Dental treatment during pregnancy. Is anesthesia really necessary? Is anesthesia necessary - what to do with anesthesia

Dental treatment for pregnant women is not only possible, but necessary. You cannot tolerate toothache; it is a huge stress for both the woman’s body and the baby. In addition, hidden foci of infection in the mouth can lead to infection of the fetus. Therefore, you should not put off visiting the dentist.

Features of dental treatment for pregnant women

Pregnancy is not absolute contraindication for any dental procedures. However, the patient must warn the doctor about her situation, and also indicate the exact duration of pregnancy.

Main nuances of therapy:

• during pregnancy, caries, pulpitis, periodontitis and inflammatory diseases gums (gingivitis, periodontitis, stomatitis);
• To fill a tooth, you can use both chemically curing materials and light-curing composites; photopolymer lamps are safe for the fetus;
• enamel bleaching is prohibited;
• dental treatment is carried out under local anesthesia (injection of Ultracaine, Articaine), it must not be allowed expectant mother endured terrible pain in the dentist's office;
• General anesthesia is strictly contraindicated.

Early and late dental treatment

The entire period of pregnancy is conventionally divided into 3 periods (trimesters).

First trimester (up to 12 weeks)

In the 1st trimester (the earliest period) the laying of all vital important organs child. The placenta is just beginning to form; it cannot yet protect the fetus from negative influence. Therefore, it is not advisable to carry out any medical intervention. However, the dentist may prescribe local drugs to relieve inflammation (Chlorhexidine, Miramistin, Cholisal).

Second trimester (approximately 13 to 24 weeks)

In the second trimester, the risk of dangers decreases significantly. The placenta serves as a reliable protective barrier for the baby. This is the optimal period for dental treatment and other dental procedures.

Third trimester (from 25 weeks to delivery)

In the 3rd trimester it occurs increased sensitivity uterus to drug effects. In addition, during this period the woman’s body is quite weakened. Therefore, “extra” stress in the dentist’s office is extremely undesirable. If possible, it is better to postpone dental treatment during lactation. However, this does not apply emergency cases, for example, acute toothache.

Dental diagnostics during pregnancy

Treatment of pulpitis and tooth extraction during pregnancy cannot be done without diagnosis. Traditional radiography (sight X-ray) - not the most the best option for pregnant patients. Fetal cells are in the process of dividing, so they are especially sensitive to radiation.

But if there is a need for such diagnostics, it is better to carry it out in the second trimester. Be sure to cover your stomach and pelvic area with a protective lead apron.

Most safe option for women during pregnancy - this is digital radiovisiography. This method is characterized by minimal radiation exposure - 90% less compared to film X-rays.

Anesthetics are used local action that do not cross the placental barrier. Another requirement for painkillers is low degree effects on blood vessels.

Lidocaine is not suitable for expectant mothers as this drug may cause muscle weakness, seizures and sharp decline pressure.

The best option is anesthetics based on anticaine:

These drugs do not harm the baby because they act locally. They also have a reduced concentration of vasoconstrictor components (adrenaline, etc.), which is safe for the mother.

Tooth extraction during pregnancy

Tooth extraction is a surgical operation that is always accompanied by psycho-emotional stress. Of course, it is undesirable for women while carrying a child.

Therefore, tooth extraction is carried out only in extreme cases:

• crown or root fracture;
• deep carious lesion, which becomes the cause purulent inflammation;
• formation of a cyst whose diameter exceeds 1 cm;
• incessant sharp pain which cannot be eliminated with conservative therapy.

Wisdom teeth removal is generally not performed during pregnancy. This operation often ends with alveolitis (inflammation of the socket) and other complications requiring antibiotics.

Implantation and dental prosthetics during pregnancy

During pregnancy, you can have any type of prosthesis, including crowns and bridges. The exception is dental implants.

Implanting a dental implant often requires a lot of vital energy. But during pregnancy, all resources are aimed at developing a healthy baby.

In addition, after implantation, anti-inflammatory and painkillers are required, which are contraindicated for the expectant mother.

Dental treatment during pregnancy can be done absolutely free if you use compulsory medical insurance policy. List of all government agencies, as well as private dentistry you will find on our website.

