timely access to dental care. Even if problems with teeth appeared directly during pregnancy,. He will not prescribe any prohibited and dangerous procedures. It is much more risky to courageously endure discomfort and pain and wait for complications to develop.
Timely treatment of gingivitis of pregnant women. Untreated gingivitis often leads to tooth loss. With the initial manifestations of inflammation of the gums, you can cope with it with specialized toothpastes and rinsing the mouth with decoctions, chamomile, oak bark. When the process aggravates, consultation with a specialist is necessary.

Pregnancy is a physiological condition characterized, among other things, by hormonal changes in a woman's body, which can lead to problems with teeth and gums. Each of the three trimesters of pregnancy has its own characteristics, but the possibilities of modern therapeutic dentistry can eliminate any of these problems in each period.

Pregnancy is characterized by a strong hormonal shock, which involves a rather complex set of hormones. In addition, during pregnancy, strong vascular changes occur, in particular, in the mucous membranes of the oral cavity, dentoalveolar ligaments (periodontal).

Hormonal and immunological changes

The physiological changes that appear in a pregnant woman occur as a result of the endocrine activity of the placenta, the release of estrogen and progesterone.

The secretion of these hormones increases during pregnancy up to 10 times for progesterone and up to 30 times for estrogens.

Some hormones associated with pregnancy, such as progesterone, have immunosuppressive (immune suppression) properties. Also, at a high level of sex hormones, polymorphonuclear chemotactism, phagocytosis and antibody response are affected. Therefore, the risk of any infection during pregnancy increases significantly.

Changes in the oral environment

During pregnancy, there are quantitative and qualitative changes in a woman's saliva. During the first three months of pregnancy, salivation increases (this phenomenon has not yet been explained). In the following months, this phenomenon of hypersalivation disappears.

The pH value of saliva changes in the direction of increasing acidity (from 6.7 to 6.2) and such a decrease in pH reduces the protective function of saliva. In addition, the presence of hormones in saliva is observed, which contribute to the growth of the number of microorganisms in saliva, the increase in bacterial contamination, the formation of plaque and dental plaques.

Pathology of the oral cavity during pregnancy

The effect of pregnancy hormones on the oral mucosa has been proven experimentally and clinically.

Inflammation of the gums (gingivitis)- This is an inflammatory process, often observed during pregnancy, aggravated by the formation of plaque and dental plaques, caused by an increase in the content of estrogens and progesterone in saliva.

Tumor of the gums (supragingival) pregnancy is a benign tumor. The etiology of its occurrence is still not clear, although injuries, poor oral hygiene and hormonal changes certainly play a role. The tumor spontaneously disappears after childbirth.

Caries. During pregnancy, either the development of carious cavities is often observed. It has been established that caries during pregnancy is provoked not only by a deterioration in oral hygiene, but also by changes in the hormonal background, a change in the pH of saliva (the acidity of which increases during pregnancy). The incidence of caries in pregnancy may also be affected by an increase in carbohydrate intake.

Diffuse toothache. Often pregnant women complain of non-localized, diffuse pain in the teeth. This is probably due to changes in blood circulation within the pulp of the teeth, which causes contractions of nerve fibers when the walls of the pulp chamber are immobile. Such pain is not associated with dental caries. If the pain suddenly appears on healthy teeth, it usually disappears after 1-2 weeks (while caries does not spontaneously disappear).

Tooth hypersensitivity. It has been established that pregnancy contributes to changes in tooth sensitivity, reaching a degree of hypersensitivity.

Erosion of teeth - demineralization, loss of substance of hard tissues of teeth under the influence of chemicals. During pregnancy, erosion occurs mainly at the level of the necks of the front teeth of the upper jaw. Erosions of the teeth are caused by hyperacidity or gastric juice, especially when vomiting during pregnancy toxemia. When erosion occurs, short-term pain sensations appear, as a rule, after eating, which spontaneously disappear after childbirth.

Treatment of diseases of the teeth and oral cavity in pregnant women

There are no contraindications for dental treatment for pregnant women. On the contrary, if treatment is not carried out, it can further adversely affect the health of both mother and baby.

