Pregnancy and bad teeth. What happens to teeth during pregnancy, how to preserve and strengthen them during an “interesting situation”? Dental examination during pregnancy is contraindicated

Dental problems in pregnant women

A baby growing inside a pregnant woman requires more nutrients to fully develop. And if he does not receive nutrients from his mother, he begins to take them himself. First of all, this concerns calcium for bone formation.

Smile of a pregnant woman

The condition of the teeth worsens due to a slight disturbance in the calcium metabolism in the pregnant woman’s body. A small hole becomes a deep cavity, or you can lose a tooth. A lack of calcium occurs due to an unbalanced diet or as a result of some pathologies.

An equally serious problem is gingivitis, which is inflammation of the gums caused by hormonal changes during pregnancy. If left untreated, periodontal disease causes gums to bleed when brushing your teeth and eating. But it doesn't end with just one toothache. Space appears between the gums and teeth, and the teeth begin to loosen. Pieces of food become clogged into the resulting cavities, which, when decomposed, contribute to the occurrence of caries.

You can reduce bleeding gums by changing your toothbrush to a softer one, doing finger massage of your gums, and rinsing your mouth with calendula, sage or chamomile. Women living in large cities are better off not using fluoride-containing toothpastes. By itself, this paste does not pose a threat and is beneficial for teeth, but together with fluoridated water it can cause enamel destruction during pregnancy. But enamel is not only destroyed due to an increase in fluoride, but can also be caused by a love of cold or hot food. For example, when hot coffee is washed down with cold mineral water or cold ice cream is washed down with hot coffee. Enamel does not like to be exposed to hard objects; you should not pick your teeth with sharp objects or chew nuts.

Pregnant women would do well to brush their teeth after eating with a toothbrush or chew gum for 10 minutes or eat an apple after eating. This should be done to cleanse plaque and to additionally release saliva reserves. Then the self-cleaning mechanism is triggered when saliva neutralizes the acids that have settled on the teeth after eating.

Our teeth are protected by saliva; it contains substances that create a barrier to unfavorable processes. During pregnancy, the composition of saliva changes, the protection weakens and the number of useful substances decreases. All this affects dental health. Having a carious tooth is dangerous in itself. Even if there is a small hole in the tooth, it will be the source of a dangerous infection that can spread to other areas. Any infection in a pregnant woman will be a risk to the health of her unborn child.

When you go to the dentist, you need to say that you are expecting a child. There are few restrictions in the treatment of a pregnant woman, this concerns the type of x-ray, type of anesthesia and whitening procedure. Prosthetics, fillings, surgical and orthodontic interventions have no contraindications. In any case, before serious manipulations in the oral cavity, an experienced specialist will consult with your attending physician with whom you are registered. You need to be treated by a dentist from whom you regularly receive treatment and whose qualifications you are confident in. It is advisable that the dentist has experience working with pregnant women.

Pregnancy is a physiological condition characterized, among other things, by hormonal changes in a woman’s body, which can lead to problems with teeth and gums. Each of the three trimesters of pregnancy has its own characteristics, but the capabilities of modern therapeutic dentistry can eliminate any of these problems in each period.

Pregnancy is characterized by a strong hormonal shock, which involves a rather complex set of hormones. In addition, during pregnancy, strong vascular changes occur, in particular in the mucous membranes of the oral cavity, dentoalveolar ligaments (periodontal).

Hormonal and immunological changes

Physiological changes that appear in a pregnant woman occur as a result of the endocrine activity of the placenta, the release of estrogen and progesterone.

The secretion of these hormones increases during pregnancy up to 10 times for progesterone and up to 30 times for estrogens.

Some hormones associated with pregnancy, such as progesterone, have immunosuppressive properties (immune suppression). Also, when levels of sex hormones are high, polymorphonuclear chemotactism, phagocytosis, and antibody response are affected. Therefore, the risk of any infection during pregnancy increases significantly.

Changes in the oral environment

During pregnancy, quantitative and qualitative changes occur in a woman's saliva. During the first three months of pregnancy, salivation increases (until now this phenomenon has not been explained). In subsequent months, this phenomenon of hypersalivation disappears.

The pH value of saliva changes towards increasing acidity (from 6.7 to 6.2) and this decrease in pH reduces the protective function of saliva. In addition, the presence of hormones is observed in saliva, which contribute to the growth of the number of microorganisms in saliva, increased bacterial contamination, and the formation of dental plaque and dental plaques.

Pathologies of the oral cavity during pregnancy

The effect of pregnancy hormones on the oral mucosa has been proven experimentally and clinically.

• Inflammation of the gums (gingivitis) is an inflammatory process often observed during pregnancy, aggravated by the formation of dental plaque and plaque caused by an increase in the content of estrogen and progesterone in saliva.
• Tumor of the gums (supragingival) pregnant women is a benign tumor. The etiology of its occurrence is still unclear, although trauma, poor oral hygiene and hormonal changes certainly play a role. The tumor disappears spontaneously after childbirth.
• Caries. During pregnancy, the development of carious cavities is often observed. It has been established that caries during pregnancy is provoked not only by deterioration of oral hygiene, but also by changes in hormonal levels, changes in the pH of saliva (the acidity of which increases during pregnancy). Increased carbohydrate intake may also influence the incidence of dental caries in pregnant women.
• Diffuse toothache. Often pregnant women complain of non-localized, diffuse pain in the teeth. This is probably due to changes in blood circulation inside the dental pulp, which causes contractions of nerve fibers when the walls of the pulp chamber are motionless. This pain is not associated with dental caries. If pain suddenly appears on healthy teeth, it usually disappears after 1-2 weeks (while caries does not disappear spontaneously).
• Tooth hypersensitivity. It has been established that pregnancy contributes to changes in tooth sensitivity, reaching the degree of hypersensitivity.
• Tooth erosion - demineralization, loss of substance from hard dental tissues under the influence of chemicals. During pregnancy, erosion is observed mainly at the level of the necks of the anterior teeth of the upper jaw. Tooth erosion is caused by increased acidity or gastric juice, especially when vomiting during pregnancy toxicosis. When erosions occur, short-term pain sensations appear, usually after eating, which spontaneously disappear after childbirth.

Treatment of dental and oral diseases in pregnant women

There are no contraindications for dental treatment for pregnant women. On the contrary, if treatment is not carried out, this can further have a detrimental effect on the health of both mother and baby.

However, when treating pregnant women at the dentist, it is necessary to observe some precautions, namely, pay attention to the following factors:

• stressful situations during treatment;
• use of ionizing (X-ray) radiation;
• anesthesia;
• filling materials;
• medications used;
• the presence of other pathologies in the body;
• choosing the moment to start treatment.

Stress

Anxiety and stress during dental surgery in a pregnant woman can be reduced by the attentive attitude and patience of the doctor. It is important that the dentist explains in detail to the expectant mother what manipulations he will perform, and that it is absolutely harmless for her unborn child.

Ionizing radiation (X-ray)

Dental x-rays are considered virtually harmless to pregnant women. However, it is recommended to observe the following rules:

• short irradiation time;
• protection of the pregnant woman’s abdomen and chest with a special apron (personal protective equipment);
• the number of x-rays should be kept to a minimum.

All of these precautions reduce the child's risk of exposure to radiation. However, it is still best to avoid X-ray examinations in the first trimester of pregnancy, unless absolutely necessary.

Anesthesia

Local anesthesia used in dentistry is not contraindicated for a pregnant woman. Regarding the drugs used, it is necessary to take into account that:

• the toxicity of painkillers increases due to a decrease in proteinemia (the presence of proteins in the blood plasma) of the pregnant woman;
• local hyperemia (overflow of blood in the vessels of the circulatory system above normal) when an anesthetic is injected causes acidification of the environment, which favors the cationic form of the anesthetic molecule to the detriment of the main form (namely, the main form acts on the nerve of the tooth, so the degree of pain relief in pregnant women may be reduced);
• all drugs have molecular weights of about 250-330, and any molecules with a molecular weight below 600 are retained by the placenta;
• the toxic dose of the anesthetic is 400 mg, which is significantly higher than the therapeutic doses used; however, it is desirable to use drugs that are least toxic, least lipid soluble, and most protein bound. The lipid solubility of the drug used determines its effect on the development of the embryo. Bonding with proteins increases the molecular weight and makes it impossible for the drug to cross the placenta.

Therefore, it is better to avoid the use of anesthesia drugs such as Prilocaine, Lidocaine and Mepivacaine. It is preferable to use Articaine (Alfacaine, Ultracaine, Primacaine, Septanest, Bucanest, Deltazin, Ubistezin).

Filling materials

No studies have shown that materials used for conservative dental treatment (composites, glass ionomer cements, etc.) or their components can penetrate the placenta or act as cellular poisons. But you should avoid using any materials containing mercury.

Medicines

If the dentist determines the presence of an infection in the oral cavity (teeth, gums), it will likely be necessary to resort to additional drug therapy. During pregnancy, you should avoid some antibiotics, some anti-inflammatory drugs, and some pain relievers.

Antibiotics

It is best to use penicillin antibiotics. First generation cephalosporins and erythromycin may sometimes be used as they have been shown to be safe. Tetracyclines should not be used because, in addition to causing dyschromia (staining) of the newborn's teeth, they are also responsible for clouding of the lens (cataracts) and congenital abnormalities of the limbs of newborns. Tetracycline can also cause fatty degeneration of liver cells and pancreatic necrosis in a pregnant woman.

Anti-inflammatory drugs

The dentist can prescribe anti-inflammatory therapy, however, the use of these drugs in pregnant women should still be avoided, both steroidal and non-steroidal. Steroid drugs can cause embryonic growth retardation, as well as affect the formation of lung tissue and tissue of some parts of the brain. Such drugs can only be used in case of a life threat, for example, in case of anaphylactic shock.

Non-steroidal anti-inflammatory drugs may be responsible for premature closure of the arterial canal, which can lead to heart problems in the newborn. Such drugs are prohibited for use in the 2nd and 3rd trimesters of pregnancy.

