Dental Treatment During Pregnancy
Ms. Lu is in her early twenties. Two of lower wisdom teeth (Fig.1: 32; Fig.2: 17) are impacted and have cavities (*). They are extracted before Ms. Lu is pregnant.
After she gets pregnant, three of her lower molars (Fig. 1: 31 (Fig.3); Fig.2,4: 18,19) have severe toothache and need emergency root canal. This is a tough issue.
Pregnancy is divided into three trimesters. Dental treatment in the first trimester may increase chance of abortion and malformation of the baby, whereas long dental treatment such as root canal in the third trimester causes serious discomfort due to growing baby and may increase chance of premature birth of the baby. The second trimester is the safest time for emergent dental treatment.
When Ms. Lu has nerve infection of the tooth #31 due to large cavity (Fig.1 *), she is in the early 2nd trimester. Root canal is finished smoothly in two appointments (Fig.3R) . Filling (F) is also done to prevent re-infection. A crown will be done after the baby is delivered.
Within a month, another tooth bothers her so much that she cannot sleep (Fig.2: 18). This tooth has had root canal done before (R1), but it gets new infection. It needs root canal to be done again. The procedure is much more difficult than root canal for the first time. To get root canal done for the second time, old root canal filling has to be dug out first. It takes a lot of time. Anyway there is no other choice, because Ms. Lu refuses extraction. It turns out that she survives the second ordeal well (Fig.4: R2 : root canal for a second time).
When Ms. Lu enters the third trimester, a third of her molar knocks on the door. The tooth #19 has had a filling (Fig.2: F). The nerve is dying and killing both the mom and the baby. In brief this tooth also needs root canal. Her tummy is as big as a water melon. She cannot lie down flat for long period of time. With a lot of care and gentleness, we manage to get this root canal done for her successfully (Fig.4 19 R). She takes breaks during lengthy, but painless treatment.
In summary, dental treatment is reserved for emergency during pregnancy. To avoid crisis, we have to take care of our teeth before getting pregnant.
Xin Wei, DDS, PhD, MS 1st edition 04/30/2012, last revision 05/04/2012