Prevention of caries in pregnant women. Caries during pregnancy: can it be treated and its effect on the fetus. Treatment of caries in pregnant women

The reasons for the development of carious processes in pregnant women do not differ from the factors that provoke the disease in other categories of patients - insufficient oral hygiene, deficiency of vitamins and nutrients.

• Decreased beneficial qualities of saliva. The nutrients that a woman receives from food are partially spent on the development of the fetus - accordingly, the content of fluoride and calcium in saliva decreases, as a result of which it ceases to protect tooth enamel from acids. In addition, the liquid partially loses its bactericidal properties and becomes unable to fight pathogenic microorganisms.

Photo 1. Photograph of the oral cavity of an adult with the presence of the initial stage of development of dental caries.

• Changes in taste sensations. After conception, women often experience changes in taste, they begin to overindulge in sweet, sour and spicy foods, which have a bad effect on tooth enamel.
• Bad oral hygiene. After the expectant mother finds out about her condition, she there are a lot of additional worries and problems which distract her from oral care.

Important! During pregnancy, it is important to take a responsible approach not only to the quality of oral hygiene, but also to the choice of dental care products - they should be as natural as possible, without containing harmful components.

Photo 3. Diagram showing signs of caries development on a tooth: stain, carious cavity and surface destruction.

Such prevention includes:

1. High quality oral hygiene. During pregnancy It is important to brush your teeth well and rinse your mouth After each meal, use special antiseptics and irrigators for this.
2. Proper nutrition. Diet of expectant mothers must include all necessary vitamins and microelements, especially calcium, phosphorus, fluorine, vitamins A, E, D.
3. Taking vitamin complexes. Products do not always provide the required amount of nutrients, so during pregnancy It is recommended to take special vitamin complexes.

Prevention of caries in pregnant women. What is antenatal prophylaxis?

Diagnosis of caries

As a rule, patients turn to the dentist when they experience constant pain and increased sensitivity of the teeth. However, it is sometimes possible to detect caries even with routine preventive care. In this case, diagnosis is carried out in two stages:

1. External examination of the oral cavity and anamnesis. The patient's lifestyle and medical history are also taken into account.
2. X-ray of the jaw. X-rays were previously not recommended for pregnant women due to risks to the health of the fetus. Today, modern equipment and precautions are used to allow the necessary research to be carried out.

The mandatory examinations that a pregnant woman undergoes before registering with a antenatal clinic include an examination by a dentist. The diagnosis is made based on examination of the oral cavity.

If further therapy is necessary, the doctor collects a complete medical history: a history of past pregnancies and the presence of concomitant diseases that may complicate the course of the disease and its treatment.

X-rays and anesthesia (especially general) are prohibited during pregnancy, but modern dentistry provides special equipment and medications that reduce the negative impact on the body to a minimum.

In other words, in extreme cases, the expectant mother will undergo an X-ray examination and treatment using anesthesia - however, unless absolutely necessary, such procedures are not performed.

Photo 2. An example of the condition of an adult’s teeth during the development of caries that has reached a deep stage.

It is necessary to understand that the period of pregnancy is the time of greatest responsibility. Any wrong actions can lead to health problems for the unborn child. For this reason, treatment of caries in pregnant women should begin with a thorough examination of the woman and collection of the necessary tests.

The dentist should have an idea of ​​how the pregnancy is progressing and whether the expectant mother has any serious diseases or abnormalities. It is important to tell your dentist about the following diseases:

• preeclampsia;
• diabetes;
• hypertension, etc.

For some problems, the dentist may need a certificate from an obstetrician-gynecologist giving permission to carry out the necessary manipulation. These measures will allow you to select the safest and most effective therapeutic technique.

The most questions in the treatment of caries arise against the background of the need to do local anesthesia or dental x-rays. Typically, obstetricians strictly prohibit such interventions, but allow procedures in cases where the possible benefit far outweighs the acceptable harm.

X-ray examinations using old-style devices are strictly prohibited for pregnant women. However, in exceptional cases, you can use modern highly sensitive equipment, which has much lower radiation exposure.

In addition, for additional protection, women cover their bellies with a special lead apron. Despite the additional protection, it is necessary to remember that under no circumstances should you undergo an x-ray, even in extreme circumstances, during the first trimester.

Since any anesthetic can spread throughout the body through the bloodstream and enter the placenta, thereby increasing the risk of premature birth or other complications, the introduction of anesthesia is also extremely undesirable.

In extreme cases, a woman may be given drugs based on articaine. This substance is synthetic and cannot penetrate the blood. Its only drawback is its short-term effect, which makes the use of the product impossible in the case of long-term dental interventions.

The main danger of caries is that it has a negative impact on the health of the mother, which directly affects the health of the unborn child. The following are examples of possible complications that the disease can cause:

• advanced caries, accompanied by severe pain, leads to the fact that a woman is deprived of the opportunity to fully eat. As a result, the vitamins and microelements the child needs begin to arrive in smaller quantities. In addition, constant pain affects the mental and emotional state of a woman;
• As a result of the inflammatory process caused by caries, body temperature often rises. In this case, the woman is forced to take painkillers and anesthetics, which can penetrate through the placenta into the blood of the fetus and cause irreversible changes in the functioning of some organs;
• development of digestive problems. Putrefactive bacteria from the oral cavity can penetrate the gastrointestinal tract of the expectant mother and cause diseases such as gastritis and ulcers. Against the background of such complications, women often develop a severe form of toxicosis.

In addition to the complications listed above, it is worth noting that fear of dental treatment and complete refusal of dental care during pregnancy threatens rapid progression of the disease and loss of teeth.

Treatment of caries during pregnancy directly depends on the period. As you know, pregnancy is divided into three trimesters, each of which is accompanied by certain recommendations and contraindications.

• treatment of caries in the first trimester. During this period, the formation of all vital systems of the body occurs; therefore, any medical, including dental, intervention is considered unacceptable. If caries is in the initial stage or the woman does not suffer from pain, then it is recommended to postpone treatment until a more favorable time. It is important to understand that painful intervention or any stressful situation can cause spontaneous abortion;
• treatment of caries in the second trimester. During this period of pregnancy, increased growth of the fetus begins. At the same time, negative interference from dental treatment is reduced several times. In case of severe inflammation, a woman may be prescribed antibiotics, but only in small doses and for local use, for example, as rinses or applications;
• treatment of caries in the third trimester. In this case, the child has almost fully formed organs and quite a lot of weight. During treatment, you must recline in the dental chair. Prolonged sitting is not recommended, as the fetus can press on the woman's large arteries, which will cause dizziness and may cause fainting. At the final stage of pregnancy, a woman's uterus is most sensitive, so any intervention can trigger premature birth. Dental treatment at this time is possible only for emergency indications. It is possible to use approved painkillers.

to gingivitis, periodontitis, bleeding gums and caries. It is the lack of calcium, the altered composition of saliva in a pregnant woman and microbes that are more active due to reduced immunity that are the main reasons why the expectant mother’s teeth deteriorate.

Special signs by which a pregnant woman can identify the onset of caries are standard for everyone: chalky spots, grooves or lines, enamel decalcification, your teeth are exposed to irritants (cold or hot drinks).