Painkillers

The most recommended painkiller is paracetamol. It is not toxic and teratogenic (contributing to the appearance of deformities in the unborn child). The use of acetylsalicylic acid (aspirin) should be prohibited. Aspirin has been shown to contribute to the formation of palatal clefts, intrauterine death of the child and growth retardation. Dextropropoxyphene is contraindicated in the first trimester due to the potential for respiratory depression in the infant. Codeine-containing drugs should not be used as they can cause congenital deformities and cardiac abnormalities.

When should a pregnant woman be examined by a dentist?

A woman must, first of all, register with a gynecologist in order to know exactly the duration of her pregnancy and the general condition of her body. Pregnancy is divided into three main periods (trimesters), during which the risks vary.

1-3 month

During the first trimester, the risk of deformities in the development of the fetus is greatest, and the likelihood of spontaneous miscarriage is high (up to 75% of miscarriages occur in the 1st trimester). During this time, dental intervention (endodontics and tooth extraction) is only necessary in urgent cases to avoid stress, pain and the risk of infection. In addition, during this period, women often experience toxicosis, irritability, and increased salivation, which interferes with normal dental treatment.

4-7 month

This is the best time for treatment at the dentist, because... The period of organogenesis (development of the child’s organs) has ended. During this period, it is desirable to eliminate all pathologies associated with the teeth and oral cavity, accompanied by pain or inflammation.

8-9 month

In the last months of pregnancy, a woman is already constrained by her weight, her movements are limited, and her due date is close. During this period, the dentist should be contacted only in emergency cases, and visits to the doctor should not be long and should take place in a semi-sitting position.

Treatment of oral pathologies associated with pregnancy

Tumor of the gums (supragingival)

The tumor disappears immediately after birth. Surgery is only necessary if the tumor interferes with the process of chewing food. In this case, the dentist can only give recommendations on oral hygiene.

Primary periodontal lesions

In case of gum disease associated with pregnancy, the first step is to remove plaque, plaque and tartar. After removing plaque, rinse your mouth with a 0.12% chlorhexidine solution. In cases of periodontal damage, only minimal treatment of the affected areas is carried out. The main therapy is postponed until after childbirth.

Caries and damage to dental tissues

To prevent caries, it is necessary to remove dental plaque and seal defects using glass ionomer cements or liquid composites. To consolidate the effect, the teeth are coated with chlorhexidine varnish. You can coat your teeth with fluoride varnish, which will help avoid the appearance of new foci of caries and prevent the occurrence of dental hypersensitivity. It is better to postpone full treatment of carious cavities with permanent filling materials until after childbirth.

In the case of pulpitis, placing calcium hydroxide into the canal will temporarily soothe the pain and have an antibacterial effect. Complete canal treatment is performed only in the second trimester or after childbirth.

Erosion of teeth

In case of erosion of dental tissues, it is recommended to rinse with a solution of baking soda (especially after vomiting); brushing your teeth with a hard brush is not recommended. It is necessary to follow a diet and exclude acidic foods from the diet (lemons, oranges, sauces made from vinegar, oil and salt).

Observation and treatment of pregnant women at the dentist is not much different from that for ordinary patients. Only a few precautions are necessary. You need to be especially careful in the first trimester of pregnancy, when dental intervention is allowed only in critical cases. All other treatment should be postponed to the second trimester. In the third trimester, treatment is indicated only if there is particular urgency.

Teeth during pregnancy need special care; it is not without reason that people say that giving birth to a child means the loss of one tooth for its mother.

Pregnancy and teeth

Bad teeth and pregnancy are not compatible concepts, and there are a number of reasons for this.

Caries actively progresses during pregnancy
- decreased maternal immunity leads to easy complications of deep caries
- a decaying tooth is a source of infection in the mother’s body, which can cause obstetric complications and infection of the child

Therefore, your teeth need to be put in complete order even before pregnancy, at the planning stage, and you need to visit the dentist several times during the pregnancy. If you have not prepared for pregnancy, a visit to the dentist will definitely be suggested to you by your supervising gynecologist at the time of your first visit to the antenatal clinic, along with all other tests and examinations.

But even if you did everything on time, you may have dental problems while you are carrying your baby. The teeth deteriorate and crumble in many pregnant women, regardless of whether they were preparing for conception or not, why does this happen? How does pregnancy affect teeth?

Starting from the second trimester, the need for calcium increases several times, because the child’s skeletal system begins to form. To build bone tissue, he needs a huge amount of calcium, but sometimes there is nowhere to get it, especially if the expectant mother does not really like dairy products, fish and refused to take prenatal vitamins. Calcium begins to be washed out of the mother's bones, and, of course, from her teeth too. Pain in the bones and back is often associated with this process, and teeth respond to the loss of calcium by demineralizing the enamel, a thin, very durable surface layer of dental tissue. This is why tooth sensitivity increases during pregnancy in almost all women.

But thin enamel becomes vulnerable to destruction. Old fillings wobble and fall out, because it is now easier for microbes to penetrate under them, teeth crumble, and fresh pockets of caries appear in the folds of crowns. Tooth pain during pregnancy can strike you unexpectedly and at any time, but more often it happens in the second half of pregnancy, when calcium deficiency is obvious, and the disease has had enough time to weaken even your strongest fillings. Based on this sad picture, the question arises: how to preserve teeth during pregnancy and is it even possible?

Yes, it's possible:

Preventive visits to the dentist
- Fully healed teeth before pregnancy
- Proper care
- Good nutrition and vitamin intake

Usually these simple measures are enough to protect a white-toothed smile.

Brushing your teeth during pregnancy is a special matter. The fact is that not only does your enamel become thin, your gums often become sensitive and even bleed.

Brushing teeth and pregnancy

Choose a medium-hard toothbrush, change it at least once every 2 months for a new one
- you should not use pastes with a high fluoride content, its excess will harm the baby. It is better not to waste money and buy a specialized paste for pregnant women at the pharmacy. Yes, it will be a little more expensive than regular toothpastes, but these pastes have a high calcium content and are created specifically for the vulnerable teeth of pregnant women. We recommend pastes such as 9 months-Pregnadent, Splat-Biocalcium, Splat-Organic, Paradontax and many others. All these pastes are medicinal and before using it, you should consult a dentist; you will still go to him at a very early date.
- brush your teeth 2 times a day, after breakfast and after dinner, after each meal, rinse your mouth with water or at least tea.

If you notice that your teeth are deteriorating, remember that during pregnancy they decay much faster, which means you should contact your dentist as soon as you notice that something is wrong.

Dental treatment during pregnancy

Dental treatment during pregnancy is even associated with some myths that have become established among pregnant women. For example, many people think that they cannot take pictures, take pain relief, cannot pull out a tooth, etc., and are afraid to go to an appointment if a tooth hurts, in case the child is harmed?

Believe me, if you have a toothache during pregnancy, delaying time will only harm yourself (it will collapse) and the baby (risk of infections). Or maybe you don’t have any problems at all, and it’s just increased sensitivity of the enamel or a wisdom tooth is growing (and this happens).

Today, dental treatment during pregnancy is carried out almost in full, as in non-pregnant women, only some things are not done, for example, teeth whitening and dentures, but everything else is possible, necessary and safe.

Yes, once upon a time they were afraid to take an extra photo, because the devices were antediluvian and created a huge radiation load. They could, like a child, be given arsenic and sent home for a week, to suffer from pain until the nerve dies. But not now.

Dental X-rays during pregnancy are performed using equipment that irradiates literally 3 cm of your body, specifically above the tooth, while your baby is completely safe. This means we can solve even the most complex dental problems.

A bad tooth during pregnancy is not a reason to remove it or treat it in wild ways. Anesthesia for dental treatment during pregnancy is carried out with minimal doses of potent modern non-toxic anesthetics that do not affect the fetus in any way. If necessary, safe anesthesia is possible at any time. They definitely won't hurt you.

Thanks to modern equipment, removal of dead tissue from a carious cavity, cleaning of canals and their further filling are carried out as sparingly as possible; moreover, they even try to keep a pregnant woman’s tooth alive for as long as possible. So, dental treatment during pregnancy is not painful, scary or dangerous.

Regarding tooth extraction. There are situations when it is easier to remove a tooth than to treat it, for example, if it is a decayed wisdom tooth. There is no need to be afraid either, you can have teeth removed during pregnancy, and if necessary, then under anesthesia too. And the best thing, of course, is to simply try to prevent tooth decay.

Optimal timing of dental examination for preventive purposes:

Registration at the antenatal clinic
- 20-24 weeks
- 32-34 weeks

Teeth after pregnancy

Your baby was born, you are happy and it seems that everything is over. No matter how it is. For six months after pregnancy, teeth may continue to be vulnerable and weak, especially if you are breastfeeding. This means that all preventive measures must continue to be observed. Take care of yourself.

One of the most controversial issues that arises for many women is dental treatment during pregnancy, about which there are a huge number of myths and rumors. Which ones are worth listening to, and which ones should you ignore?

Medical advice and recommendations will help you understand this problematic situation and make the right decision - whether or not to go to the dentist while pregnant. After all, the health of both the expectant mother and her unborn child depends on this.

Depending on the woman’s heredity and health, teeth can be very damaged during pregnancy, or they can remain completely healthy for the entire 9 months.

The latter is possible if the parents planned the birth of a child and the expectant mother’s oral cavity was sanitized (i.e., treated) even before conception. Why does a fetus growing inside a woman have such a powerful and, in most cases, destructive effect on a pregnant woman’s teeth? Doctors name several reasons:

1. Changes in hormonal levels even affect the composition and properties of saliva, which during this period contributes to the development of caries.
2. During pregnancy, the gums are supplied with large quantities of blood, which makes them loose and accessible to pathogenic bacteria. The result is inflammation in the oral cavity. The consequence is gingivitis. Left untreated, it develops into periodontitis, the main symptom of which is bleeding. All this ends in caries.
3. Because of this, women cannot avoid nausea and vomiting. Vomit has a low level of acidity due to the abundance of hydrochloric acid. They lead to erosion and thinning of tooth enamel.
4. For the intrauterine formation of the child's skeleton, a lot of calcium is consumed. The child receives it from the mother’s skeletal system, which includes teeth. If a woman does not have enough calcium during pregnancy, her teeth begin to decay.

