There seems to be a small baby boom taking place in my dental practice! Amazingly in the last ten days I have treated five moms-to-be. But pregnancy isn’t the only thing that these particular patients have in common. Each one of them (with the exception of a veteran in her fourth pregnancy) called my office before scheduling the appointment and asked the same question: “Is it safe to have dental work during pregnancy?”
From my humble perspective as both a father who observed up close and personal the two pregnancies that produced my own children, and from that of a dentist who has treated untold numbers of pregnant patients over the last three decades, pregnancy is truly one of life’s miracles. And during this extraordinary time of gestation, I have witnessed moms-to-be experience a heightened sense of responsibility that goes beyond self and often leads to an elevated health consciousness.
Routine prenatal care, nutritional awareness (eating for two), abstention from smoking, alcohol consumption, drug use (both pharmaceutical and recreational), and getting regular exercise are some of the most important measures and behavioral changes that most expectant mothers embrace to safeguard their baby’s health.
But what is often understated, and sometimes even misunderstood, is the importance of optimal dental health during pregnancy.
Preventive dental care, which includes routine examinations and cleanings, the treatment of any cavities, periodontal (gum) disease, and, if necessary, root canal, is not only safe during pregnancy, but strongly recommended. In August 2013, The American College of Obstetricians and Gynecologists published their official position that routine and preventive dental care, including the use of local anesthetic, is safe during pregnancy and is important for the health of the expectant mother as well as that of the unborn child.
While elective procedures such as tooth whitening, cosmetic procedures, and more involved and complicated procedures should be delayed until after the baby is born, basic dental care should not be avoided.
Novocaine During Pregnancy
Novocaine has not been used in dentistry for decades as more effective and better-formulated anesthetics became available but the term though still persists and is generally used as a euphemism for any local anesthetic.
The use of most local anesthetics is considered safe during pregnancy. Lidocaine is the most commonly used dental anesthetic today, and while it does pass through the placenta, it is not toxic to the developing baby. I use the minimum effective dose, but will not compromise on ensuring complete comfort for my patient. Pain, in and of itself, can induce a physiologic response that is best avoided, especially during pregnancy.
Many dentists use lidocaine combined with epinephrine (another word for adrenaline) but I tend avoid it for my pregnant patients. Epinephrine is not dangerous to use during pregnancy, but it sometimes can cause a transitory state of excitement including an accelerated heart rate that can be distressful.
Which Is The Best Trimester For Dental Work?
During the first trimester any dental treatment beyond cleanings and emergency care is best avoided. It is during this time that most of the organs and organ systems of the developing fetus are formed. However, after the first trimester the majority of formation is complete and the remainder of fetal development is devoted primarily to growth and maturation.
The safest time to receive dental treatment is during the second trimester. For pregnant women, my focus during this time is on controlling any active conditions such as decay (cavities) or gum disease. Thus I eliminate potential problems that could occur later in the pregnancy.
It is not dangerous to have dental work during the third trimester, but the increased size of the baby can make lying in the dental chair for any extended period of time very uncomfortable.
Which Medications Are Safe During Pregnancy?
Pain medication should be restricted to acetaminophen (Tylenol). Other pain medications such as aspirin and NSAIDS ibuprofen and naproxen) should be avoided. If a stronger medication that contains opioids (such as codeine) is necessary, I will only prescribe it after consultation with my patient’s obstetrician.
Antibiotics such as penicillin, amoxicillin, cephalosprins, and clindamycin are generally considered safe to use during pregnancy. But tetracycline-related antibiotics are not recommended because they have been found to cause staining in the teeth of the developing baby.
What About X-Rays During Pregnancy?
While dental x-rays, especially digital, are considered safe during pregnancy when used with proper technique and lead aprons, most expectant mothers and dentists (including me) try to avoid them unless absolutely necessary.
Remember, it is not only safe to go to the dentist while pregnant, it is recommended. If you are nervous about it, you are not alone. Let your dentist and hygienist know about your good news (even if it isn’t public knowledge yet). They will give you sound advice on how to properly care for your teeth and gums during this particularly vulnerable time. If there are any pressing matters, your dentist most certainly will speak to your obstetrician for a consultation regarding your needs.
Congratulations and enjoy your pregnancy!
Michael Sinkin is a dentist in New York City. He loves being a dentist and is known throughout the city for taking wonderful care of his patients and for his wicked sense of humor. To contact Dr. Sinkin, link here