Of course, the ideal way to avoid having to deal with toothache during pregnancy is to take care of your oral health as soon as you decide to have a baby. But, if for some reason this was not possible, the following tips are for you.

• Nutrition rule. The little organism growing inside you “takes” calcium from you for its own developing bones. If you don't consume enough foods rich in this element, your bones and teeth will suffer. Therefore, your diet should have the required amount of calcium and minerals.
• Sanitation of the oral cavity, that is, its improvement. Ideally, sanitation should be carried out before pregnancy, and then, throughout the period of bearing the baby, steadily and regularly visit the dentist.
• Vitamin therapy. It's worth thinking about what vitamins you absorb. It is known that preparations and products containing calcium and fluoride, vitamins B and D, as well as fish oil will help avoid the occurrence and development of caries better than any ointments and other pharmaceuticals.
• Daily oral hygiene. There is no need to talk about such a thing as brushing your teeth twice a day - this rule is strictly for everyone, regardless of age and gender.

Treatment_cannot_be_left_as_is? By correctly placing punctuation marks, you can avoid caries during pregnancy. As already mentioned, the disease is directly related to pregnancy, almost the same as nausea and all kinds of exacerbations.

But there are quite simple ways to avoid caries, being in an interesting position: cure your teeth before conception; Also, before pregnancy, start a course of intensive vitamin therapy and properly care for your oral cavity.

There is a common belief that caries itself does not have such a negative effect on the fetus as its treatment may have. Therefore, expectant mothers avoid visits to the dentist.

To answer these questions, we need to remember the nature of such a disease as caries. It is caused by pathogenic bacteria in the oral cavity. Doctors believe that these bacteria can enter the bloodstream through soft tissues (through their microscopic damage), thus entering the body of the developing fetus, causing various kinds of pathologies in it.

But, in fact, the likelihood of this is extremely low: bacteria can penetrate the placental barrier extremely rarely. In addition, the inhabitants of the microflora of the oral cavity have practically no chance of staying alive in the tissues of the embryo, much less exerting any influence on it.

Only viruses are ready for this. Therefore, if a pregnant woman has caries, like any other infectious disease, particularly careful oral care and regular hygiene procedures are required.

A closer connection between pregnancy and caries can be traced through the physical condition of the expectant mother. For example, due to constant tooth pain, a woman is unable to eat normally, her general emotional state worsens, and nervousness appears. This can really negatively affect the development of the fetus.

Complicated caries can affect the general physical condition of the expectant mother for the reason that damage, for example, to periodontal disease causes inflammatory processes - body temperature may rise, and it will be necessary to take antipyretic drugs, toxicosis may worsen, and digestive disorders may appear.

What drugs should not be used during pregnancy?

1. Lidocaine is a chemical for local anesthesia. Causes convulsions, dizziness, weakness and decreased blood pressure.
2. Sodium fluoride is a remedy for the treatment of caries. Used to strengthen tooth enamel. In high concentrations, it negatively affects the heart rate and fetal development.
3. Imudon is a drug for the treatment of inflammatory diseases of the oral cavity. The negative factor is unknown since no studies have been conducted.

Which procedures are best postponed?

1. Implantation. Engraftment of new implants involves the use of medications, antibiotics and additional forces of the female body. This procedure is not recommended for pregnant women.
2. Removal of wisdom teeth during pregnancy. This is a complex surgical procedure, after which it is possible to increase the temperature and take antibiotics. If the situation is not critical, then you can remove the tooth after pregnancy.
3. Teeth whitening. The chemical components in the bleaching liquid penetrate the placental barrier and have a toxic effect on the fetus. In addition, whitening destroys enamel and increases the risk of dental diseases.

1. Psychotraumatic factor. Toothache negatively affects the female body and at the same time the condition of the child.
2. Infection. Various pathogenic microorganisms can cause all sorts of complications in a child.
3. Intoxication and inflammation. Periodontal damage causes poor health, high fever, toxicosis, and digestive system disorders. This threatens late gestosis for the mother and hypoxia for the fetus.

Is it possible to treat teeth during pregnancy?

Some women mistakenly believe that treating caries during pregnancy can have a detrimental effect on the unborn child. However, in reality, greater harm is possible in the absence of professional therapy.

Theoretically, dental treatment is permissible for almost any period. However, there are some limitations and nuances that are important to consider. The first trimester can be considered the most unfavorable period for therapy, since this can negatively affect the condition of the embryo.

In the second trimester, elimination of advanced deep caries is possible. In this case, the safest medications will be used to eliminate the lesion. However, if possible, it is better to limit yourself to remineralization or icon technology, which does not require the use of anesthesia. Read more about the icon caries treatment method here.

Remineralization allows you to get rid of caries in the early stages. If the lesion is deeper, then invasive treatment cannot be avoided.

At the last stage of pregnancy, oral diseases do not pose a danger to the fetus, but potent medications can cause premature birth. In addition, at this time it is not recommended for a woman to take a reclining position for a long time, as required by therapy in the dental office.

Methods of influence

One of the safest methods is teeth mineralization, but it may not always be effective. Surgical removal of the pulp in the presence of inflammation is also unsafe due to the likelihood of painful shock without anesthesia.

In this case, elimination of the disease is postponed until the second half of pregnancy. Laser therapy may also be used as an alternative. Read more about how laser caries removal is carried out in this article.

Medicines in the form of sprays and gels are used as anesthetics, which have a local analgesic effect and do not penetrate the bloodstream.

The opinion that dental treatment during pregnancy is extremely undesirable and even dangerous is very firmly rooted in society today. However, the obviousness of this misconception can be proven without being a dental specialist.

Even initial caries in pregnant women requires a mandatory visit to the dentist. Why? Firstly, the disease progresses several times faster and can turn into pulpitis during pregnancy.

Secondly, at an early stage of treatment you can do without the use of anesthesia or x-rays. Thirdly, the expectant mother must be aware that she is not alone now, and the child can receive a genetic predisposition to caries while still in the womb!

First trimester

In the first trimester of pregnancy, a key stage of fetal development occurs - the rudiments of almost all organs and systems are formed, so any medical intervention can lead to unpleasant consequences.

Second trimester

The second trimester is characterized by intensive growth of the fetus, and the placenta takes on the function of feeding and protecting it.

The risk of child developmental disorders due to exposure to drugs is reduced, and pregnant women are recommended to undergo treatment for neglected teeth and professional cleaning of the oral cavity.

It will help eliminate plaque, which is where most bacteria accumulate.

Third trimester

In the last trimester, the risk of deterioration in the child’s health from medications is minimized, but at the same time the sensitivity of the reproductive system to negative influences and deterioration in the woman’s well-being increases, and any intervention can cause premature contractions.

Important! Dental procedures for pregnant women in the last trimester are carried out in a special position - the patient leans slightly on her left side to reduce pressure on large veins, otherwise disruptions in the functioning of the cardiovascular system and fainting are possible.

It is possible to treat caries at home only in the initial stages, but it will not be possible to get rid of the disease completely - using available means you can only slow down the destruction of tissue and eliminate discomfort.

• Gels. To eliminate the inflammatory process and pain during caries in pregnant women you can use gels that are recommended for teething in babies: Kamistad, Holisal, Kalgel, Pansoral.
• Folk remedies. As a folk remedy to relieve caries during pregnancy decoctions and infusions of medicinal herbs are used: chamomile, sage, oak bark, calendula, as well as propolis and soda solution.