However, when treating pregnant women at the dentist, some precautions must be observed, namely, pay attention to the following factors:

stressful situations during treatment;

use of ionizing (X-ray) radiation;

anesthesia;

filling materials;

medicines used;

the presence of other pathologies in the body;

choice of the moment to start treatment.

Stress

Anxiety and stress during dental intervention in a pregnant woman can be reduced by the attentive attitude and patience of the doctor. It is important that the dentist explain in detail to the expectant mother what manipulations he will carry out, that it is absolutely harmless to her unborn child.

Ionizing radiation (X-ray)

It is believed that X-ray dental examination is practically harmless for pregnant women. However, the following rules are recommended:

short exposure time;
protection of the abdomen and chest of a pregnant woman with a special apron (personal protective equipment);
the number of x-rays should be kept to a minimum.

All of these precautions reduce the risk of exposure to the child. However, it is still best to avoid X-ray examinations in the first trimester of pregnancy, unless absolutely necessary.

Anesthesia

Local anesthesia used in dentistry is not contraindicated for a pregnant woman. With regard to the drugs used, it must be borne in mind that:

the toxicity of painkillers increases due to a decrease in proteinemia (the presence of proteins in the blood plasma) of a pregnant woman;
local hyperemia (overflow of blood vessels of the circulatory system above the norm) when an anesthetic is injected causes acidification of the environment, which favors the cationic form of the anesthetic molecule to the detriment of the main form (namely, the main form acts on the nerve of the tooth, so the degree of anesthesia in pregnant women can be reduced);
all drugs have molecular weights of about 250-330, and any molecules with a molecular weight below 600 are retained by the placenta;
the toxic dose of the anesthetic is 400 mg, which is significantly higher than the therapeutic doses used; however, it is desirable to use the least toxic, least fat-soluble, and most protein-bound drugs. The fat solubility of the drug used determines its effect on the development of the embryo. The association with proteins increases the molecular weight and makes it impossible for the drug to cross the placenta.

Therefore, it is best to avoid the use of anesthetic drugs such as Prilocaine, Lidocaine and Mepivacaine. The use of Articaine (Alphacaine, Ultracaine, Primacaine, Septanest, Bukanest, Deltazine, Ubistezin) is preferable.

Filling materials

No study has shown that materials used for conservative dental treatment (composites, glass ionomer cements, etc.) or their components can cross the placenta or act as cellular poisons. But the use of any materials containing mercury must be avoided.

Medicines

If the dentist has established the presence of an infection in the oral cavity (teeth, gums), it will probably be necessary to resort to additional drug therapy. Some antibiotics, some anti-inflammatory drugs, and some pain relievers should be avoided during pregnancy.

Antibiotics

It is best to use penicillin antibiotics. Sometimes first-generation cephalosporins and erythromycin can sometimes be used because they have been found to be safe. Tetracyclines should not be used because, in addition to causing dyschromia (staining) of the teeth in a newborn, they are also responsible for clouding of the lens (cataract) and congenital anomalies of the limbs of newborns. Tetracycline can also cause fatty liver cells and pancreatic necrosis in a pregnant woman.

Anti-inflammatory drugs

The dentist may prescribe anti-inflammatory therapy, however, the use of these drugs in pregnant women should still be avoided, both steroidal and non-steroidal. Steroid drugs can cause fetal growth retardation, as well as affect the formation of lung tissue and tissue in some areas of the brain. Such drugs can only be used in case of a threat to life, for example, in anaphylactic shock.

Non-steroidal anti-inflammatory drugs may be responsible for the premature closure of the arterial canal, which can lead to heart problems in the newborn. Such drugs are prohibited for use in the 2nd and 3rd trimesters of pregnancy.

Painkillers

The most recommended pain reliever is paracetamol. It is not toxic and teratogenic (contributing to the appearance of deformities in the unborn child). The use of acetylsalicylic acid (aspirin) should be prohibited. Aspirin has been shown to promote palatine fissures, fetal death, and growth retardation. Dextropropoxyphene is contraindicated in the first trimester because of the potential for respiratory depression in the infant. Drugs containing codeine should not be used, as they can cause congenital malformations, cardiac anomalies.

When should a pregnant woman see a dentist?

