Tooth extraction during pregnancy: is it possible to remove it and when should it be done?

Second

Everyone agrees that this is the most appropriate period for dental intervention. At this time, the risk of gestation interruption is significantly reduced, and the placental barrier is formed. It very well prevents various substances from reaching the fetus, including painkillers. In addition, at this stage the belly is not yet very rounded - it will not interfere with the girl. Not only removal, but also any treatment is recommended to be carried out right now. The only serious limitation is that we do not recommend enamel bleaching, since the dye can get into the blood.

Is it possible to remove a tooth during the third trimester of pregnancy?

On the one hand, anesthesia is used completely without fear, since the placenta is well protected from the penetration of medications, and all organs and systems are almost completely formed and their development can no longer be disrupted. But, unfortunately, the likelihood of premature birth increases, because under stress (fear or pain) the uterus can contract.

If you need to sanitize the oral cavity after 34-35 weeks, it is recommended to wait until after delivery.

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.

Precautionary measures

If possible, a woman should not have x-rays throughout her pregnancy. But if it is impossible to do without this type of diagnosis to clarify the situation and make a correct diagnosis, preference should be given to radiovisiography. During it, a radiovisiograph is used - modern electronic equipment, which makes it possible to see a clear x-ray image of the area under study on a computer monitor in real time. The radiation coming from this device is much lower than that of an X-ray machine. To minimize radiation exposure, the patient's chest, abdomen and pelvis are protected with special aprons that block the passage of X-rays.

If you are pregnant and suffering from toothache, and don’t know whether it’s worth removing a tooth now or whether it’s better to postpone the procedure until the cherished “X” day, make an appointment at the Line of Smile dental clinic. Our doctors have extensive experience and will tell you how best to proceed in your situation.

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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By the time the temporary bite changes to a permanent one, twenty-eight permanent teeth appear in the mouth in place of twenty milk teeth. With proper and timely development, all the bones of the skull grow, and there should normally be enough space for such “replenishment”.

As for eights, they normally grow up much later, in girls by 18-20 years, and in young people up to 25 years. This is explained simply: it is at this age that the growth of the skeleton completely stops, and the person does not grow further. That is, if the eights have not risen, then you don’t have to wait for them any further.

Wisdom teeth often do not erupt at all or partially erupt; they can be completely in the gums (retention), located at an angle, sideways, grow into the cheek, or grow with displacement (dystopia).

Problems with wisdom teeth during pregnancy are not uncommon. During this period, “eights” that have not yet grown can erupt, and not always painlessly and physiologically, as well as intensive destruction of teeth that grew before the child was conceived and until that moment did not cause trouble.

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

As practice shows, only in 5% of cases pregnant women have to pull out the “eight”. In other situations, it is possible to do without deletion. Extraction is permissible only if there are strict indications, including:

• inability to relieve severe pain using available painkillers;
• frequent recurrence of pericoronitis;
• the formation of an abscess affecting the facial nerve;
• destruction and suppuration of bone tissue;
• the formation of a hollow tumor on the bone in the figure eight area.

In all these cases, the woman is scheduled for dental surgery. Anesthesia is selected taking into account the duration of pregnancy and existing concomitant diseases. However, earlier than in the second trimester, extraction is contraindicated.

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.

What is the safest time for removal?

As we have already explained above, in fact, there is no safe period for tooth extraction. Because even if anesthesia can be used in the second trimester, then after this operation you will need to rinse the mouth with antiseptic solutions (not all of them are allowed), and you will need to take certain medications. What if a complication develops? After all, then even stronger therapy will be required! So it’s better to hold off on deleting it. But if the indications are urgent, then any period will not be a limitation, because a bad tooth means pain, stress and, of course, an acute inflammatory process, which is also dangerous for the fetus.

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.

Safe anesthesia options for pregnant women

Dental treatment under anesthesia during pregnancy is clearly prohibited - only local painkillers can be used. However, local anesthesia for dental treatment during pregnancy is very important: severe pain during treatment can cause a surge of adrenaline, which can dangerously affect the unborn baby and even cause premature birth.

Novocaine and lidocaine should be excluded from local anesthetics - they can cause muscle weakness, cramps, pressure changes, dizziness and vomiting. Ubistezin, ultracaine, artifrin, alfacaine are considered safer painkillers for dental treatment during pregnancy, because they do not have a vasoconstrictor effect and almost do not penetrate the placenta.

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.