It is strictly not recommended to use painkillers and other medications on your own during pregnancy - almost all medications are prohibited for expectant mothers and can cause developmental disorders in the child.

A good dentist, when a pregnant woman comes to him, first of all conducts a careful examination of the patient, collects anamnesis and develops tactics for the upcoming necessary treatment.

The doctor certainly takes into account all the individual characteristics of his patient, the timing of pregnancy, and takes only those actions that will not adversely affect the condition of the expectant mother and her expected child.

What risks should women in an “interesting situation” be wary of when treating caries? The main danger is the risk of negative effects of anesthesia drugs on the developing body of the expected child.

Any anesthetic is absorbed into the blood and can pass through the placenta. Moreover, some of the anesthetic drugs can adversely affect the developing embryo. This is one of the reasons why it is very important to see a dentist throughout your pregnancy.

After all, having detected caries in time, it is possible to carry out treatment in a mild form - without the use of anesthesia, a drill and unwanted painful sensations. An advanced form of caries cannot be cured painlessly without anesthesia.

If we talk about the treatment of average caries, especially in the presence of chronic pathology, dentists recommend not to carry out any procedures until the beginning of the 2nd trimester. Why?

The formation of all organ systems in the embryo occurs in the first 12-13 weeks. It is during this period that the risk of negative effects of the medications used on the fetus is greatest, although even at this time it is small.

Starting from the 14th and 15th weeks, the use of special anesthetic drugs makes it possible to guarantee safe sanitation.

Acute pulpitis, periostitis, purulent periodontitis are treated using local anesthesia, regardless of the stage of pregnancy.

Dentists prefer to treat caries, even in a deep form, without the use of anesthetics. An injection is possible only when the patient experiences pain during excision of areas of dentin affected by caries.

For pain relief when treating pregnant women, dentists use drugs that are specially designed and adapted for this case (for example, Scandonest or Septanest in the proper dilution ratio).

Treatment of long-term pregnant women is further complicated by the fact that a woman sitting in a dental chair, due to the specific position of the fetus during this period, increases the load on the inferior vena cava and the aorta.

This can lead to a decrease in the patient's blood pressure and even loss of consciousness. To avoid this, the pregnant woman should lie in a chair, turning slightly on her side, so that the load from the fetus is reduced.

Expectant mothers need to remember that taking pain relief medications on their own at home is permissible only in case of unbearable pain, and if it is not possible to immediately consult a dentist.

Attention! When you are pregnant, when making your own decision to take a painkiller, keep in mind that any analgesic can negatively affect the condition of your unborn child.

Even a single dose of an anesthetic drug in some cases of self-medication affects the health of the fetus and mother. In addition, it is worth remembering about the individual intolerance of each specific drug, and about possible side effects (as a rule, painkillers have many of them).

Attention! During pregnancy, dental x-rays are strictly not carried out by doctors! When working with areas of the oral cavity hidden from view, other techniques are used. Even such familiar procedures as studying the quality of dental canal filling are preferred to be studied without the use of X-rays.

Radiography using modern visographs has several times less radiation exposure. In case of urgent need, dentists resort to its use, but strictly only from the 2nd trimester.

Dentists today use highly sensitive sensors, films, and protective equipment that greatly reduce the radiation load on the body. In any case, in the first trimester of pregnancy, unless there is an urgent need for radiography, it is not used.

If you have caries...

First aid for acute pain

If acute pain occurs and it is impossible to immediately visit a doctor, you can take medications based on paracetamol (in strictly limited dosages). Among them:

• Paracetamol;
• Efferalgan;
• Panadol.

In addition, it is useful to take the following measures:

• rinse your mouth with a strong soda or saline solution;
• wrap a clove of garlic in a gauze napkin and apply it to your wrist;
• rinse the mouth with infusions of medicinal herbs (chamomile, calendula, sage);
• apply a cut aloe leaf to the affected tooth;
• Apply a thin slice of lard to the tooth. Find out more about caries treatment at home here.

Causes of the disease

For some reason, pregnant women consider visiting the dentist as something superfluous and unimportant. For the entire 9 months, they run around the clinic offices and take many tests for the well-being of their child, and put off taking care of their health until later.

A woman should clearly understand that there are three good reasons why she needs to see a doctor:

1. Hormonal changes in the body contribute to pathological processes in the oral cavity.
2. A lack of calcium, especially in the 2nd and 3rd trimester, can easily destroy even the healthiest teeth. Modern dental technologies help many women in this situation to keep their teeth in excellent condition.
3. During pregnancy, the properties of saliva change: it loses its disinfecting abilities, and pathogenic microbes begin to multiply in the mouth. Also, the pH level of saliva changes and the enamel is destroyed.

To all the reasons due to which caries appears in other categories of patients (excessive indulgence in sweets, an abundance of snacks, poor oral hygiene), they are also caused by gestation. Namely:

1. In a woman’s saliva during pregnancy, the concentration of fluoride and calcium compounds decreases due to the fact that a considerable part of them goes to the needs of embryo development. Moreover, calcium is not consumed from the teeth themselves, as many mistakenly believe. But unlike at other times, remineralization and strengthening of the enamel occurs due to saliva, during pregnancy these processes slow down or completely stop. As a result, weakly mineralized tooth enamel is more easily destroyed by acidic and other bacteria.
2. Hormonal changes occur in the female body, reducing the bactericidal properties of saliva. That is, it no longer copes sufficiently with cariogenic bacteria.
3. A change in taste, and as a result, a change in a woman’s diet. It's no secret that during pregnancy a woman can be thrown into extremes. If the craving for flour and sweets increases, then this, naturally, negatively affects the condition of the teeth.
4. Poor oral hygiene. Toxicosis, fatigue, worries and fuss about the upcoming event often distract the expectant mother from oral care, which should be even more thorough during this period.

It’s also bad that, having heard a lot of advice from “caring” friends and relatives that teeth cannot be treated during pregnancy, expectant mothers simply skip preventive dental examinations.

During pregnancy, women are much more susceptible to various bacterial disorders. Sometimes dental damage is associated with a lack of important nutritional components. However, other common causes and factors are also identified:

Caries during pregnancy generally occurs more often than in other periods of a woman’s life, and often occurs very actively at this time, sometimes even in an acute form. It is quite understandable for expectant mothers to be concerned about the possible impact of caries on the fetus, as well as fears about whether it is even possible to treat teeth during such a crucial period.

In some cases, during pregnancy, caries is just beginning its destructive work (and many try to wait out this time), and the most noticeable and sensitive consequences of dental damage await the woman after childbirth.

On a note

The statistics are eloquent:

• Caries is found in 91.4% of women with a normal pregnancy and in 94% of women with toxicosis.
• The average intensity of dental damage in pregnant women is from 5.4 to 6.5 (this is a high level);
• Enamel hyperesthesia (increased sensitivity) is observed in 79% of women during pregnancy.

It is believed that caries itself during pregnancy does not have such a negative effect on the fetus as its treatment can have. Taking advantage of this popular belief, many pregnant women are wary of visiting the dentist, and the reason for this is that expectant mothers do not understand the nature of caries and the very dangers it poses.