There are many myths about whether pregnant women can have their teeth treated. Of course, dental treatment is an unpleasant process, and many even in normal times refuse to visit the dentist, let alone during the period of pregnancy. Women are ready to sacrifice their own teeth, but under no circumstances undergo treatment. This is primarily due to the widespread belief that during pregnancy it is forbidden to visit the dentist, much less use anesthesia.

Is it possible to treat teeth during pregnancy?

It is not only possible, but also necessary to treat teeth during pregnancy. And it's not even a matter of painful sensations. The main problem is that caries or any other disease becomes the first source of infection in the oral cavity. Any pathogenic microflora in a woman’s body during pregnancy is very dangerous, especially in the first trimester, when the risk of losing the fetus is highest. That is why, if caries or other ailment is detected in the oral cavity, it is necessary to urgently consult a doctor and eliminate the potential danger to the baby as quickly as possible.

In addition, it should also be taken into account that an infection in the mother’s mouth can negatively affect the newborn baby. Since the child is constantly close to the mother, she constantly kisses him and has close contact with him, harmful microorganisms can be transmitted to the baby. Children's immunity is not ready to resist certain types of pathogenic microflora, and therefore such an effect on a not yet strong organism can lead to serious complications.

Can pregnant women have their teeth treated with anesthesia?

It is possible, and in some cases even necessary, to treat a woman’s teeth with painkillers during pregnancy. Everyone knows that some dental procedures, especially tooth extractions, entail severe pain. It is not recommended for a pregnant woman to endure such severe stress, both in the second trimester and in the third trimester. As for anesthesia, no doctor will treat teeth under anesthesia for a pregnant woman. This is due to the high risk of developing pathological conditions fetus General anesthesia is used only in cases where such a risk is justified, for example, if the life of the expectant mother directly depends on its use.

Pregnant women can have their teeth treated with an injection. In this case, it is best to use means for local anesthesia latest generation. Such drugs act exactly at the injection site without spreading to nearby areas. In addition, even if the anesthetic substance enters the woman’s blood, active ingredients the drug does not reach the fetus because it does not pass the placental barrier.

Is it possible for a pregnant woman to have a dental x-ray?

All women know that x-ray radiation is very harmful both for the body of the expectant mother and for the fetus. However, in the case when X-rays are prescribed by a dentist, there is no need to worry about this, since a dental X-ray is significantly different from the usual format for such a procedure.

During radiography of a tooth, the radiation is point-specific, aimed strictly at the right tooth. At the same time, the neck and rib cage The expectant mother is covered with a special lead apron, which protects her from harmful radiation. Such a procedure cannot in any way affect the health of the woman or fetus, but it can significantly help the dentist provide quality treatment.

How is dental treatment performed for pregnant women?

Of course, in general, the dental treatment procedure for pregnant women is no different. The dentist performs the same operations that are performed on other patients, depending on the disease. However, the dentist must take a responsible approach to dental treatment for a pregnant woman, since the patient’s special condition requires the use of only approved in this case medicines. It is also important before starting treatment to question the woman in detail about the presence of any allergic reactions and intolerance to any drugs.

In addition to correctly selected therapy, medications and treatment methods, the doctor must be able to calm the patient and put her in a positive mood. A woman who is pregnant tends to experience some anxiety, agitation and increased worry, especially regarding her health. Therefore, in order to avoid increased stress for the patient, it is necessary to explain to her in detail the need for all procedures and medications, and also calmly tell her that all medications are absolutely safe.

Can pregnant women have their teeth removed?

The most suitable option for dental treatment for pregnant women is to remove the affected area of ​​the tooth and install a filling. In this case, tooth extraction is not required; the dentist simply drills out the affected area bone tissue and fills the free surface filling material. There is no point in worrying in such a situation, since modern materials for filling teeth do not have any effect on the body of the mother and her unborn child. Therefore, it is better not to let dental diseases progress, but to treat them in time.

If the disease does affect the tooth completely, then in most cases the doctor decides to remove the tooth so that the inflammation does not spread to healthy teeth. True, dentists reserve this procedure for extreme case and at the slightest opportunity they try to save the damaged tooth. If you still cannot do without removal, the dentist will also use products for local anesthesia from latest developments, since they are the safest.