Pregnancy is stress for the female body, which affects all its systems and organs in its own way. The oral cavity is no exception. If there is no sanitation, appropriate treatment, or proper care during this period, the teeth will begin to crumble, crumble and fall out, and the gums will bleed.

And this is where the question arises: is treatment necessary or not? To answer this, it is useful to first know how dental diseases affect the fetus.

Helpful advice. To avoid calcium deficiency during pregnancy, which leads to tooth decay, you need to drink Calcium D-3 Nycomed (with your doctor’s permission) and include in your diet as many legumes, nuts, seeds, fruits, grains, vegetables, herbs, berries, eggs, fish and dairy products.

The impact of dental health on pregnancy

In fact, many women doubt whether it is necessary to treat their teeth during pregnancy - is it possible to wait until the baby is born and visit the dentist after that? If you understand how closely dental diseases are related to the baby’s intrauterine development and health, such a question will not arise. Here are just a few laboratory-proven facts on this matter.

1. According to recent studies, the bacterium that causes caries often leads to premature birth or the birth of a fetus with a low body weight. It stimulates the production of cytokines in the female body - substances that cause uterine contractions.
2. Pulpitis and periodontitis (complications of caries) cause the absorption of pathogenic bacteria and toxins into the blood, which can reach the fetus and infect it.
3. Toothache is a traumatic factor for a pregnant woman, which leads to the release of hormones into the body. All this negatively affects the intrauterine development of the child.
4. An infection from a rotten tooth can enter the gastrointestinal tract and cause preeclampsia - late toxicosis.

These factors are quite enough to understand why you need to treat your teeth during pregnancy in case of exacerbation of dental diseases. At stake is the health of the unborn baby, which must be protected by any means.

But where did the myth come from that oral therapy during this period is dangerous? He has supporters and opponents: both sides are worth listening to.

Stubborn statistics. Caries is diagnosed in 91.4% of women with a favorable pregnancy. And in 94%, if it is complicated by toxicosis.

To treat or not to treat: pros and cons

Are you wondering whether it is possible to treat teeth during pregnancy and whether this is dangerous for the child? Weigh the pros and cons before making your final decision.

Behind

Doctors themselves (gynecologists and dentists) claim that it is possible and simply necessary to treat teeth during pregnancy if any problems arise with them. Arguments:

1. A bad tooth is a source of many bacteria and infections, which after the baby is born can attack his small and defenseless body, since he will be in constant contact with his mother.
2. The woman herself, without taking care of her teeth, can become a victim of the same infections, which will require treatment with antibiotics, which are highly undesirable during pregnancy.
3. After the birth of the child, the mother will have no time to run to the doctors, so it would be better to have her teeth treated during pregnancy.
4. The effect of untreated teeth on the intrauterine development of the fetus is the most negative: it can become infected, suffer from the mother’s worries about toothache, and its body weight and term may depend on this.
5. The dentist’s arsenal includes medications for dental treatment that are completely harmless to the fetus, so there is no need to be afraid of their dangerous effects on the child.

Against

But where did the opponents come from, claiming that going to the dentist would harm an unborn baby? Here's how they explain why you can't treat your teeth during pregnancy.

1. Dental treatment in the early stages of pregnancy using anesthesia can lead to disruption of tissue formation in the fetus.
2. Due to reduced immunity, there is a risk of developing complications after dental treatment.
3. The pain threshold during this period decreases, so dental treatment during pregnancy is a much more unpleasant procedure.

A woman must understand and imagine the dangers of dental treatment during pregnancy in order to warn the dentist about her situation in time. In this regard, he will choose the safest anesthetic drug and advise whether the tooth requires immediate treatment or can wait until the postpartum period.

You need to know this! Lidocaine is allowed as an anesthetic for pregnant women in dentistry, but Mepivacaine is undesirable. Paracetamol and Ibuprofen can be taken as analgesics to relieve toothache, but the latter is strictly prohibited in the later stages. Safe antibiotics for the treatment of incipient inflammation are penicillin, cephalosporin, clindamycin, metronidazole.

Treatment by trimester

For each period of pregnancy, doctors recommend different approaches to dental treatment, which all women expecting a child need to know about. The health and development of the baby may depend on how long even the most harmless anesthesia was applied.

I trimester

1. During the “mitotic” period of the first trimester (from the moment of conception to the 17th day), the embryo has a high sensitivity to toxins. Despite the fact that the fertilized egg is protected by a dense membrane, dental treatment is not recommended at this time.
2. The “organoleptic” period in the 1st trimester is even more dangerous. The formation of organs and tissues in the embryo occurs. Dental treatment with anesthetic at this stage can lead to disruption of this important process, which will lead to deviations in the further development of the fetus.
3. Dental treatment in early pregnancy is not recommended for caries and chronic pulpitis and periodontitis.
4. The exception is emergency interventions: exacerbation of pulpitis and periodontitis, which occur with pronounced pain and are fraught with purulent inflammation.

II trimester

1. The risk of negative effects of dental treatment on a child in the 2nd trimester decreases.
2. In each individual case, the doctor must take into account the toxic effect of medications used in dentistry: anesthesia, antibacterial and other drugs.
3. At this stage, it is advisable to carry out the prevention of dental diseases - professional hygiene.
4. First of all, those teeth whose condition may worsen sharply in the third trimester are treated.
5. If there is no risk, then dental treatment is postponed to the postpartum period.
6. Any decision about dental treatment at this stage is made solely by the doctor.

III trimester

1. The last weeks of pregnancy are characterized by increasing anxiety, fatigue, and rapid heartbeat for a woman. If you add to this the suffering from toothache, an unfavorable picture may emerge: you can give birth ahead of time (you can read about the consequences of early birth). Therefore, treatment is necessary.
2. On the other hand, in the 3rd trimester the uterus becomes especially sensitive to any external influences, which can also provoke premature birth. This applies to the treatment or removal of teeth under anesthesia.

Now you know when you can have your teeth treated during pregnancy: the second trimester is the most suitable time to go to the dentist. Depending on the disease, the doctor will decide what kind of therapy to carry out: preventive or surgical, nerve removal or conventional filling, with or without anesthesia.

Helpful information. The first trimester covers the period from conception to the 12th week inclusive, the second - from 13 to 28 weeks, the third - from 29 to 41.

Treatment of diseases

There are not many dental diseases, but it is they that determine the therapeutic course during pregnancy - how exactly dental treatment is carried out depending on the damage.

Caries

1. Treatment of dental caries is carried out without anesthesia.
2. There are no restrictions for fillings: the choice is made by the pregnant woman herself.

Pulpitis

1. Treatment of pulpitis is carried out only with an injection of anesthetic.
2. Modern anesthetics such as Ubistezin and Ultracain are used, which do not penetrate the placental barrier and are completely safe for the fetus.
3. They contain minimal concentrations of vasoconstrictors, and in some they are completely absent.
4. You may need an x-ray of the tooth, which is not something to be afraid of. One photo will not harm the fetus. Moreover, in modern devices the radiation dose is very low.

Periodontitis

1. Does not always require pain relief.
2. But in most cases, an x-ray will need to be taken.

Removal

1. Dental surgery during pregnancy with anesthesia is mandatory.
2. Requires strict adherence to all doctor’s recommendations in the postoperative period: do not rinse the oral cavity, do not heat it.
3. The exception is “wisdom teeth”. Their removal requires additional manipulations and postoperative use of antibiotics for treatment. So it is better to postpone this procedure until the postpartum period.

Prosthetics

1. There are no contraindications to prosthetics during pregnancy. Orthopedic dentist procedures are safe and painless.
2. Another thing is implantation, which will require large expenses from an already weakened body. The engraftment of implants also occurs under the influence of medications, which do not have the most favorable effect on the fetus.

Gingivitis

1. The most common dental disease during pregnancy, which requires mandatory treatment.
2. Treatment of mild forms of gingivitis comes down to antiseptic treatment of the gums, rinsing, professional teeth cleaning, and applications of anti-inflammatory drugs.
3. After childbirth, the symptoms of mild gingivitis disappear without a trace with appropriate and timely treatment.
4. In severe forms, surgical intervention is performed.

If dental problems are discovered during pregnancy, it is under no circumstances recommended to delay treatment. Even if it is the 1st or 3rd trimester, you must definitely visit a dentist for professional advice and follow all his recommendations. And especially for the use of folk remedies to eliminate toothache.

Medical educational program. Gingivitis is inflammation of the gums without affecting the teeth. If left untreated, it develops into periodontitis - inflammation of the tissues surrounding the tooth.

Folk remedies

Indeed, not everyone can endure toothache. And if we also take into account the decrease in the pain threshold during pregnancy, it is almost impossible to endure this torment. So what should you do if you have to wait before visiting the dentist? Harmless rinses and lotions made from medicinal herbs can always come to the rescue. Since they do not enter internally (into the blood and gastrointestinal tract), their effect on the development of the fetus is minimal, and dental treatment using traditional medicine can be a real salvation for a pregnant woman.

• Sage

1 tablespoon Brew dry or fresh sage with boiling water (200 ml), leave for about an hour. Treatment consists of rinsing.

• Salt and soda

In equal quantities (1 teaspoon each), dissolve table or sea salt with baking soda in a glass of warm water. For rinsing.

• Carnation

Warm clove powder applied to the gums helps relieve bleeding.

• Garlic, onion, salt

Grind the garlic and onion into a puree. Mix 1 teaspoon each. both, sprinkle with a pinch of salt. Place it in the hollow of the diseased tooth for 15 minutes, cover with cotton wool.

• Aloe, Kalanchoe

Squeeze the juice from the fleshy leaves of aloe or kalanchoe. For treatment, moisten the affected tooth or gums with it several times a day.

To successfully use all these folk remedies for toothache, two factors must be taken into account. Firstly, there should not be an allergy to their components. Secondly, it would not be superfluous to consult a gynecologist or dentist about their use in such an interesting position as additional dental treatment. Well, in order to never encounter the problem of toothache, you need to be able to properly care for your oral cavity.