Let's figure out what is actually more dangerous and can have a stronger effect on the fetus - and also see how you can carry a healthy baby and at the same time keep your teeth in excellent condition.

Does tooth decay affect the fetus?

To begin with, it is useful to remember that caries is a disease caused by pathogenic bacteria in the oral cavity. It is believed that through microdamage to soft tissues, these bacteria can penetrate the bloodstream, enter the fetus’s body and cause various pathologies.

However, the likelihood of this is extremely low: bacteria manage to penetrate the placental barrier only in extremely rare cases, and the inhabitants of the oral cavity have practically no chance of surviving in the tissues of the embryo and having any effect on it. Viruses mostly have these abilities. But, as with any infectious disease, the presence of caries in pregnant women requires a number of hygiene procedures and careful oral care.

Caries and pregnancy are more closely related precisely through the physical condition of the mother. For example, constant pain in a tooth affected by caries (which, by the way, is not uncommon during pregnancy) leads to a woman’s inability to eat normally and a general deterioration in her emotional state. All this together can really have some negative impact on the development of the fetus.

In addition, complicated caries also affects pregnancy in that with lesions, for example, periodontal disease, an inflammatory process occurs, which can affect the general physical condition of the expectant mother: lead to an increase in body temperature and the need to take antipyretic drugs, exacerbation of toxicosis, and disruptions in work digestive system.

But still, the main and most real danger of caries during pregnancy is the possibility of its transition to an acute form, severe damage to many teeth at once and the woman losing them in a fairly short time. In other words, tooth decay is usually more dangerous for the mother than for the fetus.

The same is true in the case of caries in a nursing mother. The only differences here are the reasons for refusing to visit the dentist: if a pregnant woman is often afraid that caries treatment will harm the unborn baby, then a nursing mother simply does not have 2-3 hours of time to go to the clinic.

Causes of caries development in pregnant women

Caries during pregnancy is largely due to the same reasons as in cases with other categories of patients: poor oral hygiene, an abundance of snacks during the day, a passion for sweets.

But for many women, additional reasons due to gestation come to the fore:

1. A decrease in the concentration of calcium and fluorine compounds both in saliva and in the blood due to some consumption of them for the needs of the developing embryo. Calcium is not consumed from the teeth themselves, as many people incorrectly believe. But the remineralization of enamel and its strengthening, which always occurs in other periods due to the action of saliva, can slow down or even stop during pregnancy. As a result, the enamel becomes weakly mineralized and is more easily damaged by acidic waste products of bacteria.
   
2. Hormonal changes in the body and, again, corresponding changes in the composition of saliva, which leads to a decrease in its bactericidal properties. Simply put, the saliva of pregnant women is in some cases less effective at destroying cariogenic bacteria.
3. Changes in diet – pregnant women can go to different extremes; they often develop strong cravings for sweets and starchy foods.
4. Improper dental care - due to fatigue, toxicosis, worries and fuss, some expectant mothers regularly forget to brush their teeth or do not do it thoroughly.

In addition, many pregnant women manage to hear a lot of statements from friends and relatives that it is impossible to treat teeth during pregnancy, and simply do not go for preventive examinations. And as a result, they miss the moment when the tooth could actually still be cured absolutely safely for the fetus.

Treatment of caries at different stages of pregnancy: is it dangerous and how is it carried out?

Caries during pregnancy is not only possible, but also absolutely necessary. Sometimes, due to the risk of acute development of the disease, timely treatment for some pregnant women is the only way to prevent it. Of course, the management of the disease itself must take into account the patient’s situation.

The main danger that arises when treating caries during pregnancy is the risk of exposure of anesthesia drugs to the fetus. All anesthetics are absorbed into the blood and can pass through the placenta, and some of them are quite capable of having an adverse effect on the developing embryo.

This is why, by the way, it is so important to see a dentist throughout pregnancy - if caries is detected at the earliest stages of its development, treatment can be carried out using remineralization methods without anesthesia, without a drill and without discomfort. But already advanced caries without anesthesia will be really painful to treat.

Often it is impossible to do without anesthesia when treating complications of caries: with pulpitis or periodontitis, this approach is unacceptable, since a pregnant woman may experience painful shock.

As a rule, dentists prefer not to treat moderate caries during pregnancy, especially if the pathology is chronic, until the beginning of the second trimester. It is in the first 12-13 weeks that the formation of all organ systems in the fetus occurs, and the risk of negative effects of medications on it during this period is maximum, although still small. Already starting from 14-15 weeks, the use of special anesthetic drugs allows for safe sanitation.

On a note

Dental X-rays are strictly not used during pregnancy. If the cavity is hidden from view, they try to resort to other methods. They even try not to study the quality of canal filling using x-rays.

Modern radiography using a visiograph has several times less radiation exposure. If there is an urgent need, it can only be done from the second trimester of pregnancy on this device.

Using local anesthesia, regardless of the stage of pregnancy, acute pulpitis, purulent periodontitis and periostitis are treated. When treating caries, even deep ones, the doctor begins treatment without the use of anesthesia and gives an injection only if the patient begins to feel pain when excision of carious areas of dentin.

Specially adapted drugs are used as painkillers for the treatment of pregnant women in dentistry, for example, Septanest and Scandonest at a dilution of 1:200,000. Pregnancy is not a contraindication for their use, and already 3 hours after the injection they are not detected in the blood.

Dentist's opinion:

Pregnancy is not a contraindication for other medications, judging by the instructions. The fact is that reducing the concentration of adrenaline, and in Scandonest - also preservatives, minimizes risks, but does not eliminate them. In any case, I observed on popular portals the position that articaine-type drugs are positioned as relatively safe for local anesthesia with relative risks, therefore they are taken in case of emergency, one of which is pain!

Towards the end of pregnancy, therapy is further complicated by the fact that when sitting in a dental chair, due to the specific position of the fetus, the load on the inferior vena cava and aorta increases, which leads to a decrease in pressure and possible loss of consciousness in the patient. To avoid this, the pregnant woman lies down in the chair slightly on her side, which reduces the load on the fetus. At the same time, the risk of teratogenic effects of anesthetics on the fetus becomes minimal by the end of pregnancy.

You can take painkillers yourself at home only if the pain is completely unbearable and it is impossible to see a doctor at the moment. If it comes to this, the doctor should see the tooth as early as possible. A good dentist will do everything possible to cure the mother’s tooth and not harm the unborn baby.

If you decide to take a painkiller yourself, then keep in mind that taking almost any drug in some cases may well have negative consequences. You can select “self-medication” in an individual case so that even a single dose of a strong painkiller will affect the health of the mother and fetus. Do not forget about individual intolerance and side effects for each drug, especially since painkillers have a whole range of them.

“At one time I went to a clinic where pregnant women did not have their teeth treated at all until the 20th week. Before pregnancy, I didn’t think about it, but when I came in the third month with initial caries, I was turned around. They said that I needed to walk around for another two months, and then they would treat me. This is a disgrace! At the spot stage, caries is treated without anesthesia and without any medications; nothing affects the fetus at all. And in two months they will open my tooth and put a filling, God forbid the nerves will be removed. I had to change the clinic, the tooth was cured, without a filling and without anesthesia. Now I’m already playing with my little one, but my tooth remains healthy.”