A woman must, first of all, register with a gynecologist in order to know exactly the gestational age and the general condition of her body. Pregnancy is divided into three main periods (trimesters), during which the risks differ.

1-3 month

During the first trimester, the risk of malformations in the development of the fetus is maximum, the probability of spontaneous miscarriage is high (up to 75% of miscarriages occur in the 1st trimester). At this time, dental intervention (endodontics and extractions) is only necessary in urgent cases to avoid stress, pain and the risk of infection. In addition, during this period, women often have toxicosis, irritability, increased salivation, which prevents normal treatment at the dentist.

4-7 month

This is the best time for treatment at the dentist, because. the period of organogenesis (development of the child's organs) is over. During this period, it is desirable to eliminate all pathologies associated with the teeth and oral cavity, accompanied by pain or inflammation.

8-9 month

In the last months of pregnancy, a woman is already constrained by her fullness, her movements are limited, the due date is close. During this period, the dentist should be contacted only in emergency cases, moreover, visits to the doctor should not be long and should take place in a semi-sitting position.

Therapy of oral pathologies associated with pregnancy

Tumor of the gums (supragingival)

The tumor disappears immediately after childbirth. Surgery is only necessary if the tumor interferes with the process of chewing food. The dentist can only give recommendations on oral hygiene in this case.

Primary periodontal lesions

In case of inflammation of the gums associated with pregnancy, the first step is to remove plaque, plaque and calculus. After removing the plaque, rinsing the mouth with a 0.12% solution of chlorhexidine is prescribed. In cases of periodontal disease, only minimal treatment of the affected areas is carried out. The main therapy is transferred to the period after childbirth.

Caries and damage to the tissues of the teeth

To prevent caries, it is necessary to remove dental deposits, hermetic restoration of defects using glass ionomer cements or liquid composites. To consolidate the effect, the teeth are varnished with chlorhexidine. You can cover the teeth with fluorine varnish, which will help to avoid the appearance of new foci of caries and prevent the appearance of hypersensitivity of the teeth. It is better to postpone the full treatment of carious cavities with permanent filling materials for a period after childbirth.

In the case of pulpitis, placing calcium hydroxide in the canal will temporarily soothe the pain and have an antibacterial effect. Full canal treatment is performed only in the second trimester or after childbirth.

Erosion of the teeth

In the event of erosion of the tissues of the teeth, rinsing with a solution of baking soda is recommended (especially after vomiting), brushing the teeth with a hard brush is not recommended. It is necessary to follow a diet and exclude acidic foods from the diet (lemons, oranges, vinegar sauces, oils and salts).

The observation and treatment of pregnant women at the dentist is not much different from that of ordinary patients. Only a few precautions are needed. You should be especially careful in the first trimester of pregnancy, when dental intervention is allowed only in critical cases. All other treatment should be carried over to the second trimester. In the third trimester, treatment is indicated only with special urgency.

Treating pregnant teeth is not just possible, but necessary. You can’t endure a toothache, it’s 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, do not put off a visit to the dentist.

Features of dental treatment for pregnant women

Pregnancy is not an absolute contraindication to any dental procedures. However, the patient must warn the doctor about her position, and also name the exact gestational age.

The main nuances of therapy:

during the bearing of a child, caries, pulpitis, periodontitis and inflammatory diseases of the gums (gingivitis, periodontitis, stomatitis) can be treated;
both chemically curing materials and light-curing composites can be used for tooth filling; photopolymer lamps are safe for the fetus;
enamel whitening is prohibited;
dental treatment is carried out under local anesthesia (injection of Ultracaine, Articaine), the expectant mother should not be allowed to suffer terrible pain in the dentist's office;
general anesthesia is strictly contraindicated.

Early and late dental treatment

The entire period of pregnancy is conditionally divided into 3 periods (trimesters).

First trimester (up to 12 weeks)

In the 1st trimester (the earliest time) all the vital organs of the child are laid. The placenta is just beginning to form, it cannot yet protect the fetus from negative influences. Therefore, during this period it is undesirable to carry out any medical intervention. However, the dentist may prescribe local drugs to relieve inflammation (Chlorhexidine, Miramistin, Holisal).