The situation with the removal of wisdom teeth is more complicated. This procedure very painful, especially if part of the tooth is covered by gum. This procedure takes a long time and can cause many complications. That is why dentists recommend leaving the removal of wisdom teeth for the postpartum period. You should resort to this procedure during pregnancy only in the most extreme situations.

The procedure for inserting teeth into a woman during pregnancy raises many questions. In this case, if the gum on which there is no tooth is absolutely healthy and does not cause any discomfort to the woman, doctors recommend postponing the installation of teeth. The fact is that the absence of teeth cannot harm the child’s body, but after their insertion complications may arise, so it is best to postpone this procedure.

In which trimester is it better to treat teeth?

As you know, the entire process of bearing a child is conventionally divided into three periods - trimesters. The first trimester is the most dangerous period for the fetus, since it is at this time that all the main systems and organs of the unborn child are formed. Any intervention in the mother’s body can significantly affect this process and provoke the appearance of serious pathologies in the baby's body.

The third trimester also requires increased attention. During this period, the child’s body is already practically formed. Any negative impact or the intervention may cause premature birth Therefore, it is not recommended to carry out any procedures during this period. If possible, it is better to treat your teeth during the second trimester.

How to save teeth for a pregnant woman?

During pregnancy, many processes begin to proceed differently than before. All pregnant women note that while carrying a child, teeth often begin to crumble and nails break. This is primarily due to the fact that most of the calcium goes into the body of the unborn child.

To keep your teeth healthy during pregnancy, you need to pay attention increased attention oral cavity to prevent the proliferation of pathogenic microflora, which can contribute to faster tooth decay. In addition, you can ask your gynecologist to prescribe a drug that contains a large amount of calcium. As a rule, women during pregnancy are prescribed calcium tablets.

Thus, it is imperative for pregnant women to have their teeth treated. However, you always need to monitor the condition of a woman’s body and understand whether there are any risks or not.

After all, in the first trimester of pregnancy, the baby and the placenta have not yet formed properly, and in the third trimester, anxiety and discomfort during dental procedures on a sore tooth can cause premature birth.

Dental fillings during pregnancy

Before filling the canal, the tooth is drilled to remove carious formations.

Drilling teeth with deep caries causes severe pain, so it is necessary to give an anesthetic injection into the gum (in several places), and when necessary, into the pulp of the tooth. After this, the patient can have the diseased tooth cleaned and filled painlessly.

Treatment of a tooth with shallow caries is possible without the use of anesthetic. But some patients have such a low pain threshold that even filling a tooth with superficial caries causes them terrible pain. With pulpitis, you cannot do without local anesthesia.

Removal of the nerve followed by filling

Depulpation during pregnancy is carried out using an arsenic-free paste (for example, Devit-S), which is placed in the tooth cavity to die and dissolve the pulp. This is the only way the dentist can reach the dental nerve.

After applying the special paste, a temporary filling is placed on the tooth, which after several days is opened and the nerve is removed. After which the tooth canals are cleaned and widened, then the root canals are filled with gutta-percha, and finally a permanent filling is placed on the tooth. As a rule, these procedures are unpleasant, but practically painless.

Make sure that you do not chew food on a tooth with a temporary filling, and when brushing your teeth, you should also avoid touching this tooth with a toothbrush. Otherwise, the temporary filling may crumble.

If the filling has broken off a little and there is an unusual taste of medicine in your mouth, immediately contact your dentist with a complaint. It is possible for the medication to leak through a crack in the temporary filling.

Anesthesia during pregnancy

Dental anesthesia is used to temporarily numb the tooth tissues, thus reducing their sensitivity, and the dentist can treat the tooth without hindrance.

Local anesthesia is used for:

• drilling teeth before filling them;
• nerve removal;
• pulp surgery;
• tooth extraction.

Recommended anesthetics during pregnancy are Ubistezin or Ultracaine D-S(namely D-S). Their use is considered acceptable for the treatment of pregnant women, because they do not affect the health and development of the fetus.