Rehabilitation after surgery

If a woman was unable to avoid surgical treatment, she needs to pay maximum attention to the rehabilitation process. Recovery will be faster if the expectant mother:

• will follow all medical prescriptions;
• will provide complete rest to the damaged area (it should not be touched with hands, tongue, or foreign objects);
• will not eat solid foods;
• will carry out high-quality oral hygiene;
• He will come for a follow-up appointment when the dental surgeon says so.

Take care of the health of your smile. If you are planning to conceive, treat any existing oral diseases in advance. If the problem arose after conception, be sure to get dental care - do not risk your health and the health of your baby.

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.

What can an expectant mother do on her own?

Pregnant women should not self-medicate. But, if the eruption of wisdom teeth proceeds according to the classic scenario and does not cause negative symptoms, the woman can calm down. In this case, she does not need to run to the dentist.

To eliminate the occurrence of unpleasant sensations associated with putting pressure on the inflamed gum, you must try to chew food on the “healthy side”. After eating, be sure to rinse your mouth with warm water or a decoction of herbs. It is also permissible to purchase a special pharmacy rinse for this purpose.

If the pain intensifies, medical consultation is indicated. If for some reason it is impossible to get it right now, the expectant mother can take a no-shpa tablet to reduce the pain. But this should be a one-time “action”.

Means for healing the hole, approved for pregnant women

It is recommended to refrain from eating for about 3 hours. Immediately after treatment, you should not heat the sore spot - this can only intensify postoperative symptoms and even provoke inflammation. Rinsing your mouth is also contraindicated, since this can damage the blood clot, which is a kind of barrier that protects the open wound from infection.

As for medications, pregnant patients are usually prescribed Paracetamol for pain (0.5 g is the maximum single dosage) and the antiseptic Amoxiclav. A chamomile decoction for mouth rinsing will help relieve signs of inflammation and provide additional disinfection. Before using it, be sure to consult a specialist.

Patients are often prescribed Amoxiclav

How is the procedure performed?

The procedure will be performed by a dental surgeon. Before this, he needs to study the results of the X-ray examination. However, if the patient is in position and the clinical picture is obvious, this stage can be avoided so as not to further jeopardize the process of fetal formation. But you shouldn’t worry if you can’t do without an image - today clinics and diagnostic centers use modern high-precision equipment to minimize the negative impact of x-rays on the human body.

An examination is required before the procedure.

Extractions are carried out in any case with the use of painkillers. Currently, for this purpose, the most gentle drugs are used that are safe for the health of both mother and baby. After administering the anesthetic, the surgeon carries out the procedure according to the standard protocol - he grabs the causative element with special forceps, sharply twists it and carefully removes it. After treatment, the patient will be given detailed recommendations for oral care.

Features of dental treatment for pregnant women

Dental treatment is a mandatory medical procedure, regardless of whether a woman is preparing to conceive a child or is already pregnant. The dentist’s tactics depend on the trimester of pregnancy, its course, the general somatic health status of the pregnant woman and indications for treatment. Peculiarities of management of pregnant women are characterized by the following features:

Treatment planning

During pregnancy, emergency dental treatment is performed, the indications for which are:

• Carious lesions of hard and soft tissues of teeth: pulpitis, periodontal inflammation (periodontitis).
• Pathological processes of soft tissues of the oral cavity, gums: gingivitis, stomatitis, cheilitis, glossitis, inflammation of periodontal tissues.
• Tooth injuries: fracture of the crown or root of the tooth, dislocation, cracks and chips of the crown part.
• Abscesses.
• Acute purulent inflammation of the jaw bone tissue.

Planned therapy (orthodontic, implantological and orthopedic treatment) is postponed to the postpartum period.

Pregnancy data

Before starting treatment, you should inform your doctor about the duration and course of pregnancy, taking medications prescribed before conception and during pregnancy, and bad habits. These data can significantly affect the treatment plan drawn up by the dentist.

X-ray diagnostics

X-ray examination is extremely undesirable in all trimesters of pregnancy: failures in the formation of fetal cells can lead to irreparable consequences and abnormalities. The 1st and 3rd trimesters are especially dangerous for radiation diagnostics, however, the 2nd trimester is no exception, although it includes lower risks of developing pathology.

Dental filling

When filling teeth, materials of both chemical and light curing are used. Curing lamps used for curing are also not safe for the developing fetus.

Anesthesia

At the present stage of development of dentistry, painkillers are produced that are absolutely harmless to the pregnant woman and the fetus. High-quality anesthesia is half the success of treatment.

We know that it is possible to treat in a certain trimester