Anna, St. Petersburg

Prevention of caries and proper preparation for pregnancy

Prevention of caries in pregnant women should begin even before pregnancy. At the planning stage, the expectant mother should check with a dentist, heal all diseased teeth, and remove plaque and tartar. At this time, the doctor will draw up a schedule of preventive visits that will need to be followed (it is not known what the cariogenic situation in the mouth will be with the onset of pregnancy and fetal development).

On a note

The question is often asked: “Can pregnant women undergo professional hygiene?” There is a list of diseases for which ultrasonic (US) teeth cleaning and the Air Flow device are prohibited or not recommended: epilepsy, the presence of a pacemaker, nasal breathing disorders, asthma, acute chronic lung diseases, HIV and hepatitis, sexually transmitted diseases, high blood sugar or diabetes mellitus, acute respiratory viral infections, herpes and airborne diseases, malignant neoplasms.

Most often this is due to the aerosol that rises when brushing teeth from plaque and tartar. A cloud of wet dust and infection can cause respiratory failure in a pregnant woman, and high blood sugar can lead to the risk of prolonged bleeding from the gums during traumatic manipulation. In some cases, the possibility of carrying out manipulations in a pregnant woman can be determined with a related specialist (gynecologist, endocrinologist, therapist, ENT doctor, oncologist).

Directly during pregnancy, caries prevention requires:

1. Compliance with the rules of oral hygiene: teeth are brushed after each meal, preferably with pastes selected by the dentist; after random acts of vomiting due to toxicosis, the mouth is rinsed with a soda solution to neutralize acids from the vomit.
2. Compliance with the diet, restriction in the diet of sweet flour and chocolate products.
3. Compliance with all the dentist’s instructions - the use of systemic preventive measures, professional teeth cleaning, visiting the dentist for routine examinations, etc.

Practice shows that the correct one during pregnancy, although it should be systematic and regular, it usually does not present any difficulties. At the same time, it is the main guarantee that a woman will keep all her teeth in good condition during pregnancy and breastfeeding.

Interesting video: is it possible to treat teeth during pregnancy and what is important for every expectant mother to know?

Some more important nuances of caries treatment during pregnancy

During pregnancy, women experience many different changes in their bodies. Dental problems are also likely to occur, especially with a lack of vitamins, minerals and trace elements. Often pregnant women are diagnosed with inflammatory processes of the gums and pulp, as well as rapidly progressing caries. Carious disorders, in turn, cause discomfort and require prompt treatment. You will learn in this article whether caries during pregnancy poses a danger to the expectant mother and fetus, as well as how it can be properly treated at this stage.

Does caries affect the fetus?

Carious lesions, as a rule, are formed as a result of the action of pathogenic bacteria on mechanically damaged dental tissue. Theoretically, pathogens enter the bloodstream, which means they can be transmitted to the fetus in the womb. However, the likelihood of pathological disorders occurring in this case is quite small, since bacteria practically do not penetrate through the placental layer.

Remember that untreated cavities during pregnancy can harm the health of both mother and baby.

Statistics data:

• caries is diagnosed in more than ninety percent of pregnant patients. Read more about methods for diagnosing caries;
• in most cases, the problem is detected early, during the period of toxicosis;
• the average intensity of the violation is quite high - up to six and a half;
• In eighty percent of pregnant women, the enamel becomes thinner, which causes increased tooth sensitivity and formation.

Despite the low probability of causing direct harm to the health of the fetus, in case of caries, the general well-being and mood of the mother can affect the child’s condition due to pain in the teeth.

Causes of the disease

During pregnancy, women are much more susceptible to various bacterial disorders. Sometimes dental damage is associated with a lack of important nutritional components. However, other common causes and factors are also identified:

Diagnostic methods

As a rule, patients turn to the dentist when they experience constant pain and increased sensitivity of the teeth. However, it is sometimes possible to detect caries even with routine preventive care. In this case, diagnosis is carried out in two stages:

1. External examination of the oral cavity and anamnesis. The patient's lifestyle and medical history are also taken into account.
2. X-ray of the jaw. X-rays were previously not recommended for pregnant women due to risks to the health of the fetus. Today, modern equipment and precautions are used to allow the necessary research to be carried out.

First aid for acute pain

If acute pain occurs and it is impossible to immediately visit a doctor, you can take medications based on paracetamol (in strictly limited dosages). Among them:

• Paracetamol;
• Efferalgan;
• Panadol.

In addition, it is useful to take the following measures:

• rinse your mouth with a strong soda or saline solution;
• wrap a clove of garlic in a gauze napkin and apply it to your wrist;
• rinse the mouth with infusions of medicinal herbs (chamomile, calendula, sage);
• apply a cut aloe leaf to the affected tooth;
• Apply a thin slice of lard to the tooth. See details about caries treatment at home.

Pregnancy involves strict restrictions on the use of medications. Therefore, it is not recommended to use any painkillers without your doctor's permission.

Treatment

Some women mistakenly believe that treating caries during pregnancy can have a detrimental effect on the unborn child. However, in reality, greater harm is possible in the absence of professional therapy.

For what periods is it permissible?

Theoretically, dental treatment is permissible for almost any period. However, there are some limitations and nuances that are important to consider. The first trimester can be considered the most unfavorable period for therapy, since this can negatively affect the condition of the embryo. In addition, the use of medications is contraindicated at this time, so it is better to postpone therapy if possible.

In the second trimester, elimination of neglected problems is possible. In this case, the safest medications will be used to eliminate the lesion. However, if possible, it is better to limit yourself to remineralization or icon technology, which does not require the use of anesthesia. Read more about the icon caries treatment method.

Remineralization allows you to get rid of caries in the early stages. If the lesion is deeper, then invasive treatment cannot be avoided.

At the last stage of pregnancy, oral diseases do not pose a danger to the fetus, but potent medications can cause premature birth. In addition, at this time it is not recommended for a woman to take a reclining position for a long time, as required by therapy in the dental office.

The treatment itself is safe at any time. Most painkillers used for anesthesia are harmful to the fetus.

Methods of influence

Medicines in the form of sprays and gels are used as anesthetics, which have a local analgesic effect and do not penetrate the bloodstream.

Prevention of caries in preparation for pregnancy

It is recommended to carry out preventive and therapeutic measures with the oral cavity even during pregnancy planning. To prevent toothache from bothering you during pregnancy, you must:

During toxicosis after vomiting, you should not immediately brush your teeth. It is important to wait about half an hour before the procedure. This will help avoid damage to the enamel.

Video

For more details on dental treatment during pregnancy, watch the video.

The pregnancy period always prepares many unwanted surprises for expectant mothers. Month after month, women's hormonal levels change, mineral reserves are depleted, and their immunity weakens. And these are just a few possible reasons for problems in the oral cavity. But this is not the end of the world, as most pregnant women claim, citing the ban on painkillers. This is just a reason to devote a few free hours to your loved one and your health. Moreover, treating teeth is now a pleasure compared to the level of dentistry 10 years ago. True, pregnant women need an individual approach to dental treatment, but everything is not as scary as it seems. Let's look together for answers to the question: “Are teeth treated during pregnancy?”