To make the injection into the gum easier to tolerate, the injection site is treated with Novocaine. Thanks to him, the puncture of the tissue will be barely felt. Warn the dentist in advance that you are pregnant, so that when treating the injection site with Novocain, the dose of anesthetic is minimal.

Please note: the cheek, tongue, lips and other areas of the mouth that come under the spray of Novocain spray will become numb. So don't be alarmed, this is how it should be. Try not to worry and breathe evenly through your nose.

Novocaine is acceptable when treating pregnant women, but you should not swallow saliva after treating the injection site with this drug; spit it into a bowl.

Be careful! Any painkiller can cause skin allergic reaction and others side effects(low blood pressure, weakness and dizziness), therefore, it is first necessary to test the individual tolerance of the drug by applying a small amount of the drug to the gums cotton swab, soaked in anesthetic.

Dental X-ray during pregnancy

Modern dental clinics are equipped with visiographs (digital x-rays), which are suitable for taking dental photographs of pregnant women and children, since the radiation from these devices is so small that it cannot have a negative effect on the body of the expectant mother and fetus.

If the dentistry you choose does not have such equipment, a spot film X-ray of the tooth will be suitable, using a special lead apron or vest for the pregnant woman to protect the child and the woman’s organs from radiation.

X-rays use doses of radiation that are safe for humans and, in addition, the duration of exposure x-rays- short-term, so there is no need to worry about this.

During my obstetric practice, a dozen women observed by me were x-rayed in the first trimester, unaware of pregnancy, and all of them gave birth healthy babies. Some of them had complications during pregnancy, which were caused by illnesses that were not treated in time.

It is much worse for a pregnant woman to live in a polluted city with eternally smoking chimneys of factories and factories, inhaling cigarette smoke at passive smoking and use low alcohol drinks(even in small quantities).

A. Berezhnaya, obstetrician-gynecologist

When diagnosing teeth using an X-ray machine, a person receives a radiation dose of 0.2-0.3 mSv (unit of measurement - millisievert), and only targeted irradiation of the abdominal area of ​​a pregnant woman using a dose of 1-2 mSv or higher is considered negative for the embryo. .

From negative consequences X-ray exposure pregnant in permissible doses, scientists most often note the birth of a child with low birth weight.

A person also receives a certain dose of radiation when flying on airplanes. In everyday life, sources of radiation are the cathode-ray picture tube of a television and a computer screen.

Removal of a tooth

Tooth extraction is undesirable during pregnancy only for the reason that this procedure can cause complications in the form of inflammation and increased body temperature. And as you know, body temperature above 37.8 °C can harm the baby, especially if it persists high levels a few days.

Therefore, if possible, it is better to postpone tooth extraction until the postpartum period.

However, if inflammation has already begun, and toothache does not subside, it is necessary to remove the disturbing tooth in the coming days using anesthesia approved for pregnant women (see the paragraph on anesthesia above), otherwise an infection developing in the mouth of the expectant mother can harm the baby.

After tooth extraction, you must carefully monitor general health(measure body temperature) and rinse your mouth at least 5-6 times a day with healing and anti-inflammatory decoctions of herbs, for example, chamomile and calendula.

1. CAN PREGNANT WOMEN HAVE THEIR TEETH TREATED?

During the period of pregnancy future mom monitors his health more carefully. After all, harm to the baby developing in the womb can cause not only the disease, but also the treatment of the disease by one or another method.

Therefore, the question of whether problematic teeth are treated for pregnant women in the early and late later, worries every woman during this period. Is it possible to have teeth filled and removed during pregnancy? , is anesthesia dangerous, is it worth pulling out a wisdom tooth or is it better to postpone such an operation.... for these and others current issues you will find the answers in this material.

We hasten to immediately reassure pregnant women: most dental problems are completely solvable. Treatment with modern equipment, the use of painkillers and the latest generation of filling materials virtually eliminate the possibility of harm to the developing fetus. at any stage of pregnancy.

Therefore, do not put off visiting the dentist under any circumstances if you have a toothache or a filling has fallen out. After all, harm to your baby can be caused not only by a source of infection in a sore tooth, but not enough chewing food thoroughly due to increasing pain.

