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Teeth Trouble

Common Dental Concerns During Pregnancy

By Kimberly A. Loos, D.D.S.

I have never been pregnant. Now that I have presumably lost some credibility with my target audience, let me try to redeem myself. I am a dentist familiar with pregnancy-related dental treatment issues. As an expectant parent, you are particularly concerned about the influence of dental amalgams (silver fillings), radiographs (x-rays), and anesthetics on the developing fetus. How am I doing so far?

Traditionally, dentists have offered conservative treatment options to pregnant women. Today, dental visits during pregnancy are not taboo. Oral infections should be treated immediately because they can rapdily spread throughout the body. Systemic infections can adversely affect the fetus. If you are experiencing pain, emergency treatment and minimal emergency radiographs should be completed immediately. Toothaches usually do not subside without professional intervention! Annual dental exams and routine teeth cleanings are encouraged. However, elective treatment should be postponed until after you give birth. Elective treatment includes most cosmetic dental procedures. Routine radiographs should also be postponed.

Most obstetricians and dentists prefer that dental treatment take place during the second trimester, if possible. Many physicians and dentists agree that dental care during the first trimester should be kept to a minimum. The first trimester is the time when most of the fetal organs are developing. While dental treatment may not necessarily harm these organs, it is best to minimize any potential risk. During the second half of the third trimester, dental care should also be minimized. This is mostly due to the comfort of the expectant mother. When laying back in the dental chair during the late stages of pregnancy, the uterus can place pressure on the inferior vena cava (the main vein which returns blood to heart from the lower extremities). Not only is this uncomfortable, but it can also create a loss of consciousness. If treatment is to be rendered at this time, a shifting in the mother's position must be allowed every 3-7 minutes. In addition, if the situation is stressful (as visiting the dentist can be for some people), premature labor can be induced.