Second trimester (approximately 13 to 24 weeks)

In the second trimester, the risk of hazards is significantly reduced. 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 (25 weeks to delivery)

In the 3rd trimester, there is an increased sensitivity of the uterus to drug exposure. In addition, during this period, the woman's body is quite weakened. Therefore, "extra" stress in the dentist's office is highly undesirable. If possible, it is better to postpone dental treatment for lactation. However, this does not apply to emergency cases, such as acute toothache.

Diagnosis of teeth during pregnancy

Without diagnostics, the treatment of pulpitis and the extraction of teeth during pregnancy is not complete. Conventional radiography (targeted x-ray) is not the best option for patients "in position". Fetal cells are in the process of dividing, so they are particularly sensitive to radiation.

But if there is a need for such a diagnosis, it is better to carry it out in the second trimester. Be sure to cover the abdomen and pelvic area with a protective lead apron.

The safest option for women during pregnancy is digital radiography. 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 a low degree of effect on blood vessels.

Lidocaine is not suitable for expectant mothers, as such a drug can cause muscle weakness, cramps, and a sharp drop in blood pressure.

The best option is anticaine-based anesthetics:

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 during childbearing.

Therefore, tooth extraction is carried out only in extreme cases:

fracture of the crown or root;
deep carious focus, which causes purulent inflammation;
the formation of a cyst, the diameter of which exceeds 1 cm;
persistent severe pain that cannot be relieved with conservative therapy.

Removal of wisdom teeth during pregnancy is generally not carried out. Such an operation often ends with alveolitis (inflammation of the hole) and other complications that require antibiotics.

Implantation and prosthetics of teeth during childbearing

During pregnancy, you can put any type of prosthesis, including crowns and bridges. The exception is dental implants.

The implantation of a dental implant often requires a large expenditure of vitality. But during pregnancy, all resources are directed to the development of a healthy baby.

In addition, after implantation, anti-inflammatory and analgesic drugs are required, which are contraindicated for the expectant mother.

Dental treatment during the period of bearing a child can be done absolutely free of charge if you use the CHI policy. You will find a list of all state institutions, as well as private dentistry, on our website.

Pregnancy is an important event and a wonderful period in the life of any woman. However, during this period, the risk of developing various dental diseases increases significantly. This is due to the general restructuring of the body, including hormonal levels and metabolism, and a decrease in the protective sludge of the body. How to keep your teeth healthy during pregnancy? And what to do if dental diseases appear in a woman in position?

Why treat teeth during pregnancy?
Upon learning of her pregnancy, the first doctor a woman should visit is a dentist, even if there has never been a problem with her teeth. Pregnancy is accompanied by a restructuring of the hormonal background of the woman's body, as a result of which the immune system is weakened, and as a result, favorable conditions are created for the development of many microorganisms, including the oral cavity. Therefore, even caries during pregnancy develops much faster than in the normal state. The process of forming and carrying a pregnancy takes a lot of strength from a woman. For the bone structure of a child, a woman's body needs a significant amount of calcium, fluorine, phosphorus and other minerals, the lack of which is replenished from the mother's bones and teeth. This kind of process adversely affects the bone tissue and teeth of the future young mother, as a result of which caries develops very quickly.

If caries is not treated, it can lead to the development of more complex dental diseases - pulpitis (inflammation of the nerve of the tooth) and periodontitis, which should also not be ignored during pregnancy, since in the future a young mother will acquire many problems not only with her health, but also with baby's health. For example, infections penetrate through the inflamed teeth and gums of the mother into the body of the unborn child, weakening his body, as a result of which he may develop a tendency to allergies, and most importantly, caries will appear on the first teeth that appear.

If earlier it was contraindicated to treat teeth during pregnancy, since the technologies used were dangerous for the health of the unborn baby, today, according to most experts, it is simply necessary to treat bad teeth during pregnancy. In addition, modern dental clinics have in their arsenal special medicines for pregnant women, safe digital X-ray equipment (the minimum radiation dose, the action is local and narrowly focused), highly qualified specialists correctly select anesthesia for pregnant women, which would both effectively anesthetize and not harm future child. In addition, special dental clinics for pregnant women have already appeared in our country, which have been effectively operating in the West for a long time.