IMPORTANT!

It is very undesirable to refuse an anesthetic injection during dental treatment. The fact is that from a sharp unpleasant pain A large dose of adrenaline is released into the blood. This may provoke increased uterine tone (hypertonicity) , which negatively affects physical condition baby in the womb. Therefore, anesthesia of a problematic tooth is really necessary during pregnancy.

But from general anesthesia During dental treatment, it is better for a pregnant woman to refuse. Under anesthesia, some functions of the female body slow down and this can affect the functioning of the developing fetus.

Dental implantation during pregnancy is very dangerous, since this operation requires the use of potent drugs and after the procedure, a long period of implant healing begins, which is accompanied by additional load on female body.

Sometimes it is necessary to take a photo of the root and inside of the diseased tooth. Modern devices for execution x-rays are safe enough that you can undergo the procedure by covering your tummy with a lead shield.

Avoid teeth whitening during pregnancy! Bleach contains substances that thin the already fragile layer of enamel. In addition, they can penetrate the baby through the placenta and cause developmental disorders.

2. DENTAL TREATMENT DURING PREGNANCY

Already in the early stages of pregnancy Be sure to visit your dentist and, if necessary, treat problem teeth. In addition, consult with a specialist about the method of care that is suitable for you. oral cavity during the period of gestation. A pregnant woman's saliva composition changes, active work microbes and calcium deficiency provoke the destruction of tooth enamel. If you don't care for your teeth properly, you are more likely to develop caries. A caries will not only lead to deterioration of the condition of your teeth , but can also be passed on to the baby.

Except proper care For the oral cavity, a pregnant woman needs to consume a sufficient amount of vitamins and microelements. Unfortunately, foods in your diet do not always contain enough substances that you and your baby need. Therefore, ask your doctor to choose the most suitable preparations with vitamins and microelements for you.

For example, in the 2nd trimester of pregnancy, the skeleton begins to actively form in the fetus , which increases the need for calcium. A lack of calcium can lead to bleeding gums and destruction of tooth structure.

TO dangerous diseases for fetal development may include gingivitis . If itching appears in the gum area, be sure to go to the dentist, as this typical symptom gingivitis. If this disease is not treated, periodontitis will begin to develop. According to experts, periodontitis is very dangerous for the development of the fetus, since the infection begins to actively spread through the bloodstream.

Tooth extraction during pregnancy

Most safe period for the development of the baby - 2nd trimester. It is better to perform the procedure for removing a diseased tooth during this period, but if necessary, you can pull out a tooth in the 1st and 3rd trimester. Modern means for anesthesia do not cross the placental barrier and cannot provide harmful influence on fetal development.

But it is advisable to postpone the removal of the so-called “wisdom tooth” until postpartum period, since in some women this procedure causes a noticeable deterioration in well-being and an increase in temperature . Therefore, wisdom teeth are pulled out only in cases of extreme necessity.

3. CARIES AND PREGNANCY

What causes dental caries and how dangerous is this disease for a pregnant woman? Below you will find information on how to properly care for your oral cavity and what prevention can significantly reduce the likelihood of developing caries in a woman. You will also find out how effective the treatment of this disease is in the 1st, 2nd and 3rd trimester of pregnancy.

4. DENTAL ANESTHESIA USING MODERN MEANS

Local anesthesia is used before filling or removing a diseased tooth. As we noted above, the anesthesia procedure relieves a pregnant woman from stress and dangers to the fetus. physical reactions. Dental treatment during pregnancy should not be accompanied by pain, and modern anesthetics such as Ubistezin or Ultracaine perfectly relieve a woman from discomfort. However, such drugs (the main pain-relieving component is articaine) cannot affect the pregnancy or development of the baby.

Tips for pregnant women to care for their teeth:

How to properly care for your teeth, gums and the entire oral cavity so that treatment of problem teeth during pregnancy is not required. Watch video tips from dentists.

For a woman, pregnancy comes with many restrictions. At the same time, a responsible expectant mother tries to minimize harm to herself and the child she is carrying, checking the specific influence of each event, be it medical procedures or visiting the bathhouse. However, one of the most frequently asked questions concerns security.

