What should I do if I have dental problems during my pregnancy?

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General Dental Care
BAppSc (Orth) Hons (Usyd), DDS (Melb)

dental problems during pregnancyMany women are reluctant to visit the dentist during pregnancy. However, it is even more important than usual for a pregnant woman to have any dental problems addressed as and when they occur.

While some pregnant women have concerns about the types of filling materials used and about whether dental X-rays can have harmful effects, there is in fact no clinical evidence to support either. There is, however, evidence of harmful effects to the foetus caused by untreated dental disease.

Let’s look at the above two concerns and some others often raised by pregnant women, as well as the unsafe alternative of avoiding dental treatment.

Filling materials

Amalgam has traditionally been the preferred material used in fillings due to its durability and strength. Nevertheless, even though the Australian Dental Association, the Food and Drugs Administration and the World Health Organisation all deem dental amalgam safe to use in pregnant patients, most dentists prefer not to use it due to the patient’s potential exposure to mercury.

Personally, I prefer to use BPA-free resin composites, glass ionomer cements, or ceramic filling materials, all of which have been shown to cause no adverse effects in pregnancy.

X-rays

Modern digital dental X-rays produce 80 to 90 per cent less radiation than the older manual X-rays – placing them well below the safety threshold for pregnant patients. Nevertheless, as a precaution your dentist will minimise the number of dental X-rays you need to have while you are pregnant.

Prescription medication

Any prescription medication that is essential for a woman’s well-being should still be administered during pregnancy. Medications that are commonly prescribed in dentistry, such as Amoxicillin and paracetamol, come under the Therapeutic Goods Administration’s (TGA’s) Category A (“Safe to use during pregnancy”). Even so, it is wise to bear in mind that medication often doesn’t treat the cause of an oral infection or any other dental problem, and dental treatment is necessary for continued oral health.

Local anaesthetics

The most commonly used local anaesthetic in dentistry, lignocaine, also falls within the TGA’s Category A. Nevertheless, in pregnant women, as a precaution, the dose administered will always be the minimum required to achieve anaesthesia.

Untreated dental disease

If root canal infection or periodontal infection occurs during pregnancy, treatment is essential so as to prevent exposure of the mother and baby to that bacterial infection. Studies have shown that infection caused by certain types of bacteria that are common in dental infections can retard growth of the foetus, causing preterm and low birth weights. It is therefore important – for the pregnant woman’s oral health and for the safety of her unborn child ­– to treat dental problems when they arise.

What is the best time for dental treatment during pregnancy?

Treatment of an urgent nature (such as root canal or periodontal infection) should be performed at any time during pregnancy. However, the optimal time for this and any other dental treatment is at the start of the second trimester. At this time, nausea and vomiting have usually subsided, there is no risk of harm to the foetus and the uterus is not yet large enough to cause the patient discomfort in the dental chair.

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