I have an opinion. Some doctors believe that sage, like essential oils, provoke uterine cramps, so they should not be used for dental treatment during pregnancy. On the other hand, rinsing with these infusions is so insignificant in the amount of active substances entering the blood that it is hardly worth fearing miscarriage or premature birth from such therapy.

We have already found out how much pregnancy affects the oral cavity. Therefore, it is so important to keep it clean throughout the entire 9 months. Proper dental care is the best prevention of dental diseases, eliminating painful treatment and dangerous anesthesia.

1. It is better to purchase a 5th generation brush with a multi-level arrangement of micro-textured, artificial bristles. The projections allow you to penetrate into hard-to-reach interdental spaces, where plaque accumulates, contributing to the demineralization of teeth. The brush should be of medium hardness or soft.
2. The toothbrush is changed every 2-3 months, i.e. 3-5 times during pregnancy.
3. It must be kept perfectly clean: each time after cleaning, rinse it under running water and store it in a glass with the bristles facing up to dry completely.
4. To remove plaque, it is recommended to use floss - special threads.
5. There are special toothpastes for pregnant women - it is better to use them (for example, Pregnadent). If you haven’t found any, look for those whose composition is safe for the body: they should not contain sodium lauryl sulfate, triclosan, fluorine, or abrasive substances. It would be good if the tube said “hypoallergenic”.
6. You should not brush your teeth immediately after vomiting, which is a common companion for pregnant women during toxicosis. The enamel, which is exposed to hydrochloric acid at such moments, quickly wears out.
7. It is advisable to use mouth rinses after each meal.
8. A woman needs to think about her dental health even before pregnancy. Treatment of all diseased teeth will be required; you need to start taking a complex of vitamins with a mandatory calcium content. Try to eat right, add more cheese, cottage cheese, and nuts to your diet.
9. While carrying a child, you should definitely visit the dentist, even if your teeth do not bother you, at the beginning and in the middle of pregnancy, and then immediately before giving birth.
10. The expectant father also needs oral sanitation before the baby is born.

Good oral hygiene significantly reduces the risk of caries and other dental diseases. And then the question will not arise whether to go for treatment or refuse, whether it is harmful or not. But in any case, you need to know about possible complications after dental problems during pregnancy.

Innovative developments. Why is it better to use fifth-generation toothbrushes during pregnancy? The bristles on it remove 3.5 times more plaque and bacteria from the surface of the teeth than regular brushes. And then there will be no need for dental treatment - only prevention will be needed.

Complications and consequences

Complications can result from refusing dental treatment during pregnancy. Undesirable consequences can also occur if the rules of dental therapy have been violated. For example, it was prescribed in the early stages with corresponding contraindications, or drugs were prescribed that had a detrimental effect on the fetus.

During pregnancy

1. The immune system becomes vulnerable during pregnancy, so that an infection emanating from a diseased tooth, which was previously limited to the oral cavity, risks becoming generalized and developing into sepsis.
2. Intrauterine infection of the fetus due to untreated caries.
3. If dental treatment was performed during pregnancy with anesthesia in the first trimester, this is fraught with deviations in the intrauterine development of the fetus (read also:).
4. Preeclampsia - late toxicosis.
5. Premature birth.

After the birth of the child

1. Low body weight of the newborn.
2. A child may be born nervous and capricious because his mother during pregnancy suffered a traumatic factor such as pain, which will only intensify in the absence of dental treatment.
3. If you do not treat your teeth during pregnancy, after the birth of your baby, you can accidentally infect him. Its source is diseased teeth. The method of infection is your kiss, the pacifier you licked for him. These bacteria can even pass into breast milk. The result is serious illnesses in the infant.

Dental treatment during pregnancy is not only necessary, but also a necessary event. However, it is carried out competently, with the involvement of specialists. Dental diseases are dangerous and harmful for the child and the mother, not the therapy itself. Doctors will never prescribe drugs or procedures that will negatively affect the intrauterine development of the fetus. Trust them - and no infection will be able to overcome you and your baby.

Caries during pregnancy is quite common. What is dangerous during this period and can it be treated in such a delicate position of a woman? Conflicting opinions and frequent fears lead to the fact that tooth decay leads to other complications for the body of the mother and the unborn child.

When should you see a doctor, what can he do and how can he help, what medications should I use? All this will be discussed in this article. After all, if you notice tooth decay in time and perform the necessary manipulations, you can not only maintain oral health and a beautiful smile, but also contribute to a healthy pregnancy.

Causes

Why do women often experience tooth decay and caries during pregnancy? Doctors identify a number of factors that can affect this process:

• due to hormonal changes in a woman’s body, the composition of saliva is disrupted, as a result of which its protective properties are reduced and bacteria spread more actively throughout the oral cavity;
• insufficient hygiene, when less time and attention is paid to brushing teeth due to various difficulties, especially during toxicosis;
• unbalanced nutrition, in which the female body does not receive enough of the necessary microelements for the formation of healthy teeth;
• passion for sweet, sour or floury foods accelerates the destruction of enamel;
• frequent snacking worsens the acid-base balance in the mouth;
• vomit especially damages the structure of hard tissues, corroding it with its chemical composition;
• a significant decrease in calcium and fluoride in the body of a pregnant woman, since the bulk of them consumed with food is spent on the formation of the embryo;
• rare visits to the dentist, when the initial stages of diseases are missed.

Many expectant mothers are afraid that dental treatment during this period is dangerous for the child and therefore avoid visiting the clinic for any symptoms. They believe that it is better to endure pain than to use the services of a specialist. In fact, such avoidance of dental procedures threatens serious consequences for the mother and fetus.

Why is caries dangerous during pregnancy?

This disease is caused by a special bacterium, Actinomyces Naeslundii. If it is present in the mouth, it often enters the woman’s stomach and bloodstream along with food and, as a result, causes increased tone of the uterus, opening of the cervical canal and destruction of the membranes.

Therefore, any type of caries (regular or cervical) can cause premature birth or lead to early miscarriage if the cause of the disease is not eliminated and the active destructive activity of these microorganisms in the mouth is not prevented.

How does it affect the woman and the fetus?

In the presence of infectious foci on the teeth, bacteria spread throughout the body, enter the bloodstream and contribute to various ailments. From such pathogenic effects, the fetus experiences a developmental delay, certain congenital diseases, and the child may be born with low weight or some abnormalities.

Also, from extensive caries, periodontal tissues or pulp become inflamed, which will lead to other diseases. And this, in turn, will be manifested by the following symptoms:

• increased body temperature;
• impaired functioning of the digestive system;
• appearance or exacerbation of toxicosis.

Separately, it is necessary to say about toothache. Its gradual increase will worsen the general psycho-emotional state of the woman, which will also negatively affect the course of pregnancy and the formation of the fetus. And the need to take painkillers will have a bad effect on the development of the embryo.

Those women who had caries during pregnancy and did not see a doctor know that it is much easier to cure it in the early stages than to allow various serious disruptions in the functioning of their or their child’s body. Therefore, you should not avoid visiting the dentist just because you are pregnant.

Can X-rays and anesthesia be used?

Modern medicine offers various methods of anesthesia, both local and general. However, during pregnancy it is recommended to use only injections into the gums or other means with a local effect. For this, the safest ones remain Septanest, Ubistezin, Scandonest. But they are approved for use by women only from the 14-15th week of pregnancy, when the placenta is already fully formed, protecting the fetus.

A special issue remains the harm of X-ray exposure. Sometimes in the process of treating caries during pregnancy it is difficult to do without it. But conducting such an examination is strictly prohibited. Exceptions include some extreme cases. And at the same time they still try to use other diagnostic methods.

Now there are special films with super sensitivity and special sensors that require much less dangerous radiation. If there is an urgent need to take an X-ray of a tooth during pregnancy, they are used together with a protective apron made of lead. But even doing this in the first trimester is prohibited.

Methods of diagnosis and therapy

So, what conclusion can we draw? Is it necessary to treat caries when a woman is in a delicate position or is it better to wait until after childbirth? In each case, you should consult a doctor and leave the decision on this issue at his discretion. Here it is important to take into account the patient’s medical history, her condition, the course of pregnancy, various health problems, in particular with the oral cavity, and much more.

The most important factor remains the timing:

1. The first trimester is particularly dangerous from any external influences. It is divided into the period of fertilization and after it. But in each of these time periods, it is advisable to exclude any dental procedures, as well as taking medications or using anesthesia. The fetus is especially sensitive to toxins, stress, and any unnecessary influence can disrupt the formation processes of all organs and systems. In addition, this period is characterized by a woman’s uncomfortable state, when she suffers from vomiting, nausea, heartburn and may faint from excessive stress. It is believed that only extreme acute conditions (pulpitis, periodontitis) can be treated using this term.
2. The second trimester is characterized by a calmer course of pregnancy. At the same time, the fetus gains weight and grows in size, but is well protected from any external influences by a reliable placenta. This period is favorable for dental treatment. In some cases, the doctor may postpone some manipulations to the postpartum period, if the problem does not threaten the development of complications.
3. The third trimester also becomes dangerous in terms of treatment. At week 25, the fetus begins to grow rapidly and put pressure on the inferior genital vein, which forces the woman to take only comfortable positions. Sitting in the dental chair for long periods of time can cause increased blood pressure, increased heart rate, and even fainting. Excessive emotional experiences and the influence of medications can cause increased uterine tone and lead to premature birth, which is also undesirable. Therefore, during this period, only treatment of acute conditions is carried out, which cannot be postponed. But at the same time, the woman should take a more comfortable position on her left side in the doctor’s chair in order to withstand the intervention without unnecessary unpleasant consequences.

How to relieve toothache?

If you have any symptoms of an ongoing pathological process, you should visit a doctor as soon as possible. But if it is not possible to do this immediately, then it is necessary to relieve the pain of a woman in a delicate position in safe ways. For this, folk recipes are offered:

• rinse the mouth with soda or saline solution;
• use decoctions of medicinal herbs for the same purposes - St. John's wort, etc.;
• apply chopped garlic wrapped in gauze to your wrist;
• you can hold a piece of lard in your mouth near the sore tooth;
• aloe leaf can also eliminate pain symptoms for a while;
• plantain and its juice have a similar effect.