Is it possible to treat teeth during pregnancy?

Carrying out relevant activities is not only not prohibited, but is also strongly recommended. one of the strongest. Its occurrence is fraught with great stress and, as a consequence, exhaustion of the body.

In addition, strong psychological stress can cause temporary changes hormonal levels, which is harmful for the pregnant child. However, not all dental procedures can be performed during pregnancy.

The implementation of some of them can negatively affect the body of the expectant mother and the fetus inside her. It should also be taken into account that at some times it is not recommended to carry out any medical procedures.

Although in the case of dental procedures, the likelihood of harm to the fetus as a result of some kind of intervention is relatively low.

It is best, of course, to take care of dental treatment in advance. This minimizes the likelihood of stress-related problems caused by dental pathologies.

Dental procedures and pregnancy

The following drugs are most often used to treat dental pathologies in pregnant women:

• Artifrin;
• Ubistezin;
• Alfacaine.

The advantage of these drugs is that their use does not lead to strong increase adrenaline level.

This is due to high psycho-emotional stress. It occurs even if local anesthesia has been administered.

There are exceptions in which tooth extraction is allowed during pregnancy:

• , which cannot be eliminated therapeutic methods . In such situations psycho-emotional stress significantly higher than that typical for surgery;
• . In this case, not only does pain syndrome, but also inflammation, defiant education large quantity pus. The latter can also lead to blood poisoning. And the infection that gets into it will certainly penetrate the practically helpless body of the fetus, which will certainly lead to a number of disorders in it. Therefore, pathology of this kind should be gotten rid of as soon as possible;
• . But this factor is not always a reason for surgical intervention. Dentists recommend getting rid of a tooth when the size of the cyst in diameter exceeds 10 millimeters;
• broken root or crown. If what is left of the tooth is not removed, an infection may develop inside it. It, as in the case of deep caries, can negatively affect the health of the pregnant child.

There is also an operation that is not performed at all during pregnancy. She is. This is due to the fact that after such an operation high probability. This infection necessary, the intake of which can cause significant harm to an unborn baby.

Now about the question that concerns the opposite procedure: is it possible to insert teeth into a woman who is carrying a child. In the case of , it is also permissible to do this. These activities will not harm either the pregnant woman or the fetus.

cannot be installed during pregnancy. Not a single clinic will agree to conduct this operation pregnant. You can verify this if you go to the website of any dentistry and read the list of contraindications for this procedure.

The corresponding limitation is due to the fact that the engraftment of an artificial root requires the expenditure of a large amount of energy. And during pregnancy, a lot of energy goes into the development of the fetus.

If you neglect this contraindication, one of two problems is possible. The first is the high probability that the implant simply does not take root. The second is the occurrence of disturbances in the development of the fetus, but this happens rarely.

When should pregnant women not have their teeth treated?

The most dangerous period for the fetus is the first trimester. It lasts 12 weeks from the moment of conception. This period is called early.

It is on it that all organs in the body are outlined, and the fetus itself is completely defenseless for any external attacks (be it bacteria and viruses or aggressive chemicals).

Therefore, during the first trimester, expectant mothers are prohibited from any surgical operations. The only thing a dentist can do is prescribe soft remedies, eliminating inflammation.

Any more serious treatment only possible if absolutely necessary. During (13-25 weeks) many restrictions on dental procedures are lifted. By this time, the placenta, which protects the fetus from external influences, becomes quite reliable.

The third semester lasts from the 25th week until the baby is born. During this period, as at the very beginning of pregnancy, aggressive procedures are not recommended. In the third semester, the uterus becomes very sensitive, while the woman’s body is very exhausted.

During this period, her body reacts sharply to both stress and medications. Therefore, it is better not to treat teeth either with or without anesthesia. You should wait until lactation time, and only then visit the dentist’s office.

Video on the topic

Is it possible to treat teeth during pregnancy? Answer in video:

As you can see, dental treatment during pregnancy is possible, although with quite a few big amount reservations In addition to those mentioned above, there are others.

Therefore, with some degree of probability, dentistry may refuse services after studying the condition of the body of a woman who will soon have to give birth to a child.