Is it safe to visit the dentist during pregnancy?【supervised by doctor】

Introduction

It is said that during pregnancy, women are more prone to cavities and periodontal disease. Conversely, recent studies have shown that pregnant women with periodontal disease have a 2 to 4 times higher risk of premature birth or low birth weight babies. There are also reports indicating a higher probability of developing pregnancy-induced hypertension, making dental treatment extremely important for delivering a healthy baby.

In this article, we will briefly explain the relationship between pregnancy and dental treatment, as well as summarizing whether it is okay to visit the dentist during pregnancy, dental treatment that is advisable during pregnancy, and treatments that should be avoided. We will also discuss useful information about prenatal dental health examinations and frequently asked questions about dental treatment during pregnancy.

Why does oral environment change easily during pregnancy?

During pregnancy, it is said that the oral environment is more prone to change due to the influence of female hormones. The sudden increase in female hormones during pregnancy is believed to lead to an increase in periodontal bacteria. Additionally, saliva decreases, making the mouth more susceptible to becoming dirty. Furthermore, changes in diet due to morning sickness or general discomfort, as well as the inability to perform self-care activities such as brushing teeth, are common. When these factors overlap, the oral environment deteriorates, making it more susceptible to cavities and periodontal disease.

Cavities during pregnancy

During pregnancy, as explained earlier, changes in the oral environment make it more susceptible to cavities and periodontal disease. Additionally, due to factors like discomfort, cavities can progress unnoticed, and by the time they are discovered during a dental check-up, they may have already become severe.

While the bacteria causing cavities do not directly transfer to the baby in the womb, if cavities are not treated before childbirth, there is a possibility of transferring cavity-causing bacteria to the baby after birth, potentially leading to cavities in the baby.

When to undergo dental treatment during pregnancy

We sometimes receive questions about the optimal timing for dental treatment during pregnancy. Essentially, dental treatment can be undergone at any time. Especially for urgent dental treatment requiring immediate attention, such as significant gum inflammation and swelling, there is no need to delay treatment due to pregnancy or breastfeeding. Delaying dental treatment may actually lead to more problems. For non-urgent treatments, it’s advisable to undergo them during the mid-pregnancy period.

When visiting the dentist, it’s important to consult with your regular obstetrician and bring your maternal and child health handbook. Make sure to inform the dentist that you are currently pregnant, how many weeks pregnant you are, and provide an update on your current condition. This will enable the dentist to consider the appropriate treatment options for you.

Early pregnancy

During the early stages of pregnancy, except in cases of emergency, extensive treatments such as extractions are often avoided. However, preventive measures for cavities and periodontal disease can typically be safely performed during early pregnancy. Extractions may pose concerns due to the necessity of using local anesthesia and the likelihood of needing painkillers or antibiotics post-extraction, which could potentially raise teratogenic concerns with certain medications.

NIPT (Non-Invasive Prenatal Testing) from early pregnancy

For those concerned about whether their baby may have congenital disabilities, NIPT is recommended. NIPT is a test that examines chromosomal abnormalities such as trisomy 21 (Down syndrome), trisomy 18 (Edwards syndrome), and trisomy 13 (Patau syndrome) in the fetus from the mother’s blood. Compared to traditional prenatal diagnostic tests using blood samples, NIPT is considered to have extremely high accuracy in terms of sensitivity and specificity. It can be performed as soon as pregnancy is confirmed through ultrasound, allowing parents to learn about the baby’s condition early on.

Mid-pregnancy

The mid-pregnancy period is considered the most suitable time for dental treatment during pregnancy. If extensive dental treatment, including extractions, is needed, it is typically performed during the mid-pregnancy period. However, even during the generally stable mid-pregnancy period, there may be situations where dental treatment is not advisable, such as if the individual is managing gestational diabetes, high blood pressure, or receiving treatment for threatened miscarriage or preterm labor. Before undergoing dental treatment, it’s advisable to consult with your regular obstetrician for guidance.

Late pregnancy

The late pregnancy period is characterized by a gradual increase in the size of the abdomen. Prolonged periods lying on the back can lead to a condition known as “supine hypotensive syndrome,” so it’s advisable to avoid lengthy treatments during this time. Supine hypotensive syndrome occurs when the enlarged uterus compresses the inferior vena cava, a large vein that returns blood from the lower body to the heart, while lying on the back for an extended period. Compression of the inferior vena cava restricts blood flow returning to the heart, resulting in decreased blood supply to the heart.

Effects of dental treatment on the baby

When it comes to the impact of dental treatment on the baby during pregnancy, there is usually no need to worry, especially within the scope of routine dental procedures. Here, we will explain each common dental treatment (fillings, anesthesia, X-ray examinations) in detail.

Is it okay to have fillings?

Fillings for teeth are possible even during pregnancy. There used to be a theory suggesting that composite resin used for dental fillings contained environmental hormones that could affect the baby. However, this theory has now been debunked. You can confidently undergo treatment without worry.

Is anesthesia okay?

The anesthesia used in dentistry is local anesthesia, so it has minimal impact on the baby in your womb. In fact, undergoing treatment without anesthesia and experiencing pain could lead to stress. If you’re in the stable period of pregnancy (after 16 weeks), it’s advisable to receive treatment with the minimum necessary amount of local anesthesia to minimize stress. If you’ve experienced discomfort from dental anesthesia in the past or have been told that you require a higher-than-normal dose of anesthesia, it’s essential to discuss this thoroughly with your dentist.

Is it okay to undergo X-ray examinations?

It is possible to undergo X-ray examinations for dental treatment during pregnancy. The amount of radiation emitted from dental X-ray equipment is minimal, and since it’s also distant from the abdomen, the impact on the baby is very slight. Furthermore, wearing a protective apron over the abdomen provides additional safety during the examination. The information obtained from X-ray examinations is crucial for accurate diagnosis and treatment. To minimize exposure, it’s essential to discuss with your dentist beforehand to ensure only the necessary examinations are performed.

What is prenatal dental health examination?

Prenatal dental health check-ups are dental examinations available during pregnancy. They are subsidized by local governments, so the cost is typically free. Since dental issues are more likely to occur during pregnancy, and as mentioned earlier, periodontal disease increases the risk of preterm birth and low birth weight babies, these check-ups are conducted in collaboration between local governments and dental associations to ensure safer pregnancies and childbirths, based on legal mandates. The weeks of pregnancy when these check-ups are available may vary depending on the municipality, so please contact your local government for detailed information.

Conclusion

In summary, we’ve briefly covered dental care during pregnancy. Protecting the health of your teeth and mouth is crucial for delivering a healthy baby. It’s entirely possible to undergo dental treatment safely during pregnancy with proper precautions. Whether you’re currently pregnant or considering pregnancy, I encourage you to proactively seek dental treatment to ensure a conducive environment for welcoming your baby whenever the time comes.

Article Editorial Supervisor

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Dr Hiroshi Oka

NIPT specialist clinic, MD

Graduated from Keio University, School of Medicine