For some reason, pregnant women consider visiting the dentist as something superfluous and unimportant. For the entire 9 months, they run around the clinic offices and take many tests for the well-being of their child, and put off taking care of their health until later. What's the end result? Even a small problem that could take 15 minutes to solve at the dentist can lead to tooth extraction and chronic periodontal disease by the end of pregnancy.

A woman should clearly understand that there are three good reasons why she needs to see a doctor:

1. Hormonal changes in the body contribute to pathological processes in the oral cavity.
2. A lack of calcium, especially in the 2nd and 3rd trimester, can easily destroy even the healthiest teeth. Modern dental technologies help many women in this situation to keep their teeth in excellent condition.
3. During pregnancy, the properties of saliva change: it loses its disinfecting abilities, and pathogenic microbes begin to multiply in the mouth. Also, the pH level of saliva changes and the enamel is destroyed.

Advice! Don’t consider bad teeth during pregnancy to be a small problem that will resolve itself. It is better to do a preventive examination rather than get lost in guesswork and worries. Contact only specialists who have experience in treating teeth for pregnant women. Will they know when, how and with what treatment can be carried out?

Is it possible to treat teeth during pregnancy?

Many women, when going to the dentist, ask the same question: “Are teeth treated during pregnancy?” Everyone would like to hear the word “no” and postpone this procedure as far as possible. But dental treatment during pregnancy is the responsibility of every expectant mother who takes care of herself and her baby. You, of course, ask, what does the fruit have to do with it? The fact is that inflammatory processes in the oral cavity may not affect the development of the fetus in the best way. Even a simple carious tooth, which does not bother a woman, serves as a source of microorganisms that enter the stomach and provoke late toxicosis. Just imagine how quickly the infection will spread throughout the mother’s body if the purulent focus is in the root area of ​​the tooth? Or will severe gingivitis be passed on to an already born child through a mother’s kiss? There are many options here, and not all of them are harmless.

Normally, a woman has 2% calcium in her body. Very often during pregnancy she does not receive enough of this mineral from her diet or she has problems with metabolism and calcium is not absorbed. In this case, the holes in the teeth will be accompanied by night cramps in the limbs, and the risk of postpartum hemorrhage will double. In addition, the newborn baby will have a risk of allergic reactions and rickets. Therefore, a preventive examination by the dentist should be carried out every trimester.

Some statistics...

45% of pregnant women come into contact with a problem such as gingivitis. Their gums swell and bleed, discomfort and bad breath appear. For most of them, these problems go away on their own after childbirth if they followed the recommendations of specialists.

Suitable pregnancy strings for dental treatment

We are already convinced that it is possible to treat teeth during pregnancy. But when is the best time to do this? If a critical moment comes, then you need to go to the dentist immediately for help. If time permits, then treatment is carried out in the period from 14 to 20 weeks of pregnancy, that is, in the second trimester. Starting from 14-15 weeks, the fetus is already protected by the placental barrier. At this stage of pregnancy, the use of anesthetics with minimal adrenaline or radiography (in extreme cases) is allowed. In the first trimester, the embryo is just forming and organs and systems are being laid down, so the use of anesthesia and any drugs is contraindicated. After 20-24 weeks, it is physically quite difficult for a woman to undergo such an event as dental treatment.

On a note! In the 3rd trimester, the fetus puts strong pressure on the aorta. If a woman has to undergo dental treatment, then her position in the chair should be special. To prevent fainting or a drop in blood pressure, a woman needs to lie on her left side.

Diseases that can and should be treated during pregnancy

If it so happens that you need dental treatment during pregnancy, firstly, don’t worry, and secondly, tell the doctor what week of pregnancy you are, about its progress and about taking medications, if you are taking them. This will help the doctor choose the optimal and safe treatment tactics.

Advice! Careful hygiene using fluoride-containing toothpastes without the effect of whitening will help protect teeth during early pregnancy.

If you have caries...

Caries is a common hole in a tooth. At the stage of its occurrence, caries can be easily treated and does not require pain medication. If the process is started, the destruction of dental tissue will reach the pulp and removal of the nerve and more stringent treatment will be required. The only limitation is arsenic. Its use is unacceptable. And there are no restrictions in the choice of fillings. You can fill your teeth with both chemical fillings and light-curing fillings using ultraviolet lamps.

Important! Toothpastes with fragrances and flavoring additives can provoke attacks of toxicosis. Repeated vomiting increases the acidity of saliva and causes destruction of enamel.

If you have gingivitis or stomatitis...

Gingivitis in pregnant women is a hypertrophied enlargement of the gums under the influence of hormonal imbalances in preparation for childbirth. The gum tissue becomes easily inflamed and can completely cover the dental crowns. With this condition of the oral cavity, a woman is simply unable to maintain hygiene and needs professional help. Self-medication with home remedies will only worsen the disease and it will end in a complex form of periodontitis. According to the results of recent studies, women with exacerbation of severe forms of periodontitis during pregnancy experienced premature birth and some pathological conditions in newborns.

A timely visit to the doctor will ease your painful condition with gingivitis and protect your baby from exposure to toxins. The doctor will prescribe treatment of the gums with an antiseptic, rinses and applications to relieve inflammation, and conduct professional oral hygiene.

Due to weakened immunity, women often experience stomatitis in the oral cavity. Small ulcerative lesions cause severe pain and swelling. This disease does not pose any particular danger, but it won’t hurt to go to the doctor. He will advise you on a spray that is appropriate during pregnancy.

If you have periodontitis or pulpitis...

Inflammation of the nerve (pulpitis) and around the root dental tissues (periodontitis) is a consequence of untreated caries. The treatment of such diseases already requires the use of an anesthetic, and in order to properly fill the dental canals, you will have to take an x-ray. Modern radiovisiographic devices irradiate 10-15 times less than their ancestors. In addition, a lead apron will protect the baby from radiation.

If you suffer from tartar...

During pregnancy, both teeth and tartar create many difficulties. Plaque and tartar can cause gums to bleed and encourage the proliferation of “bad” microorganisms. This procedure does not involve pain and is performed using ultrasound or special instruments.

What anesthesia can be used during pregnancy?

There is still a myth circulating among pregnant women that if a tooth hurts during pregnancy, it will have to be treated without anesthesia. This forces frightened women to go to the dentist on weak legs, expecting terrible pain in the dental chair. And only when they see a doctor, they learn that a new generation of painkillers is actively used in practice to treat pregnant women.

Anesthetics based on articaine and mepivacaine (“Ultracaine”) contain a minimal amount of vasoconstrictor components and have a purely local effect, without passing through the placenta to the child. Therefore, suffering from toothache causes much more severe damage to your child than dental anesthesia during pregnancy.

On a note! General anesthesia is contraindicated during pregnancy.

X-ray during pregnancy: is it acceptable?

Not every doctor will be able to “blindly” fill a crooked canal or diagnose a cyst or hidden caries. This will require an x-ray. It is allowed only after the 12th week of pregnancy.

How to do X-rays for pregnant women:

1. She is covered with a lead blanket.
2. Determine the appropriate exposure and use Class E film.
3. All necessary photographs are taken simultaneously.

It is important to know!

It is preferable to go to a clinic where there are modern devices with microdoses close to the normal background radiation.