During pregnancy, you can remove teeth, treat caries, periodontal disease, gingivitis, bleeding gums, inflammation of the teeth, and it is also possible to install braces. But with implantation and removal of tartar, it is worth waiting, these procedures are not recommended for carrying out during pregnancy.

If you do not have any problems with your teeth during pregnancy, it is still recommended to visit the dentist's office every three months (only three during pregnancy), where the doctor will talk about all the nuances of oral care during pregnancy and recommend a brush and toothpaste .

Another reason for the obligatory visit to the dentist during pregnancy and after it is periodontal disease and its initial stage - gingivitis (inflammation of the gums), the signs of which increase towards the end of pregnancy. Particularly careful observance of hygienic rules in the care of the oral cavity can greatly alleviate the condition and prevent possible complications. However, it is impossible to completely get rid of this disease on its own. And untreated gingivitis leads to tooth loss even more often than untreated caries. If a woman develops gingivitis during pregnancy, the chance that the condition of the oral cavity returns to normal after the birth of a child is much higher than if the woman suffered from this disease before pregnancy. Therefore, it is recommended to visit the dentist at least once a year even before pregnancy. In the treatment of gingivitis, as a rule, professional teeth cleaning and anti-inflammatory therapy are carried out.

In addition to dental treatment, it is also necessary to remove plaque and stones.

When is the best time to treat your teeth during pregnancy?
In the first trimester of pregnancy, the formation of all organs and systems of the unborn child takes place, in the second trimester - the development of these organs and systems, in the third trimester - the preparation or already independent functioning of these systems and organs. Each trimester has its own characteristics of the course: the first and third trimesters have the largest number of "critical" periods, so any medical interventions are not desirable in these months. An exception in this case are those medical procedures and manipulations that are necessary to save the life and health of the unborn child and his mother. The second trimester remains, which is considered relatively safe. Therefore, the period from the fourth to the sixth month of pregnancy (this is 14-20 weeks) is recommended to be used for dental procedures. When visiting a dentist, it is imperative to warn the doctor about your position, gestational age, and indicate the medications you are taking. Depending on these factors, treatment tactics will be developed.

Treatment of caries during pregnancy.
Since anesthesia in the treatment of teeth in pregnant women is categorically contraindicated, then, as a rule, the treatment of caries in a pregnant woman is carried out without anesthesia. With the help of a dental drill, the dentist removes damaged tooth tissues and places a filling, the choice of which can be made to your taste (chemical or light curing). Neither one nor the other seal carries any danger, either for the mother or for the child. If, nevertheless, anesthesia is needed, you should not worry about this, since today there are special anesthetics (Ubistezin, Ultracain) that have only a local effect, without penetrating the placental barrier. This means that they are absolutely safe for the unborn child. In addition, these preparations contain a rather low concentration of vasoconstrictors, and some do not contain them at all (drugs based on mepivacaine).

Inflammation of the nerve or pulpitis is treated with anesthesia, which was discussed earlier. Treatment of periodontitis (inflammation of the root tissues of the tooth), most often, is carried out without the use of anesthetics. However, in both cases, x-rays are needed, which allow high-quality root canal filling. In general, x-rays are contraindicated before the 20th week of pregnancy. After this period, X-rays are allowed, only the doctor must know about your situation. If the office is not equipped with a special X-ray unit (the radiation dose is reduced tenfold), which protects the doctor and patient from radiation, the doctor will provide you with a so-called lead apron that protects your stomach.

Extraction of teeth during pregnancy.
If it is not possible to save the tooth, it is removed under local anesthesia. In order to avoid any complications, it is necessary to strictly follow all medical recommendations (do not rinse, do not heat the surgical area, etc.). If it is necessary to remove the "wisdom tooth", then it is better to postpone such removal for later, since such removal is usually accompanied by the appointment of antibiotics.

Prosthetics, fluoridation and whitening of teeth during pregnancy.
There are no contraindications for prosthetics. Procedures performed by an orthopedic dentist are usually painless and safe. But implantation of teeth is not recommended, since the process of engraftment of implants is accompanied by high costs for the body. And a young mother should direct all her strength and energy to the development of a healthy child. In addition, implants are most often engrafted under the influence of drugs, the action of which reduces the reactivity of the body, which is an absolute contraindication during pregnancy.

