Dental treatment

Pregnancy is a physiological process, and therefore this condition is not a contraindication for dental treatment. On the contrary, oral health during this period of a woman’s life is very important, since not only the outcome of pregnancy, but also the health of the unborn child depends on it. But for pregnant patients, adjustments to the timing and type of dental care, as well as prescribed medications, are required.

Poor oral health can lead to premature birth and intrauterine infection of the fetus.

Dental treatment during pregnancy

The dentist should consider the following:

1. 
   
2. There is an increased risk of fetal teratogenicity due to certain medications;
   
3. Susceptibility to hypotensive syndrome in the supine position as a result of decreased blood pressure and cardiac output;
   
4. Potential danger of developing disseminated vascular coagulopathy due to an increase in blood clotting factors.
   

Physiological changes in the expectant mother's body include changes in the oral cavity with a concomitant increase in susceptibility to oral infections.

In addition, increased carbohydrate intake, increased oral acid due to vomiting and decreased saliva production and increased acidity of saliva increase the risk of tooth decay.

Changes in its physicochemical composition include a decrease in sodium and pH, an increase in the level of potassium, protein and estrogen. An increase in the hormone estrogen in saliva, as well as active proliferation and desquamation of mucosal cells are an ideal environment for the growth of pathogenic bacteria.

Frequent vomiting, which occurs in the first trimester, can contribute to the development of an acidic environment, leading to the growth of caries pathogens, as well as acidic demineralization of tooth enamel. Pregnant women should brush their teeth, rinse their mouth with water, and use antacids more often.

Typically, pregnant patients are not immunocompromised; however, there is a decrease in cellular immunity as well as natural killer cell activity. Increased hormone levels in pregnant women cause the gums to swell and bleed, and food debris accumulates in them, causing increased irritation of the oral mucosa. Regular warm salt baths can help relieve irritation (1 teaspoon salt to 1 glass of water).

Women with carious lesions have large numbers of Streptococcus mutants in their saliva, which can be easily transmitted to their infants after birth.

Periodontal diseases are bacterial infections of the gums, characterized by acute and chronic inflammatory changes and loss of bone support to the teeth. In order not to provoke the development of periodontal diseases while bearing a child, dentists recommend removing tartar and plaque and undergoing a professional hygiene procedure.

In the first trimester, the baby’s organs and systems are formed, and therefore the fetus is most susceptible to external and internal factors. All problems with teeth and gums that arise before 15-16 weeks should be postponed if possible, since the placenta has not yet formed and the baby is defenseless.

Dental treatment It is best performed in the safest time - the second trimester and the first half of the third trimester. During this period, periodontal disease therapy and preventive measures may be carried out, as well as simple restorative procedures that eliminate potential problems and control active disease. After 16-20 weeks, nausea subsides, and the size of the abdomen is not yet very large, so dental treatment takes place without any problems. In the second half of the third trimester, it is uncomfortable for a woman to sit or lie in a chair for a long time.

If dental treatment requires an x-ray examination, then the expectant mother must wear a lead apron and separately protect the thyroid gland, which produces hormones that promote gestation. Modern X-ray machines have a lower radiation dose than their ancestors, but X-rays should be minimized and only performed in the most extreme cases.

Dental treatment for a pregnant woman is carried out with local anesthesia, and anesthetics should contain a minimum amount of adrenaline. If pulpitis has developed, then to relieve pain, analgesics are prescribed in a very short course.