Yes, it is safe to visit the dentist during pregnancy.
Many 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. Pregnancy changes the chemistry of the female body, and this change can have implications for a pregnant woman’s dental health.
Because of the vulnerability of the human foetus, it is not advisable to have X-rays taken during pregnancy, unless the risk outweighs the benefits. So always make sure you tell your dental practitioner if you are pregnant; then they will avoid any risk to your unborn child.
While it is safe to have a local anaesthetic for dental treatment while you are pregnant, some other types of anaesthetic should not be used on pregnant patients, so again make sure you alert your dental professional to your condition. Happy gas is one form of anaesthetic that is unsafe for pregnant patients. If you are particularly anxious about dental procedures, you should discuss with your practitioner other ways of relaxing during your treatment.
Other dental procedures that cannot be undertaken while a patient is pregnant are the removal or replacement of silver (amalgam) fillings, and teeth whitening.
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.
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.
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.
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 anaesthetic used in dental procedures is safe for pregnant patients as long as it is below the maximum dosage. The dentist will ‘aspirate’ the anaesthetic to reduce the amount that goes into your bloodstream.
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 affect 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.
If you require more complex dental procedures, such as filling or crowns during pregnancy, the ideal timing would be the second trimester, when (hopefully!) any morning sickness has subsided, so that interventions in your mouth can be tolerated, and also before your belly is such that lying in the dentist’s chair for prolonged periods is quite uncomfortable.
The first trimester should be avoided if possible, as this is when the foetus is most vulnerable; and the third trimester is normally too uncomfortable for the patient. Elective treatments, such as teeth whitening and other cosmetic procedures, should be postponed until after the birth.
If you are in pain and an oral infection needs to be treated either with root canal or an extraction, the procedure obviously needs to be carried out as soon as possible, before the infection can spread and worsen. Your dentist and/or specialist will most likely need to take an X-ray to diagnose the problem accurately and assist in optimal treatment, and this decision will not be taken lightly. It will be performed only if the gain stands to outweigh the risk, and all care will be taken to protect your unborn child with lead shields. Consultation between your dental practitioner and your obstetrician will take place if any medication needs to be prescribed for your infection.
Let your dentist know the stage of your pregnancy and how you are feeling (for example, are you comfortable lying on your back for a period of time?) so that he or she can tailor your appointments to suit the stage of your pregnancy.
Finally, enjoy your pregnancy, and all the best with the birth of your child!