Pregnancy and  Dentistry

Guidelines for Oral Health Care in Pregnancy

• Dental care is safe and essential during pregnancy

• Pregnancy is not a reason to defer routine dental care or treatment

• Diagnostic measures, including needed dental x-rays, can be undertaken safely

• Scaling and root planning to control periodontal disease can be undertaken safely; avoid using metronidazole in the first trimester

• Treatment for acute infection or sources of sepsis should be provided at any stage of pregnancy. A number of antibiotics are safe for use

• Treatment, including root-canal therapy and tooth extraction, can be undertaken safely

• Needed diagnosis, preventive care, and treatment can be provided throughout pregnancy

• Emergency care can be provided at any time during pregnancy

• Delay in necessary treatment could cause unforeseen harm to the mother and possibly to the fetus

Medical Conditions and Dental Treatment Considerations

Hypertensive Disorders and Pregnancy

Hypertensive disorders, including chronic or preexisting hypertension and the development of hypertension during pregnancy, occur in 12–22% of pregnant women. Dental treatment can safely be carried out in Consultation with the woman’s prenatal care provider whenever necessary.

Diabetes and Pregnancy

Gestational diabetes is usually diagnosed after 24 weeks of gestation. Any inflammation process, including acute and chronic gum (periodontal) infection, can make diabetes control more difficult. Meticulous control to avoid or minimize dental infection is important for pregnant women with diabetes. Controlling all sources of acute or chronic inflammation helps control diabetes.

Heparin and Pregnancy

A small number of pregnant women with the diagnosis of thrombophilia (a blood disorder) may be receiving daily injections of heparin to improve pregnancy outcome. Heparin increases the risk for bleeding complications during dental procedures. Dental providers should consult with the woman’s prenatal medical provider prior to dental treatment.

Risk of Aspiration and Positioning During Pregnancy

Pregnant women have delayed gastric emptying and are considered to always have a ―full stomach. Thus, they are at increased risk for aspiration. Maintaining a semi-seated position or positioning with a pillow helps avoid nausea or aspiration and can make the woman feel more comfortable.