To preserve and strengthen tooth enamel during pregnancy, local fluoridation with fluorine-containing solutions and varnishes is recommended. In domestic practice, the application method of fluoridation is used, in which the so-called “individual spoon” (wax casts of teeth) is made, into the recesses of which a fluorine-containing composition is poured, after which the casts are superimposed on the patient’s teeth (10-15 procedures), and the second method is carrying fluorine-containing varnish with a brush on the surface of the teeth (3-4 visits).

Teeth whitening procedure during pregnancy is absolutely safe and harmless for the expectant mother and fetus. It is carried out in two stages: the removal and removal of plaque and tartar using ultrasound and the treatment of teeth with special whitening pastes. Teeth whitening is carried out within an hour.

How to keep your teeth during pregnancy?
The birth of a child must be taken very seriously, therefore, long before pregnancy itself, both parents must cure all damaged teeth, since affected teeth are a source of infection that negatively affects the health of mother and baby.

The best and most effective way to fight bacteria is to thoroughly brush your teeth in the morning and evening. During pregnancy, it is best to use a medium hard toothbrush. The brush for the entire period of pregnancy must be changed three times. If your gums bleed heavily, use a soft-bristled brush. But the use of an electric brush during pregnancy and lactation is not recommended.

To care for the oral cavity, you should additionally use dental floss or floss, which allows you to clean the interdental spaces, you can use dental elixirs, which have a cleansing and protective effect. Also, after each meal during pregnancy (and not only), you should rinse your mouth with boiled water.

Toothpaste used during pregnancy must also be of high quality: it prevents the development of caries and gum disease and strengthens tooth enamel. A suitable toothpaste can be recommended by the dentist during the consultation.

In addition, in order to save teeth during pregnancy, one should limit oneself from the consumption of carbohydrate foods, especially sweet and starchy foods. The diet of a pregnant woman should be balanced and include the necessary macro- and microelements and vitamins (calcium, phosphorus and fluorine, as well as vitamin D). The daily diet should include fish oil, chicken eggs, cod liver, vegetables and fruits, cottage cheese, cheese, nuts and other foods. A woman during pregnancy should take daily vitamin and mineral complexes for pregnant women.

Pregnancy requires a special attitude from a woman to herself. It is necessary to be attentive, sensitive and responsible for your health during this period more than ever. A visit to the dentist by a pregnant woman should become mandatory for everyone along with visits to her attending obstetrician-gynecologist. A sore tooth or a swollen bleeding gum is not just aching pain somewhere in the mouth. This is inflammation and the source of infection. This is unacceptable in the body of a future mother. The conjectures of hundreds of people have sunk into oblivion that teeth cannot be treated during pregnancy. It is possible and very necessary.

What is gingivitis

Swollen gums, blood on your toothbrush, and bad breath... If you're familiar with these problems, chances are you've experienced pregnancy gingivitis. This disease has a hormonal basis. During pregnancy, the blood supply to the mucous membranes of the body changes. As a result, the periodontal papillae (the area of the gum between the teeth) may slightly increase. Poor oral hygiene stimulates the growth of bacteria. And here is the result: gingivitis.

At this point, special attention should be paid to oral hygiene. With proper care and taking into account hormonal changes, gingivitis is likely to go away soon after childbirth. But if the situation in the mouth is neglected, hormonal changes in a woman's body can give rise to more serious problems. If you have signs of gingivitis, it is recommended to immediately consult a doctor. The dentist (or specialist hygienist) will conduct a professional cleaning of the teeth, prescribe anti-inflammatory therapy and recommend maintaining good hygiene.

Dental treatment during pregnancy

Let's start with anesthesia. You can't do without it. Good anesthesia is the basis of any treatment. If the patient is in pain, the doctor is unlikely to be able to carry out all the manipulations with high quality. For successful treatment, the doctor needs a calm, relaxed patient with a wide open mouth. And this is possible only in the absence of pain. Only extremely rare cases of allergies can force a doctor to refuse anesthesia.