Removal and prosthetics of teeth during pregnancy

The need for tooth extraction during pregnancy is rare, but it does occur if you have neglected your tooth and caries has completely affected it. The process is absolutely safe for pregnancy, except for the patient’s anxiety. After tooth extraction during pregnancy, you should avoid hypothermia or overheating of the damaged area of ​​the gum.

Prosthetics are considered acceptable during pregnancy, especially if the woman feels great and initiates it herself. If necessary, it is allowed to install braces.

Interesting!

Dental caries is diagnosed in 91.4% of women with normal pregnancy.

Severe tooth sensitivity (enamel hyperesthesia) is observed in 79% of pregnant women.

Which procedures are best postponed?

1. Implantation. Engraftment of new implants involves the use of medications, antibiotics and additional forces of the female body. This procedure is not recommended for pregnant women.
2. Removal of wisdom teeth during pregnancy. This is a complex surgical procedure, after which it is possible to increase the temperature and take antibiotics. If the situation is not critical, then you can remove the tooth after pregnancy.
3. Teeth whitening. The chemical components in the bleaching liquid penetrate the placental barrier and have a toxic effect on the fetus. In addition, whitening destroys enamel and increases the risk of dental diseases.

What are the dangers for a baby from a mother’s bad teeth?

1. Psychotraumatic factor. Toothache negatively affects the female body and at the same time the condition of the child.
2. Infection. Various pathogenic microorganisms can cause all sorts of complications in a child.
3. Intoxication and inflammation. Periodontal damage causes poor health, high fever, toxicosis, and digestive system disorders. This threatens late gestosis for the mother and hypoxia for the fetus.

What drugs should not be used during pregnancy?

Before you are given an anesthetic injection and asked to make an application, ask what drug will be used.

1. Lidocaine is a chemical for local anesthesia. Causes convulsions, dizziness, weakness and decreased blood pressure.
2. Sodium fluoride is a remedy for the treatment of caries. Used to strengthen tooth enamel. In high concentrations, it negatively affects the heart rate and fetal development.
3. Imudon is a drug for the treatment of inflammatory diseases of the oral cavity. The negative factor is unknown since no studies have been conducted.

We carry out doctor's orders

Even if all the teeth are healthy and there is no hint of even the most harmless gingivitis, all pregnant women are simply obliged to visit the dentist when registering to receive valuable recommendations:

1. The ideal option is to treat your teeth at the stage of pregnancy planning.
2. Get regular check-ups with your dentist.
3. Maintain oral hygiene: dental floss, mouthwash, soft toothbrushes and high-quality toothpastes.
4. Adjust the menu so that it contains a sufficient amount of calcium.
5. If you suffer from toxicosis, be sure to rinse your mouth with soda solution after vomiting.
6. To prevent gingivitis, rinse your mouth with a herbal decoction of chamomile, oregano, mint and St. John's wort.

Women must responsibly prepare for such a happy period in their lives as pregnancy. But, if for some reason it was not possible to prepare your teeth and health in general in advance, then come to the dentist for help as early as possible and remember that treatment should be carried out at 4, 5 and 6 months of pregnancy.

Special reasons during pregnancy are associated with gestation:

• Decreased calcium and fluoride levels in saliva and blood. Some of these microelements are spent on the developing embryo. Calcium from teeth is not used for the development of the unborn child, contrary to popular misconception. However, the remineralization and strengthening of enamel, which occurs due to the properties of saliva, slows down or stops during pregnancy. Weakened enamel becomes easily damaged and vulnerable to oral diseases, incl. caries.
• Hormonal changes. They lead to changes in the composition of a pregnant woman's saliva. The result of such processes is a decrease in the bactericidal properties of saliva. Bacteria that contribute to the appearance and development of caries become less vulnerable.
• Diet changes. Often, expectant mothers abuse sweet, salty, and flour foods.
• Toxicosis. Hydrochloric acid contained in vomit contributes to the destruction of enamel.
• Failure to attend preventive examinations. The widespread belief that dental treatment is undesirable during pregnancy leads to advanced oral diseases.

During pregnancy, teeth are most susceptible to caries

Why is it dangerous?

• Premature birth;
• Small birth weight.

Contribute to these phenomena cariogenic bacterium Actinomyces naeslundii. They provoke the production of substances that cause contraction of the uterus and dilation of the cervical canal - anti-inflammatory cytokines. The expansion of the cervical canal is accompanied by the destruction of the membranes. These processes lead to premature birth.

Harm from caries complications

Tooth decay can harm your unborn baby

Complications that accompany advanced caries can also cause harm to the unborn child. The affected area reaches the neurovascular portion of the tooth, as a result of which pulpitis or periodontitis may develop. Inflammation of the dental pulp and the development of a purulent focus of inflammation in the area of ​​the root apex leads to the release of toxins. They enter the blood and are carried throughout the body. This may entail:

• Temperature increase body (the need to take antipyretics);
• Exacerbation toxicosis;
• Crashes in the operation of the system digestion.

Toothache, which occurs with pulpitis and periodontitis, - traumatic psychological factor for the woman's body. Painful sensations can cause changes in some systems and organs of an ordinary person. Such phenomena will affect the developing embryo.

How to relieve toothache

You should resort to self-treatment only as a last resort!

The first step is to carefully examine the tooth. If there are food particles left in the hole, they must be carefully removed with tweezers or a toothpick. After this, you need to brush your teeth and rinse your mouth. You can rinse with a decoction or infusion of medicinal herbs or a solution of soda and salt.

The most reasonable solution in such a situation is to consult a dentist. If it is not possible to make an immediate visit, you can use medicines or folk remedies. Folk remedies are considered safer.

Folk remedies

• Rinse a decoction of sage, chamomile, plantain, St. John's wort, calendula with salt or soda;
• Table carnation(seasoning). The powder should be sprinkled on the inflamed gum.
• Garlic. It must be peeled, finely chopped and wrapped in a bandage or gauze. The result is applied to the wrist, where the pulse is felt.
• plantain leaf. The leaf must first be squeezed to release the juice. After this, roll it into a flagellum and place it in the ear (you need to take into account the location of the source of pain). You can also thoroughly wash, chop and squeeze fresh leaves of the medicinal plant, and then rub the juice on your gums every two hours. You can rinse your mouth with two tablespoons of juice diluted with a glass of boiled water.
• Aloe, Kalanchoe, Pelargonium. A leaf of one of these plants can be applied to the inflamed gum.
• Lard. The product is cleared of salt, if required. The slice is placed between the tooth and cheek. After 15-20 minutes the pain should stop.

At home

Medicines that can relieve toothache during pregnancy:

No-shpa - effective and safe

• No-shpa;
• Drotaverine (analogue of No-shpa);
• Grippostad (cautious use in the first trimester of pregnancy is acceptable);
• Paracetamol (will help with mild pain);
• Tempalgin (half a tablet);
• Pentalgin (half a tablet);
• Kalgel (apply to the inflamed gum);
• Ketanov;
• Nurofen;
• Ibuprofen ( prohibited for use in the 3rd trimester).

Accept more than one tablet any of these medications is strictly prohibited. You can place a cotton ball in the hole of the tooth (if there is one). The material can be moistened in advance with dental drops, clove or mint oil. When taking any medications, remember several rules and characteristics of the body during pregnancy:

• More than anything the fetus is vulnerable in the first trimester. After the third month, the embryo is protected by the placenta, which weakens the effect of medications on it.
• We must always remember dosage.
• The use of medicines is only permissible if emergency.
• Rinse with cold water absolutely forbidden.