In the second trimester of pregnancy, it is permissible to take painkillers, but in moderate dosage and for a short period. Among the safe medications are the sanitation of the oral cavity and the treatment of all dental diseases.

Thoroughly at least twice a day, and rinse after each meal.

For maximum prevention of pathologies, clean the interdental space with additional means - toothpicks, etc.

After gagging, do not immediately pick up a toothbrush. It is enough to first rinse your mouth and only after half an hour perform hygienic treatment of the surface.

Try to adhere to a properly balanced diet so that all the necessary vitamins and microelements that can meet the needs of the fetus and the female body are supplied with food.

Visit your dentist on time. After all, caries detected at the initial stage, when it still looks like a white spot, is quite easy to treat and does not require any serious or dangerous interventions for the fetus.

Pregnancy is a very trembling and exciting state in a woman’s life, but it is associated with an increased risk of many diseases. Among others, teeth suffer; sometimes teeth are even considered a marker (indicator) of the health of a pregnant woman. So, we will tell you how pregnancy affects teeth, whether it is necessary to treat teeth during pregnancy and whether it is safe for a pregnant woman to do this, and you will also receive recommendations for prevention and self-help measures.

How does pregnancy affect teeth?

During pregnancy, the condition of teeth definitely worsens and this is due to the influence of two factors at once:

1. Hormonal changes.

Starting from the early stages of pregnancy, the body gradually switches to a different hormonal background. To maintain pregnancy, natural immunosuppression (suppression of immunity) is necessary; this mechanism allows the mother’s body to “come to terms” with the presence of the fetus (the fetus is a foreign independent organism, because half of its chromosomes were inherited from the father). Natural immunosuppression during pregnancy is provided by progesterone, a hormone whose content increases significantly with the onset of pregnancy. In addition to the positive effect, decreased immunity contributes to a much faster progression of caries and gum disease. This applies to both diseases of the teeth and gums that existed before pregnancy and did not manifest themselves, as well as newly acquired ones.

2. Increased consumption of minerals.

The increased consumption of minerals, primarily calcium and phosphorus, is due to the needs of the growing fetus. Calcium is necessary for the baby to build the musculoskeletal system, the formation of the organs of vision and hearing. If there is insufficient supply of calcium from the outside, the concentration of ionized calcium in the mother’s blood decreases and it begins to be washed out of the skeletal system, including from the teeth (to a lesser extent). However, teeth are a very sensitive object and the loss of even a small amount of calcium salts weakens and thins the enamel. if calcium replenishment does not occur, then the teeth become extremely vulnerable to infection (remember immunosuppression).

There are factors predisposing to dental disease during pregnancy:

Severe toxicosis in the first half of pregnancy. Vomiting in pregnant women provokes dental deterioration due to two mechanisms: damage to tooth enamel by the acidic contents of the stomach with frequent vomiting and heartburn, and a violation of general metabolism, which occurs when food is indigestible and lack of appetite due to nausea.

Late vomiting of pregnancy. Late (after 22 full weeks) vomiting of pregnant women itself indicates a metabolic disorder and possible intoxication of the body, and also interferes with a balanced diet (dairy products, as a rule, cause attacks of nausea).

Anemia of pregnant women. The more pronounced the anemia of a pregnant woman, the worse the supply of minerals to tissues and organs.

History of chronic diseases of the digestive tract. If before pregnancy a woman suffered from chronic gastritis, peptic ulcer, gallbladder dyskinesia, cholecystitis, pancreatitis, then during pregnancy the course of these conditions may worsen. The reason for the deterioration is the high content of progesterone, which reduces the tone of ALL smooth muscle organs, but if this is good for the uterus, then a decrease in the tone of the esophagus, stomach, and gall bladder leads to disruption of their work, heartburn, nausea, and belching. Periodic reflux of acidic stomach contents into the oral cavity leads to damage to tooth enamel and opens the door to infection.

Adherence to irrational diets before and during pregnancy. This includes veganism (refusal of all products of animal origin, including indirect ones, such as honey and other bee products), a strict raw food diet (this way of eating often leads to hyperacid conditions and also damages the gums), and a diet with severe restriction of calories and protein.

Poor nutrition (excess flour, abuse of fast food, consumption of carbonated drinks, etc.) also does not contribute to both health in general and dental health in particular. This diet is low in fiber, but rich in simple sugars, which provide abundant food for oral bacteria.

Is it necessary to treat teeth during pregnancy?

The answer here is clear - YOU NEED IT!

During pregnancy, pre-existing problems may become worse and appear, and the risk of new caries is high. Ideally, a woman approaches pregnancy as planned and undergoes sanitation of all foci of infection before conception (oral cavity, throat and tonsils, sinuses, gastrointestinal tract, urinary system, reproductive system and bronchopulmonary apparatus). But this is not always the case.

Therefore, when you register with the antenatal clinic, one of the first referrals you will receive is to the dentist for a preventive examination and, if necessary, treatment.

Optimal timing of dental examination for preventive purposes:

Registration at the antenatal clinic (up to 12 weeks)
- 20-24 weeks
- 32-34 weeks.

The minimum scope of examination is twice during pregnancy: at registration and in the third trimester.

In the first trimester, dental treatment is indicated only for emergency indications (active caries, acute toothache), this is due to the undesirability of using anesthesia.

The second trimester is the ideal time for therapeutic measures. The period from 14 to 26 weeks is considered the safest for treatment. Almost all types of dental care can be provided. It is not recommended to just start dentures, since dental tissues are quite fragile, and the gums are loose, there is a possibility of implant failure and an increased risk of infection.

It will also not hurt to carry out hygienic teeth cleaning, fluoridation and other types of enamel protection. But it is better to refrain from removing tartar; this procedure has a strong effect on the enamel, and its restoration during gestation will be slow, increasing the risk of cervical caries.

If there are indications, it is possible to perform tooth filling, depulpation and canal filling.

Tooth extraction is performed according to extreme indications, but is not contraindicated. Limitations may arise due to the choice of anesthesia, which takes into account the balance of benefit to the mother and risk to the fetus.

If necessary, it is possible to install braces, but only after consulting an orthopedic dentist.

In the third trimester, all of the listed types of dental care are also allowed.

Anesthesia for dental treatment. Is it possible or not?

Difficulties in providing dental care arise in the first and third trimester, this is due to restrictions in the use of local anesthetics. Most drugs contain adrenaline, which reduces the toxicity of the anesthetic, but creates a sharp, albeit short-term, vasospasm. In the first trimester, this is also dangerous due to a possible increase in the tone of the uterus, and in the third trimester, spasm of all blood vessels can lead to a jump in blood pressure in the mother, which indirectly affects the condition of the fetus.

Providing local anesthesia in the second trimester is considered the safest and most recommended.

Currently, drugs based on articaine hydrochloride (ultracaine, ubistezin, alfacaine, brilocaine) without adrenaline are most often used in pregnant women. The use of these anesthetics is safe; they do not penetrate the hematoplacental barrier to the baby and do not cause vasospasm.

Is it possible to take dental x-rays during pregnancy?

If possible, any radiation exposure should be avoided during pregnancy. But sometimes without this examination it is impossible to determine the extent of the damage, and therefore the amount of assistance provided. Now there are X-ray machines with minimal radiation exposure, as well as special dental tomographs. The study is performed according to indications, starting from the second trimester.

If you go to a dental clinic in early pregnancy other than through the antenatal clinic, always inform the dentist about your situation.

What are the dangers of untreated teeth during pregnancy?

1. An untreated tooth will continue to decay, and if you delay treatment until after childbirth, it is possible that treatment will be much more difficult or tooth extraction will be indicated.

2. An untreated tooth is a source of infection. As you know, the most evil and active bacterial flora is found in the oral cavity. The oral cavity comes into contact with many external pollutants (contaminated food, inhalation of suspended matter and dust, household infectious agents, such as the habit of biting nails or the tip of a pen, wetting a finger with saliva when turning pages, and so on).

The mouth has an ideal temperature and humidity environment for bacteria, as well as an abundant blood supply. Infectious agents can penetrate the bloodstream, and therefore to the child, through the mother-placenta-fetus system. Chronic circulation of bacteria threatens many adverse consequences: intrauterine infection of the fetus, chronic fetal hypoxia, increased risk of preeclampsia in the mother.

Prevention of tooth decay during pregnancy:

1) Balanced diet.

Rational nutrition implies nutritious food in sufficient quantities, which brings maximum benefit to the mother and child. Preference is given to lean meats, any fish, dairy products, cereals, vegetables, fruits and herbs.

If we are talking about a diet that prevents tooth decay, then first of all we are interested in foods rich in calcium. Contrary to popular belief, cottage cheese is not a calcium-rich product; the content of this mineral in cottage cheese is the same as in kefir or broccoli.

Calcium rich foods:

cheeses (Parmesan cheese comes first), sesame seeds, canned sardines, almonds, herbs (parsley, lettuce and basil), cabbage, beans and chocolate. Dairy products contain calcium in small quantities (the most calcium-rich product is skim milk), but in an easily digestible form, so they should not be neglected.

Red and black currants, sorrel, spinach and gooseberries make it difficult to absorb calcium due to their high content of fruit acids. In combination with these acids, calcium forms insoluble compounds that will not bring benefits, but will simply be excreted from the body. Coffee, tea and cola also make it difficult to absorb calcium due to the presence of caffeine and tannin.

2) Hygiene.

Oral hygiene is the basis of dental health. Currently, various methods of care are available, you just need to not be lazy regularly (use them 2 times a day).

The toothbrush should be soft or medium hard and should be changed at least once every 3 months.

Teeth cleaning is carried out according to a simple algorithm.

Before cleaning, you need to rinse your mouth to remove the bacterial mass that has accumulated overnight. Before use, the brush should be washed with soap or scalded with hot water. This rule is rarely observed by anyone, but think about how many bacteria have settled and multiplied on the brush overnight, especially since the humid and warm atmosphere of the bathroom is very conducive to this.

