Caries during pregnancy occurs generally more often than at other periods of a woman’s life, and often occurs very actively at this time, sometimes even in acute form. The expectation of future mothers about the possible influence of caries on the fetus is quite understandable, as well as fears about whether teeth can be treated at all in such a crucial period.
In some cases, during pregnancy, caries is only beginning its destructive work (and many are trying to wait out this time), and the most noticeable and sensitive consequences of the teeth are waiting for a woman after childbirth.
On a note
Statistics is eloquent:
- Caries is found in 91.4% of women with normal pregnancy and in 94% of them with toxemia.
- The average intensity of tooth damage in pregnant women is from 5.4 to 6.5 (this is a high level);
- Enamel hyperesthesia (hypersensitivity) is observed in 79% of women during the gestation period.
It is believed that the caries itself during pregnancy does not have such a negative impact on the fetus, which can have its treatment. Taking advantage of this popular belief, many pregnant women are wary of visits to the dentist, and the reason for this is that the future moms do not understand the nature of caries and the dangers themselves.
Let's see what is actually more dangerous and more likely to affect the fetus - caries or its treatmentand also see how you can make a healthy baby and at the same time keep your teeth in excellent condition.
Does tooth decay affect the fetus?
For a start, it is useful to recall that caries is a disease caused by pathogenic bacteria in the oral cavity. It is believed that through microdamages of soft tissues, these bacteria can enter the bloodstream, enter the fetus and cause various pathologies.
However, the likelihood of this is extremely small: bacteria can only penetrate the placental barrier in extremely rare cases.and the inhabitants of the oral cavity have practically no chance of surviving in the tissues of the embryo and exerting at least some influence on it. Such abilities are mainly possessed by viruses.But, as in the case of any infectious disease, the presence of caries in pregnant women involves a number of hygienic procedures and careful care of the oral cavity.
Caries and pregnancy are more closely related precisely through the physical condition of the mother. For example, persistent pain in a caries-affected tooth (which, by the way, is not uncommon during pregnancy) leads to the inability of a woman to eat normally, a general deterioration of her emotional state. All this together can really have some negative effect on the development of the fetus.
In addition, complicated caries affects pregnancy by the fact that with lesions, for example, periodontal inflammation occurs, which can affect the general physical condition of the expectant mother: lead to an increase in body temperature and the need to receive antipyretic drugs, exacerbation of toxicosis, disruption in work digestive system.
Still, the main and most real danger of dental caries during pregnancy lies in the possibility of its transition to the acute form, a strong lesion of many teeth at once and the woman’s loss in a fairly short time.In other words, for the mother caries is usually more dangerous than for the fetus.
The same is true in the case of caries in a nursing mother. Here, only the reasons for refusing a visit to the dentist differ: if a pregnant woman is more often afraid that caries treatment will harm the future baby, then the nursing mother simply does not have 2-3 hours to go to the clinic.
Causes of caries 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 many women come to the forefront of additional reasons, due precisely to gestation:
- The decrease in the concentration of calcium and fluoride in saliva and in the blood due to some of their consumption for the needs of the developing embryo. Calcium is not consumed from the teeth themselves, as many consider incorrectly. But remineralization of enamel and its strengthening, always proceeding in other periods due to the action of saliva, during pregnancy may slow down or stop altogether. As a result, the enamel becomes poorly mineralized and is more easily damaged by the acidic waste products of bacteria.
- Hormonal changes in the body and, again, the corresponding changes in the composition of saliva, which leads to a decrease in its bactericidal properties. Simply put, the saliva of pregnant women in some cases less effectively destroys cariogenic bacteria.
- Changes in the diet - pregnant women can throw at different extremes, they often have a strong craving for sweets and flour.
- Violations in the care of teeth - due to fatigue, toxemia, worries and fuss, some expectant mothers regularly forget to brush their teeth, or do not do it carefully.
In addition, many pregnant women have enough time to hear from friends and relatives of the allegations that they cannot be treated during pregnancy, and they simply do not go for preventive examinations. And as a result - they miss the moment when the tooth could still be cured absolutely safe for the fetus.
Treatment of caries at different stages of pregnancy: is it dangerous and how is it performed?
Caries during pregnancy can not only be treated, but definitely necessary. Sometimes, due to the risk of acute development of the disease, timely treatment for some pregnant women is the only way to prevent generalized caries. Of course, the management of the disease itself should take into account the situation of the patient.
The main danger arising from the treatment of caries during pregnancy is the risk of the effects of anesthetic preparations on the fetus. All anesthetics are absorbed into the bloodstream and can pass through the placenta, some of which are quite capable of having an adverse effect on the developing embryo.
Therefore, by the way, it is so important to be observed at the dentist throughout pregnancy - when caries is detected at the earliest stages of its development, treatment can be carried out using remineralization methods without anesthesia, without a drill and unpleasant sensations. But already started caries without anesthesia will heal really painful.
It is often impossible to do without anesthesia in the treatment of complications of caries: with pulpitis or periodontitis, such an approach is unacceptable, since a painful shock can occur in a pregnant woman.