Treatment - dangers and consequences if left untreated

If you start caries, you can lose your teeth (not all of them, of course). In addition, carious processes will negatively affect the child. It is better to treat caries immediately, while it is safe for the child and mother.

Features of treatment

Features of treatment in pregnant women

Treatment begins with anamnesis collection. The duration of pregnancy plays an important role, which will be discussed a little later. The dentist carefully examines the history of past pregnancies (if any) and associated diseases (hypertension, eclampsia, diabetes, etc.). Often the patient should consult with an obstetrician-gynecologist. This allows you to fully assess the risk of complications after dental treatment.

The carious process during pregnancy occurs rapidly. If you ignore it at the chalk stain stage, you risk losing the tooth. Usually they manage to catch caries at the middle stage, but it is more difficult to treat. The dentist selects a treatment method according to the patient’s body and age. Most often this is excision of the carious area and filling. Complicated caries is very difficult to cure; this is done under local anesthesia.

Is it possible to treat?

It is possible and necessary. Each trimester is assigned its own type of medical action.

1st trimester

Conventionally divided into two periods:

• From the moment of fertilization until the implantation of the egg. This time is unfavorable for dental treatment. The embryo is extremely sensitive to the effects of various drugs, stress and toxins. High risk of miscarriage.
• From the 18th day - the beginning of the formation of organs and tissues of the embryo. This period is characterized by frequent fainting, nausea, vomiting, heartburn, increased salivation, and an increased gag reflex. It is not advisable to carry out treatment at this time, as this may affect the developing fetus.

At 6-7 weeks, the baby begins to develop the rudiments of temporary teeth. Treatment procedures can disrupt this process, which will further lead to trouble. Problems may also arise later in the 1st trimester. It is impossible to treat caries during the 1st trimester. During this period, an exception is made only for emergency cases accompanied by suppuration and acute pain. Such cases are considered:

• Pulpitis;
• Exacerbation of chronic periodontitis.

2nd trimester

"Fruit" period. At this time, the embryo grows rapidly. The risk of negative consequences of dental treatment is reduced, but remember the toxicity of medications (anesthesia, antibacterial agents).

At this time it is necessary to carry out prevention diseases of the oral cavity. At this stage of pregnancy, they treat teeth where caries may worsen in the third trimester. Sometimes the dentist decides to leave dental treatment for the postpartum period if there are no possible areas of exacerbation.

3rd trimester

In the 3rd trimester, treatment is indicated only in urgent cases

During this period, the weight of the unborn child increases. Along with it, the pressure on the aorta and inferior vena cava increases. This leads to a woman’s rapid heartbeat, rapid decrease in blood pressure, and loss of consciousness. This is an important factor, since patients are reclining during dental treatment.

The sensitivity of the uterus to the influences of the external world increases in the later stages, which can even cause premature birth. Also, this period is accompanied by increasing anxiety and fatigue of the woman, which can also affect the treatment. Medical intervention at such times is advisable only in urgent cases. The expectant mother on the chair should be positioned slightly on her left side (the angle is about 15 degrees) to reduce the pressure of the fetus on the inferior vena cava and aorta.

Pain relief, anesthesia, anesthesia: can it be used?

Local anesthesia is used to treat complications of caries (periodontitis, pulpitis, etc.). Sometimes injections of anesthetic drugs are given for acute pain that occurs during treatment. To treat caries painlessly, you need to visit the dentist regularly. General anesthesia is contraindicated for pregnant women!

At 14-15 weeks, the use of special anesthetic drugs is allowed. For pain relief the following are used:

• Ultracaine;
• Septanest;
• Ubistezin;
• Scandonest.

X-ray

As a diagnostic method contraindicated during pregnancy. An alternative is films and sensors that are ultra-sensitive. They require ten times less X-ray radiation than conventional films. Also used protective equipment (lead apron). Sometimes x-rays are still used in emergency situations, but this is not a recommended procedure. It is strictly forbidden to use radiography in the 1st trimester.

How caries affects fetal development

Chronic inflammation in the oral cavity can lead to:

• The occurrence of intrauterine infection;
• Delayed fetal development;
• I will have a miscarriage;
• Premature birth.

Treatment of caries in a pregnant woman is carried out extremely carefully. Pain and discomfort (with acute complications of the disease) can harm the unborn child. The fetus is harmed by any infectious focus in the oral cavity, because toxins directly affect it (the fetus).

Tooth decay due to breastfeeding

From night feedings

This practice can cause caries in the baby. Doctors recommend stop night feedings after six months, as this often leads to the development of early caries. Caries in a mother can also occur during lactation.

Features of treatment

A contraindication to the treatment of caries for a breastfeeding mother can only be severe stress or fatigue. Before a dental procedure you need feed the baby and express milk for next time (preferably). All drugs will be eliminated from the body after 3-6 hours. After treatment, you need to express the milk and pour it out. After this, you can safely continue breastfeeding your baby.

X-rays during breastfeeding are not prohibited, but the use of protective equipment is mandatory. If filling the mother's teeth is safe for the child, then taking antibiotics precludes breastfeeding. Also, dental implantation cannot be performed during lactation.

Possibility of using anesthesia

Pain relief during breastfeeding is relatively safe. For pain relief during breastfeeding, mepivacaine, lidocaine, and ultracaine are used.

Caries and childbirth

Caries can negatively affect the birth of a child. This could be premature birth or miscarriage. Also, intrauterine infections caused by caries will affect the health of the unborn baby.

Prevention of caries in pregnant women

• Preliminary dental treatment. Planning a pregnancy includes visiting the dentist. It is better to treat your teeth right away than to put yourself and your baby at risk during pregnancy.
• Careful oral hygiene. You should brush your teeth (avoid horizontal movements) after eating and use dental floss. You can also use an irrigator to rinse hard-to-reach parts of the mouth.
• Do not brush your teeth immediately after vomiting. It is necessary to rinse your mouth with a solution of baking soda, then you can brush your teeth. Brushing your teeth is possible no earlier than half an hour later.
• Diet control. You should reduce the number of snacks and consumption of sugary foods. You also need to eat foods rich in vitamins and microelements (cottage cheese, spinach, etc.).
• Regular visits to the dentist. The doctor carries out a complex to protect teeth from caries. This includes professional teeth cleaning, gum massage, and preventive examinations.

FAQ

Can there be a miscarriage due to caries?

Yes maybe.

Is it possible to get pregnant with dental caries?

Of course. But it is better to cure caries first so that no problems arise.

Can caries cause a missed abortion?

Yes, severe forms of caries can cause this phenomenon.

Is tooth decay transmitted from mother to child?

It's possible. If a mother with caries uses a cutlery to eat and then feeds her child using the same utensil, the child may also develop caries.

Wisdom tooth caries during pregnancy - treat or remove?

At the first signs of an illness, you should contact your dentist. If wisdom tooth caries is caught at an early stage, it is possible to get by with treating the pocket using special liquid preparations. This will allow surgery to be postponed until an appropriate time. In another case, excision of the hood is performed. To avoid complications, you need to consult a doctor in time.