You need to brush your teeth for three or more minutes. Why exactly three minutes? The fact is that you should do about 300-400 brushing movements, and this takes just about 3 minutes. Direct brushing is performed in three techniques: “sweeping” and “sweeping” movements from top to bottom to clean the front and back surfaces of the teeth, back and forth movements to clean the chewing surface and circular polishing movements in conclusion.

After this, you need to clean the inside of your cheeks and the surface of your tongue. Use the back of a toothbrush with a ribbed surface to do this. If you have toxicosis, do not press too hard on your tongue, especially in the root area, as this will provoke vomiting.

After brushing, rinse your mouth again with warm water and wash the brush. The brush should stand in the cup with its head up to dry.

For intermediate hygiene, use dental floss, irrigator and mouth rinses.

Dental floss

Floss must be used very carefully if there is a problem with bleeding gums. Floss is used to clean spaces between teeth that are difficult to reach with a brush.

An irrigator is a device that gently washes away dirt from the spaces between teeth using a stream of water under low pressure.

Irrigator

During toxicosis, when vomiting periodically bothers you, you need to take special care of your dental health. After each vomiting, rinse your mouth with warm water, a weak solution of soda (1/2 - 1 teaspoon per glass of warm water, if this does not provoke vomiting), and then use mouth rinses.

3) Taking vitamins and mineral complexes.

Taking into account the vitamin and mineral poverty of our modern diet, all pregnant women are advised to take special complexes, starting from the early stages (Femibion ​​Natalcare I, Elevit Pronatal). In combination with a fortified diet, this is usually sufficient.

But if necessary, the prescription of additional calcium supplements (calcium D3-Nycomed, Calcemin Advance) is indicated. The medications are taken under the supervision of a doctor, the duration is determined individually.

Timely care and contact with a dentist will save you from many problems and preserve the beauty of your smile. Take care of yourself and be healthy!

Obstetrician-gynecologist Petrova A.V.

From this article you will learn:

• is it possible to treat pulpitis during pregnancy,
• during what periods it is necessary to treat periodontitis during pregnancy,
• When should dental treatment not be performed during pregnancy?
• Is dental treatment allowed while breastfeeding?

The article was written by a dentist with more than 19 years of experience.

Treatment of caries during pregnancy -

So, is dental treatment possible during pregnancy... Dental treatment during pregnancy is possible during strictly defined periods. We will introduce you to these periods below.

Examination and history taking –
At the very beginning of communication with a pregnant woman visiting a dental clinic, the doctor should examine the patient and collect an anamnesis, and also understand the tactics of possible dental treatment depending on the stage of pregnancy in order to minimize the risk of adverse effects on the fetus.

The doctor must carefully collect a medical history (history of previous pregnancies, pregnancy-related diseases such as diabetes, hypertension, preeclampsia, eclampsia...). Sometimes, to assess the risk of complications of dental treatment, a consultation with the obstetrician-gynecologist who is seeing the patient is necessary.

Radiography in pregnant women –
During pregnancy, X-ray examinations in which X-rays pass through or in close proximity to the fetus are prohibited. Nowadays, highly sensitive films and sensors are actively used in dentistry, which require 8-10 times smaller X-ray radiation than conventional traditional films. In addition, there are special protective equipment (lead apron).

Those. In some emergency cases, radiography in pregnant women is possible, but still undesirable. It is strictly contraindicated only in the 1st trimester of pregnancy.

Treatment of caries during pregnancy: tactics

1. First trimester of pregnancy –

Two periods can be distinguished here:

• The most unfavorable period for dental treatment is the period from the moment of fertilization until the implantation of the fertilized egg (approximately the 17th day). This period is characterized by significant sensitivity of the embryo to medications, toxins, stress... During treatment, there is a high probability of spontaneous abortion.
• On the 18th day, the formation of organs and tissues in the embryo begins. Clinical features of this period are nausea, vomiting, increased salivation, heartburn, increased gag reflex, and frequent fainting.
  During this period, it is undesirable to carry out dental treatment for pregnant women, because treatment can lead to disruption of the formation of organs and tissues in the fetus.

conclusions –
Dental treatment during pregnancy cannot be carried out in the 1st trimester! An exception can be made only for emergency interventions, against the background of acute pain or purulent inflammation. Treatment of pulpitis during pregnancy, acute periodontitis, as well as exacerbations of chronic periodontitis can serve as an example of emergency interventions, because These diseases occur with severe pain and the development of purulent inflammation.

However, treatment of caries, chronic pulpitis or chronic periodontitis, i.e. diseases that are not accompanied by acute symptoms of inflammation are best carried out in other periods.

2. Second trimester of pregnancy -

The second period is called “fetal” because At this time, the fetus is growing rapidly. The risk of undesirable effects of dental treatment on the fetus in this trimester decreases, however, it is necessary to take into account the toxic effects of drugs used in dentistry (anesthesia, antibacterial and other drugs).

conclusions –
During this period, it is necessary to carry out the prevention of dental diseases (professional hygiene), as well as to treat precisely those teeth that have a high risk of exacerbation in the third trimester. If there is no such risk, then it is advisable to postpone treatment to the postpartum period. This decision must be made by the dentist.

3. Third trimester of pregnancy -

As fetal weight increases (especially in the supine position), fetal pressure on the aorta and inferior vena cava increases, resulting in decreased cardiac output. This may be accompanied by rapid heartbeat, a sharp decrease in blood pressure, and even loss of consciousness. This is important to consider because... During dental treatment, patients are in a semi-lying position.

In the later stages of the third trimester, the sensitivity of the uterus to external influences increases, which can lead to premature birth. Also during this period, the pregnant woman experiences increasing fatigue and anxiety, which can also complicate the implementation of therapeutic measures.

conclusions –
It is advisable to carry out only emergency interventions. In this case, the position of the pregnant woman in the dental chair should be “slightly on her left side” at an angle of 15 degrees. In this position, the fetal pressure on the aorta and inferior vena cava will be less.

Dental treatment while breastfeeding –

Dental treatment for a nursing mother is not only possible, but necessary. Dental treatment during lactation may be temporarily contraindicated only in certain psychological conditions associated with severe stress and fatigue. However, if the child is breastfed, it is still necessary to take certain precautions related to the exposure of the child to various medications, for example, those used for pain relief, through breast milk.

Dental treatment during menstruation –

There are no special contraindications for dental treatment on such days. However, if your periods are accompanied by increased nervousness, severe weakness, as well as a severe psycho-emotional state, then it is better to postpone dental treatment to more favorable days.

Caries in pregnant women: causes

There is a widespread belief among women that rapid tooth decay during pregnancy is due to the fact that during pregnancy the fetus' need for calcium and phosphorus increases. And there is a myth that teeth can soften or fall out during pregnancy.

However, to date there is no study that would confirm these findings. On the contrary, hundreds of studies show that calcium in the tooth enamel of pregnant women is in a stable form, and the increased need for calcium is compensated by the mother’s body not by leaching it from the teeth, but by increasing its absorption from the gastrointestinal tract and reducing its secretion in the urine and sweat .

Observations show that increased tooth decay during pregnancy due to caries is associated in most pregnant women with a significant deterioration in oral hygiene, as well as a change in their food preferences - consumption of large amounts of carbohydrates and acids, which stimulate the development of cariogenic microflora and trigger the processes of caries formation. Lack of oral hygiene in these conditions leads to the fact that teeth begin to decay “as if” faster,
than usual.

Prevention of caries in pregnant women –

To prevent caries, pregnant women can be recommended:

• Nutrition -
  Frequent snacks between main meals and sugary drinks are very harmful. Every time you snack and don’t brush your teeth, you supply cariogenic microorganisms in the oral cavity with food, which enhances their destructive properties.

The effect of caries on pregnancy -

Why is caries dangerous during pregnancy? Is it even worth having dental treatment during pregnancy or is it better not to risk it?

The effect of caries on the fetus –
The effect of caries on the fetus has been proven in studies. A study conducted by American scientists revealed a clear relationship between the number of Actinomyces naeslundii (a bacterium that has a pronounced cariogenic effect) and premature birth and the birth of a fetus with low body weight. It is assumed that these bacteria also stimulate the production of anti-inflammatory cytokines (substances that cause contraction of the uterus and dilation of the cervical canal) in the body of a pregnant woman. The more the cervical canal expands, the more destruction of the fetal membranes and premature birth occur.

Towards the end of the diaper and romper period, it can be scary to look into your mouth. Concern is brought not only by the lack of shine of teeth, but also by their outstanding fragility. The constant presence of dental chips in the mouth causes irritation. There is no need to talk about the absorption of fruits at all, only in grated form - the teeth do not tolerate stress. Let's add to this increased bleeding and salivation.

In order for the child to be born healthy and beautiful, and for the expectant mother to maintain a dazzlingly attractive smile, it is necessary to listen to the advice of specialists.

Forgotten caries

Everyone advises planning a pregnancy, but in some situations it is quite difficult. Pregnancy does not always occur when you want it. In some situations, you have to wait for years for the appearance of a lucky star. Preparations can take so long that it’s easy to forget about pregnancy. And there is no need to talk about a random “vagrant bird”. In general, the first thing a pregnant woman needs to do after returning from the gynecologist is to make an appointment with the dentist. The feeling of complete health is often apparent. A careful examination of the dentition will definitely reveal a couple of holes.

Caries is based on three main problems: damage to the enamel, eating a lot of sweets and microflora in the mouth.

During pregnancy, all three causes are hypertrophied. Frequent vomiting in the first trimester can lead to “acidification” of saliva. Increased appetite contributes to the consumption of more easily digestible carbohydrates (sugar, chocolate, etc.).

In an acidic environment and in the presence of carbohydrates, microflora develops quickly. A vicious circle is formed. Microorganisms, breaking down sugar, contribute to even greater acidification of saliva and destroy enamel. Considering the causes of caries, it becomes clear how important prevention is.

Treatment of caries during pregnancy is not contraindicated, rather the opposite. All kinds of holes in the teeth, even small ones, should be healed. Remember that a small hole can be the entrance to a larger cave.