As a rule, the treatment of average caries during pregnancy, especially if the pathology occurs in a chronic form, dentists prefer not to hold until the beginning of the second trimester.It is during the first 12-13 weeks that all the organ systems of the fetus are laid down, and the risk of the negative influence of medications on it during this period is maximum, although it is still small. Already from 14-15 weeks the use of special anesthetic drugs allows you to safely carry out rehabilitation.
On a note
Radiography of teeth during pregnancy is not categorically applied. If the cavity is hidden from the eyes - try to resort to other methods. Even the quality of the canal filling is tried not to be studied with the help of X-rays.
Modern radiography on the visiograph has several times less radiation exposure. When urgently needed, it can only be done from the second trimester of pregnancy on this machine.
With the use of local anesthesia, regardless of the period of pregnancy, acute pulpitis, purulent periodontitis and periostitis are treated. During the treatment of caries, even deep, the doctor begins treatment without the use of anesthesia and makes an injection only if the patient begins to feel pain during the excision of the carious areas of dentin.
Specially adapted drugs, for example, Septanest and Scandonest at a dilution of 1: 200 000, are used as painkillers for the treatment of pregnant women in dentistry.Pregnancy is not a contraindication for their use, and within 3 hours after the injection they are not detected in the blood.
Opinion of the dentist:
Pregnancy is not a contraindication in other drugs, judging by the instructions. The fact is that a decrease in the concentration of adrenaline, and in Scandonest - also preservatives, minimizes the risks, but does not eliminate them. In any case, I observed on popular portals the position that articaints are positioned as relatively safe for local anesthesia with relative risks, therefore they are made in case of emergency, one of which is pain!
By the end of pregnancy, therapy is complicated by the fact that when sitting in a dental chair, because of 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, a pregnant woman lays down in a chair a little on its side, which allows to reduce the load on the part of the fetus. At the same time, the risk of teratogenic effects of anesthetics on the fetus by the end of pregnancy becomes minimal.
Independently take painkillers at home only with completely unbearable pain and inability to consult a doctor at the moment. If it came to that, the doctor should see the tooth as soon 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 the pain medicine on your own, then consider that taking almost any drug in some cases may well have negative consequences. You can choose in the individual case, "self-treatment" that even a single reception of a strong painkiller will affect the health of the mother and fetus. Do not forget about the individual intolerance and side effects of each drug, especially since they have a whole range of painkillers.
Feedback
“At one time I went to a clinic where, before the 20th week, pregnant women didn’t treat their teeth at all. Before pregnancy, I did not think about it, but when I came in the third month with initial caries, I was turned. They said that you need another two months to walk, and then they will be treated.This is a disgrace! At the stage of the spot caries, and without anesthesia, and without any drugs are treated, the fetus is not affected by anything at all. And in two months I will already have a tooth opened, I will put a filling, God forbid, my nerves will be removed. I had to change the clinic, the tooth was cured, without a filling and without anesthesia. Now, now I play with a little, but my tooth remains healthy. ”
Anna, Saint Petersburg
Prevention of caries and proper preparation for pregnancy
Prevention of caries in pregnant women should begin before the onset of pregnancy. At the planning stage, the expectant mother should be checked by the dentist, heal all aching teeth, remove plaque and tartar. The doctor at this time will draw up a schedule of preventive visits, which will need to be observed (it is not known what the cariogenic situation in the mouth will be with the onset of pregnancy and the development of the fetus).
On a note
In the first trimester of pregnancy, it is not recommended to carry out any traumatic manipulations, in contrast to the 2 and 3 trimesters, where the hygienic condition of the oral cavity, in addition to the health of the teeth, has a leading value
Often the following question is asked: “Can pregnant women be given occupational hygiene?”.There is a list of diseases in which ultrasound (US) toothbrushing and Air Flow apparatus are not recommended or recommended: epilepsy, cardiac pacemaker, nasal breathing problems, asthma, chronic lung diseases in exacerbations, HIV and hepatitis, venereal diseases, high blood sugar or diabetes mellitus, acute respiratory viral infection, herpes and airborne diseases, malignant neoplasms.
Most often it is associated with an aerosol that rises while brushing your teeth against plaque and stone. A cloud of wet dust and infection can cause respiratory failure in a pregnant woman, and elevated blood sugar - the risk of prolonged bleeding from the gums during traumatic manipulation. In some cases, the possibility of manipulating a pregnant woman can be determined with an adjacent specialist (gynecologist, endocrinologist, general practitioner, ENT specialist, oncologist).
Directly during pregnancy, prevention of caries requires:
- Compliance with the rules of oral hygiene: teeth are cleaned after each meal, preferably with pastes, selected by the dentist; after occasional acts of vomiting during toxemia, the mouth is rinsed with a solution of soda to neutralize acids from the vomit.
- Dieting, restriction in the diet of sweet flour and chocolate products.
- Compliance with all the requirements of the dentist - the use of systemic prophylaxis, professional dental cleaning, a visit to the dentist for routine check-ups, etc.
Practice shows that correct caries prevention during pregnancy, although it should be systemic and regular, it usually does not present any difficulties. However, she is the main pledge that during pregnancy and lactation a woman will keep all her teeth in good condition.
An interesting video: is it possible to treat teeth during pregnancy and what is important for every expectant mother to know
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