Further, the answer to the main question: modern painkillers of the artecaine series are not contraindicated for pregnant women. These drugs (they have many commercial names) are not toxic and are quickly eliminated from the body. And most importantly, they do not pass the hemoplacental barrier, and, accordingly, are safe for the child.

When is an x-ray required?

If caries has destroyed most of the tooth, inflammation has gone very far, and the expectant mother is in pain, most likely it is pulpitis. This is what experts call inflammation of the dental nerve. We note right away that cotton wool with arsenic is a stone age in dentistry. It must be said that the poison with such a characteristic name is very harmful to the tooth in particular and to the person as a whole. With modern means, the problem of pulpitis is solved in one visit to the clinic. But not in pregnant women.

In the case of acute pain and inflamed pulp, the doctor will be able to help, but you will have to return to the dentist's chair immediately after childbirth. Under the influence of anesthesia, the doctor will be able to remove the inflamed nerve, clean the channels, but the dentist will have to fill the tooth only temporarily. In the process of treatment, the doctor must take an x-ray (and most often not one) - make sure that the canal is tightly sealed up to the top of the root. Without an x-ray, it will not be possible to seal the canals with high quality. X-ray radiation is well studied. It is known that in large quantities it negatively affects the human body. However, this is not about modern dentistry. To take a picture in the dental office, microdoses of X-rays are used.

The next time you're in the dentist's chair, pay attention to the small "badge" hanging on the pocket of the doctor's coat. This is an individual X-ray dosimeter. If the clinic is equipped with modern installations, the readings on these dosimeters are equal to the background values. However, it's still not worth the risk. If there is no urgent need, it is still better not to take a picture and suspend treatment at an intermediate stage.

But there are situations when a snapshot is indispensable. In this case, pregnant women are advised to take an x-ray not on film, but on a visiograph using protective equipment (you will be put on an “apron” that protects the internal organs and the fetus from x-rays). Trust the doctor. After all, he is guided by the main principle - "do no harm."

Once again, we note: if the treatment of pulpitis has stopped at an intermediate stage, do not delay visiting a doctor after the birth of a child. The temporary filling is not reliable. It should be replaced with a permanent one as soon as possible.

Extraction of teeth during pregnancy

This situation is not uncommon. If a doctor recommends a tooth extraction, any patient should understand that this is a surgical operation. These are not scary words, it just won't hurt. One or two anesthetic cartridges - and you will not feel anything (the admissibility of the latter was mentioned above). In the case of such recommendations, it may be worth going to another specialist, because how many doctors - so many opinions. One dentist can only remove, and the other will try to save the tooth.

However, if the situation is obvious and the tooth is to be removed, agree to the operation. Save the focus of inflammation and infection - harm the health of the mother and the unborn child.

After the operation, when the anesthesia wears off, you will most likely have a hard time. There will be discomfort at the site of the operation, even pain is possible. Pregnant women are not recommended to take any painkillers. In case of acute pain - paracetamol. And here the conclusion suggests itself - you should not delay until such a situation that you have to remove your teeth during pregnancy. You don't have too many of them - only 32.

Our great-grandmothers used to say that a woman gives up one tooth for every baby. Carrying a child, and then breastfeeding him, the mother really spends a lot of trace elements and vitamins, shares her immunity with the child. But this does not mean that a pregnant woman pays with her teeth. If you restore your balance of vitamins in time, and not take them from the reserve of your body, there will be no harm to health at all. This popular belief arose at a time when no one had heard of oral hygiene, and dentistry as such did not exist at all. No matter how many children a woman has, all her teeth will remain in place if you follow simple hygiene rules and visit the dentist regularly. After all, the timely help of a doctor will save you from future problems with your teeth, both for you and for your baby.

Any inflammatory process in the body, including those in the oral cavity, provokes an increase in the level of leukocytes in the blood. We are talking not only about acute inflammations that hurt, but also chronic processes that can only be diagnosed by an x-ray. Without it, the doctor can only make a preliminary diagnosis. Therefore, it is better to visit a dentist before pregnancy. But if this did not work out, be sure to visit a specialist in the early stages in order to get ahead of the pain and plan possible treatment before childbirth. For major dental interventions, we recommend the second, most relaxed trimester of pregnancy. However, if necessary, most dental procedures can be performed during the entire period of pregnancy.