There are no restrictions regarding the filling material. Moreover, it is better to use a fluoride filling material (which uses a special lamp to cure).

Superficial caries, as a rule, does not require mandatory anesthesia. But if ordinary caries is complicated by the development of pulpitis, then you cannot do without an anesthetic. The doctor will select the safest drug.

I feel what I feel in my teeth

During pregnancy, it is especially important to eat right.

However, if hot and cold dishes cause severe aching pain, appetite disappears, in this case at least two suffer (mother and fetus).

The problem of increased tooth sensitivity is associated with the thinning of the enamel, which, like a shell, covers the underlying dentin, enveloping the vessels and the actual sources of pain - the nerves. The appearance of pain is an impetus that forces you to go to the dentist. There may be several reasons for thinning enamel. One of them, the most common, is the loss of calcium by the enamel, as a result of insufficient intake from food and increased consumption by the body. Another reason is early toxicosis, which was already mentioned above. Another reason that is not related to pregnancy, but does occur, is the wrong choice of toothpaste.

Toothpastes of the "Sensitive" type have been developed especially for those with teeth with increased sensitivity.

According to dentists, the most common cause of tooth sensitivity is improper brushing.

To learn how to properly brush your teeth, you must contact a dental center. Training is carried out individually in one session. The cost of this procedure is about 300 rubles. As a rule, the dentist invites the pregnant woman for a follow-up cleaning. To assess whether the patient is coping with the task correctly or not.

Tooth sensitivity can be caused by cervical caries, when a hole in the tooth is located at its base, next to the gum. Then the solution to the problem is only a filling in the problem area. If tooth sensitivity does not decrease, despite all efforts, then “Sensigel” will help, it contains special substances that reduce tooth sensitivity. The cost of the drug is 180-190 rubles. The dental office has pharmacological agents to reduce tooth sensitivity that have a prolonged effect (up to 6 months), but the cost of the procedure is much more expensive.

Bleeding Gums

If you suddenly notice that while brushing your teeth, traces of blood remain on the brush, and when you further rinse your mouth, the foam from the toothpaste turns pink, this means that you have increased bleeding gums. Increased bleeding is a warning sign that all is not well.

Healthy teeth do not necessarily mean healthy gums. Increased bleeding of gums during pregnancy is not uncommon. It may be due to hormonal changes in a woman’s body. To solve this problem, you need to consult a doctor. In this case, the diagnosis sounds like this: “gingivitis of pregnant women.”

To prevent the occurrence of this unpleasant disease, plaque should be removed and tartar in the subgingival area should be removed. In a dental office, these procedures are performed using different techniques. One of them - the so-called "air flow" - is carried out without the use of a bur and without a tip. A stream of air, water and powder flows under pressure. In this way, plaque and partially tartar are removed. This procedure is also called gentle whitening, since the teeth are restored to their natural shine and whiteness, and the enamel structure does not deteriorate.

Another method of preventing gingivitis allows you to completely remove massive deposits of tartar. It requires the use of ultrasound. The procedure is completed by polishing the teeth and coating them with a special fluoride varnish. Both “air flow” and other methods will require significant material costs. The cost is approximately the same - 80-90 rubles per tooth.

As a rule, gum inflammation is caused by “harmful” microflora of the oral cavity.

A number of toothpastes, including extracts of medicinal plants, have an antiseptic effect. Additions of chamomile, calendula, and sage relieve inflammation and strengthen the gums. To enhance the effect of the paste, it is supplied with a complex of vitamins.

If, however, gingivitis does develop, then after removing plaque and tartar, the dentist will most likely suggest using a special gel for the gums; you can read about it in more detail in the “review of oral hygiene products for pregnant women.”

The gel is used in addition to toothpaste, and not instead. If the manifestations of gingivitis are severe, then gingival anti-inflammatory dressings are used. The course is 3-10 sessions. They contribute to the rapid subsidence of the inflammatory process and reduce bleeding.

It is worth checking your toothbrush; sometimes the reasons for increased bleeding of the gums are quite commonplace - the bristles are too hard.

Increased bleeding may be a symptom of a more serious disease - periodontitis. Periodontium is the soft tissue surrounding the tooth. Their inflammation is periodontitis. It is quite severe and can result in the loss of healthy teeth.

I don't want to eat, but my mouth is watering

During pregnancy, drooling is common. This type of toxicosis does not pose a threat when it is moderate. Sometimes drooling is a consequence of uncontrollable vomiting. When it takes on a grandiose scale, solivation can reach 1 liter per day.

In this case, the appetite is impaired, the patient loses weight, her health worsens, and the patient must be admitted to a hospital. Treatment is necessary to avoid significant fluid loss. Moreover, with severe salivation, maceration of the skin around the mouth occurs, which can become an entry point for infection.

Some toothpastes have astringent properties: “Lokalut”, “Oral B”, etc. To prevent irritation, apply a rich cream to the facial skin. X-RAY

Is dental examination contraindicated during pregnancy?

It’s not for nothing that everyone advises to heal your teeth before pregnancy. After all, once it occurs, dental treatment can be difficult. It should be noted that we are talking about problem teeth, for which a simple filling is not an option. Sometimes, in order to provide qualified assistance, it is necessary to first take a picture of the tooth, and then, depending on the situation, treat or remove it. In the first and last trimesters of pregnancy, X-ray examination is not recommended. However, in the second trimester of pregnancy, the ban on dental x-rays is lifted.

If suddenly a problematic tooth makes itself known at an “unexpected time”, and the doctor insists on taking an image, you should not worry too much about it. Because before taking a picture, the laboratory technician will put on a lead apron, which will protect you from that insignificant dose of X-rays that are necessary in this situation.

To avoid trouble, it is better to inform your dentist about your pregnancy. There is a more gentle research method - computer visiography. In this case, the image of the tooth is displayed on a computer screen, the X-ray beam is more focused, and the dose is approximately 10 times less than when taking a conventional X-ray.

Healthy teeth for the father and mother are the key to healthy teeth for the child

Already in the fifth or sixth week of pregnancy, the rudiments of the baby’s teeth are formed. If the mother has a “bad” mouth by this period of pregnancy, then the process of mineralization of the fetal tooth buds is disrupted, which over time will lead to problems for the child, both with milk and permanent teeth.

For normal growth of bones and tissues of the unborn child, in addition to other minerals, sufficient amounts of calcium and fluoride are necessary. A well-balanced diet rich in vitamins A, C, D, minerals, plus nutritional supplements or prenatal vitamins will fully compensate the body and promote good overall health and normal dental development for the baby. Nutritional supplements and vitamin-calcium complexes are individually selected by a gynecologist.

Foods richest in calcium: milk and dairy products, kale, broccoli, spinach, baby turnips. Calcium is best absorbed from fish products.

A lack of calcium may be indicated by seizures and tooth decay in the mother. If symptoms appear, you should consult a doctor. You should not take calcium supplements on your own, as an excess of it will lead to skeletal disorders in the fetus.

However, the quality of the baby’s teeth depends not only on the condition of the mother’s teeth. Half of all dental problems in babies are caused by their father. No matter how much a pregnant woman takes care of her mouth, when communicating with her husband, kissing him, she transfers “harmful” microflora into her oral cavity. The husband should have all his teeth treated after, or better yet before, he finds out about his wife’s pregnancy.

There probably won’t be a parent who hasn’t hugged and kissed their barely born child. Every kiss is a swarm of microorganisms, and not always harmless ones.

Be it a father, grandfather or grandmother, everyone considers it their duty to cuddle and breathe on the baby. Before allowing all relatives near the baby, a prudent mother should first send her household members to the dentist's line.

Germs and prevention

Expectant mothers simply have to watch their mouth. Severe microbial infection of the teeth and gums of the expectant mother can serve a very sad purpose. Poor hygiene facilitates the unhindered penetration of bacteria from the mother’s mouth into the body of her baby. To prevent unpleasant consequences it is necessary:

Brush your teeth after each meal for 2-3 minutes, since the action of the antibacterial and mineral components of toothpastes occurs when the paste is in the mouth for at least this time.

• Use additional oral hygiene products (gels, rinses, breath fresheners).
• Change your toothbrush every 3 months.
• Carry out professional teeth cleaning at least once every 4 months, and after childbirth - once every 6 months.

Most favorable timing for dental treatment during pregnancy:

1st visit - at 6-9 weeks of pregnancy,
2nd visit - at 16-18 weeks,
3rd - at 26-28 weeks,
4th, last, before birth at 36-38 weeks of pregnancy.

Before pregnancy and after childbirth, optimal special periods are not established.

"Tooth rash" after childbirth?

I hope that the child was not born in pain? In order for the child to grow and develop quickly, nature provided the woman with a source of nutrition for the baby - milk. Constant production of a nutritious product is possible only with a regular supply of necessary vitamins from outside. If the teeth have withstood the stress of pregnancy, this does not mean that the feeding process will go unnoticed. It happens that during feeding, teeth simply “melt” before our eyes. What's happening?

Apparently, there is a lack of calcium (or fluorine) in the body. In order to prevent possible destruction, it is necessary to ensure a sufficient supply of minerals, taking into account the consumption for the formation of milk. The mammary glands produce about a liter of milk per day (or even more).

Dental prosthetics and pregnancy

This problem is especially relevant during late pregnancy. After 30 years, it is difficult to find a woman who has not lost at least one tooth. And if there are no teeth or they require removal, then the question of prosthetics arises. Anyone who has already received their “bridge” or “implant” knows how much time, effort and money goes into this process (in any case, a good half of the pregnancy can pass).

Is it possible to have dental prosthetics during pregnancy? Yes, you can. When using modern materials, prosthetics can be completed in 2 weeks. This process will require 2-3 visits. If pregnancy occurs after the start of the prosthetic process, then it is necessary to complete it, since against the background of hormonal changes in the body, the teeth may become loose, change the position and inclination, which will further complicate prosthetics.

Implantation is out of the question, since this is a surgical operation, it is difficult to perform and complications may occur.

Rotten tooth! Delete or wait?

