Pregnancy and the Dentist
The pregnant dental patient presents several unique medical problems. Dental care must be rendered to the mother without affecting the developing baby. Providing routine dental care to pregnant patients is generally safe. However, the delivery of dental care can involve potentially harmful elements.
Health and Dental Problems Associated with Pregnancy.
During the pregnancy several health problems can occur. These include: fatigue, syncope (fainting), postural hypotension, anemia, tachypnea (increased rate of respiration), nausea, and vomiting.
The most common dental finding of pregnant patients is pregnancy gingivitis. This is characterized by red and inflamed gum tissue.
One percent of pregnant women will experience a pyogenic granuloma (pregnancy tumor). This benign growth of the gum tissue can disappear after the pregnancy or may have to be surgically removed after the pregnancy.
Dental considerations for the pregnant patient.
The most important goal in the pregnant patient is the establishment of a healthy oral environment and excellent oral hygiene. The hormonal changes of pregnancy can lead to exaggerated inflammatory responses to plaque and bacteria. Therefore, meticulous oral hygiene is necessary. Maternal periodontal disease (gum) disease increases the baby risk for low birth weight.
Elective dental care is best avoided during the first trimester. This does not include dental cleanings as dental cleanings are a big part of maintaining and establishing good oral hygiene. The second trimester is the safest time to do routine dental work. The third trimester is safe to do routine dental work but towards the end of the third trimester it may be difficult for the pregnant patient to be comfortable in the dental chair.
Animal and Human data support that no increase in gross congenital anomalies or intra-uterine growth retardation occurs as a result of exposures during pregnancy totaling less than 5 to 10 centiGray (cGy).
• A medical chest x-ray = .008 cGy
• Natural background radiation is approximately .0008 cGy daily
• A full mouth series of dental x-rays (18 films) with a lead apron results in 0.00001 cGy
On pregnant patients who present with a dental emergency we use two lead aprons and will only take one or two x-rays. Thus, the radiation exposure is extremely limited.
Drugs and the pregnant patient:
Local anesthetics with epinephrine are considered safe. However, it is my experience that most of my patient’s OB/GYN doctors want dental anesthetic to be used without epinephrine.
Over the counter pain relief for pregnant women is acetaminophen (Tylenol). Aspirin and Advil should never be taken by pregnant women.
Penicillin, erythromycin, and cephalosporins (first and second generation) are considered safe to mother and child. Tetracycline must never be used during pregnancy because it binds to hydroxyapatite causing severely brown teeth, hypoplastic enamel, and inhibition of bone growth.
For medical and legal reasons the patients OB/GYN is always consulted prior to any dental treatment. A new child is a blessing. If you are pregnant and need a knowledgeable and caring dentist, then call Dr. Nugent at 713-941-8261.
Visit us at 3421 Burke Rd Ste A, Pasadena Texas 77504.