Elena K.: “Before pregnancy, I had very bad teeth, some required removal, and I didn’t have enough time and courage to go to the dentist. Now that I’m pregnant, I’m afraid to be left completely without teeth. What’s the best thing to do?”

Due to the environment, not everyone can boast of healthy and white teeth, especially those with average and low incomes. So if pregnancy threatens to deprive you of your last teeth, you need to take immediate action. Remove all rotten, damaged teeth that cannot be restored. Firstly, this will eliminate the source of infection from the mouth, and secondly, diseased teeth tend to worsen during childbirth. And then you may have to give birth in the dentist’s office with an acute toothache.

Thanks to the development of new anesthetics that do not pass through the blood-placental barrier, removal will not be a particular problem. New drugs "Ubistezin" and "Ultracain DS" will provide fast and reliable anesthesia.

The safest time for tooth extraction is the 3-6th month of pregnancy.

Regular toothbrush or electric?

During the first half of pregnancy, a medium-hard toothbrush is suitable. By the third trimester, it is better to choose a soft brush, as this will avoid bleeding gums. Of course, unless there is a tendency to form hard plaque.

If you are used to using an electric toothbrush, then it is better to put it aside during pregnancy and use it only occasionally. Undoubtedly, the electric miracle removes plaque better. However, it has a greater traumatic effect on the gums than a regular toothbrush, and the gums are perhaps one of the most vulnerable places in a pregnant woman’s mouth.

If you really want to thoroughly clean your teeth, leave this procedure to a professional. Cleaning your teeth at the dentist's office will cost about 1,000 rubles.

Traditional methods

For lovers of traditional medicine, you can suggest, in addition to everything previously listed, to rinse your mouth with an infusion of chamomile, calendula, sage and other medicinal plants. Self-production of products such as “egg shell plus lemon” and other compositions is undesirable, since the effect is doubtful, but the harm may be serious.

Pregnancy is an important event and a wonderful period in the life of any woman. However, during this period the risk of developing various dental diseases increases significantly. This is due to a general restructuring of the body, including hormonal levels and metabolism, and a decrease in the body’s protective fluids. How to keep teeth healthy during pregnancy? And what to do if a pregnant woman develops dental diseases?

Why treat teeth during pregnancy?
Having learned about her pregnancy, the first doctor a woman should visit is a dentist, even if she has never had problems with her teeth. Pregnancy is accompanied by a restructuring of the hormonal background of a woman’s body, as a result of which the immune system is weakened, and as a result, favorable conditions are created for the development of many microorganisms, including the oral cavity. Therefore, even caries during pregnancy develops much faster than in the normal state. The process of forming and carrying a pregnancy takes a lot of energy from a woman. For the bone structure of a child, a woman’s body needs a significant amount of calcium, fluorine, phosphorus and other minerals, the deficiency of which is replenished from the mother’s bones and teeth. This kind of process negatively affects the bone tissue and teeth of the expectant young mother, as a result of which caries develops very quickly.

If caries is not treated, it can lead to the development of more complex dental diseases - pulpitis (inflammation of the nerve of the tooth) and periodontitis, which should also not be ignored during pregnancy, since in the future the young mother will acquire many problems not only with her health, but also with baby's health. For example, infections penetrate through the inflamed teeth and gums of the mother into the body of the unborn child, weakening his body, as a result of which he may develop a tendency to allergies, and most importantly, caries may appear on the first teeth that appear.

If previously it was contraindicated to treat teeth during pregnancy, since the technologies used were dangerous for the health of the unborn baby, today, according to most experts, it is simply necessary to treat bad teeth during pregnancy. In addition, modern dental clinics have in their arsenal special medications for pregnant women, safe digital X-ray equipment (minimal dose of radiation, the effect is local and highly targeted), highly qualified specialists competently select anesthesia for pregnant women, which would simultaneously effectively relieve pain and not cause harm to the future child. In addition, special dental clinics for pregnant women have already appeared in our country, which have been effectively operating in the West for a long time.

During pregnancy, you can remove teeth, treat caries, periodontal disease, gingivitis, bleeding gums, inflammatory processes in the teeth, and it is also possible to install braces. But you should wait with implantation and removal of tartar; these procedures are not recommended for use during pregnancy.

If you don’t have any dental problems during pregnancy, it is still recommended to visit the dentist’s office once every three months (three in total during pregnancy), where the doctor will tell you about all the nuances of oral care during pregnancy and recommend a brush and toothpaste .

Another reason for mandatory visit to the dentist during pregnancy and after it is periodontal disease and its initial stage - gingivitis (inflammation of the gums), the symptoms of which increase towards the end of pregnancy. Particularly careful adherence to hygienic rules in oral care can significantly alleviate the condition and prevent possible complications. However, it is impossible to completely get rid of this disease on your own. And untreated gingivitis leads to tooth loss even more often than untreated caries. If a woman develops gingivitis during pregnancy, the chance that the condition of the oral cavity will return to normal after the birth of the child is much higher than if the woman suffered from this disease before pregnancy. Therefore, it is recommended to visit the dentist at least once a year even before pregnancy. When treating gingivitis, as a rule, professional teeth cleaning and anti-inflammatory therapy are carried out.

In addition to dental treatment, it is also necessary to remove plaque and tartar.

During what period of pregnancy is it best to treat teeth?
In the first trimester of pregnancy, the formation of all organs and systems of the unborn child occurs, in the second trimester - the development of these organs and systems, in the third trimester - the preparation or independent functioning of these systems and organs. Each trimester has its own characteristics: the first and third trimesters account for the largest number of “critical” periods, so any medical interventions are not advisable during these months. The exception in this case is those medical procedures and manipulations that are necessary to preserve the life and health of the unborn child and his mother. That leaves the second trimester, which is considered relatively safe. Therefore, the period from the fourth to the sixth month of pregnancy (this is 14-20 weeks) is recommended to be used for dental procedures. When visiting a dentist, it is imperative to notify the doctor about your situation, stage of pregnancy, and indicate the medications you are taking. Depending on these factors, treatment tactics will be developed.

Treatment of caries during pregnancy.
Since anesthesia during dental treatment in pregnant women is strictly contraindicated, as a rule, treatment of caries in a pregnant woman is carried out without anesthesia. Using a drill, the dentist removes damaged tooth tissue and places a filling, which can be chosen according to your taste (chemical or light-curing). Neither one nor the other filling poses any danger, either for the mother or for the child. If anesthesia is still needed, do not worry about this, since today there are special anesthetics (Ubistezin, Ultracain) that have only a local effect and do not penetrate the placental barrier. This means that they are absolutely safe for the unborn child. In addition, these drugs contain a rather low concentration of vasoconstrictors, and some do not contain them at all (preparations based on mepivacaine).

Inflammation of the nerve or pulpitis is treated with anesthesia, which was mentioned earlier. Treatment of periodontitis (inflammation of the peri-root tissues of the tooth), most often, is carried out without the use of anesthetics. However, in both cases, X-rays are necessary, which allow high-quality filling of the root canals. In general, x-rays are contraindicated before the 20th week of pregnancy. After this period, x-rays are allowed, only the doctor must know about your situation. If the office is not equipped with a special X-ray unit (the radiation dose is reduced tens of times), which protects the doctor and patient from radiation, the doctor will provide you with a so-called lead apron to protect your stomach.

Tooth extraction during pregnancy.
If it is not possible to save the tooth, it is removed under local anesthesia. To avoid any complications, you must strictly follow all medical recommendations (do not rinse, do not heat the surgical area, etc.). If it is necessary to remove a wisdom tooth, then it is better to postpone such removal until later, since such removal is usually accompanied by the prescription of antibiotics.

Prosthetics, fluoridation and teeth whitening during pregnancy.
There are no contraindications to prosthetics. The procedures performed by an orthopedic dentist are usually painless and safe. But dental implantation is not recommended, since the process of engrafting implants is accompanied by large costs for the body. A young mother should direct all her strength and energy to the development of a healthy child. In addition, implants are most often implanted under the influence of medications, the action of which reduces the body’s reactivity, which is an absolute contraindication during pregnancy.

To preserve and strengthen tooth enamel during pregnancy, local fluoridation with fluoride-containing solutions and varnishes is recommended. In domestic practice, the application method of fluoridation is used, in which a so-called “individual tray” (wax casts of teeth) is made, into the recesses of which a fluoride-containing composition is poured, after which the casts are applied to the patient’s teeth (10-15 procedures), and the second method is carrying fluoride varnish with a brush on the surface of the teeth (3-4 visits).

The teeth whitening procedure during pregnancy is absolutely safe and harmless to the expectant mother and fetus. It is carried out in two stages: removing and removing plaque and tartar using ultrasound and treating teeth with special whitening pastes. Teeth whitening is carried out within an hour.

How to preserve teeth during pregnancy?
The birth of a child must be taken very seriously, therefore, long before pregnancy itself, both parents should cure all damaged teeth, since affected teeth are a source of infection, which negatively affects the health of mother and baby.

The best and most effective way to fight bacteria is to thoroughly brush your teeth in the morning and evening. During pregnancy, it is best to use a medium-hard toothbrush. The brush must be changed three times during the entire period of pregnancy. If your gums are bleeding heavily, use a soft-bristled brush. But it is not recommended to use an electric brush during pregnancy and breastfeeding.

To care for the oral cavity, you should additionally use dental floss or floss, which allows you to clean the interdental spaces; you can use dental elixirs, which have a cleansing and protective effect. Also, after every meal during pregnancy (and not only) you should rinse your mouth with boiled water.

Toothpaste used during pregnancy should also be of high quality: it should prevent the development of caries and gum disease and strengthen tooth enamel. Your dentist can recommend a suitable toothpaste during your consultation.

In addition, in order to preserve your teeth during pregnancy, you should limit yourself from consuming carbohydrate foods, especially sweets and starchy foods. A pregnant woman's diet should be balanced and include the necessary macro- and microelements and vitamins (calcium, phosphorus and fluorine, as well as vitamin D). Your daily diet should include fish oil, chicken eggs, cod liver, vegetables and fruits, cottage cheese, cheese, nuts and other products. During pregnancy, a woman should take vitamin and mineral complexes for pregnant women daily.