Caries in pregnant women, treatment, diagnosis. Caries during pregnancy: can it be treated and how does it affect the fetus?

Caries, which occurs during pregnancy, is not always treated, which is associated with the fears of expectant mothers of harming the fetus. As a result, they endure this disease to the last, consulting a doctor only in cases of its exacerbation. How justified are these actions? Is it even possible to treat caries during pregnancy?

The statement that pregnancy inevitably leads to tooth decay and loss is somewhat exaggerated. In fact, the influence of this period on the occurrence and development of carious defects is individual and depends on several factors.

The main causes of the occurrence and development of caries during pregnancy are:

• changes in the composition of saliva and its protective properties as a result of hormonal changes;
• improper or insufficient oral hygiene, leading to the accumulation of pathogenic plaque;
• lack of fluoride necessary to strengthen tooth enamel;
• frequent snacking between meals;
• changes in eating habits leading to increased consumption of sour and sweet foods;
• frequent vomiting during toxicosis, leading to the destruction of tooth enamel due to the effect of hydrochloric acid contained in the vomit.

By the way, the widespread belief that an acute lack of calcium leads to the development of caries during pregnancy has no basis.

According to the latest scientific research, the level of calcium in a woman’s teeth remains stable throughout the gestational period. And to provide the growing fetus with the element it needs so much, it is automatically absorbed from the gastrointestinal tract.

Video: dentistry during pregnancy

The effect of caries during pregnancy on the fetus

The main reason for the need for dental treatment during pregnancy is the possibility of developing a number of complications. The most common of them are pulpitis and periodontitis.

The first disease is characterized by inflammation of the dental nerve, and the second - by the peri-root tissues of the tooth. The inflammatory process is accompanied by the formation of toxic substances and the proliferation of pathogens. Once in the stomach, they are absorbed into the mother’s blood and spread throughout the body.

Thus, an untreated tooth can become a source of infection, negatively affecting the condition of the fetus and leading to the development of late toxicosis or even premature birth.

Prolonged, persistent pain experienced by a pregnant woman due to complications of caries also negatively affects her nervous system. And this greatly complicates the overall course of pregnancy. You can avoid these consequences by consulting a doctor in time for examination and qualified treatment of caries.

Photo: Mother’s sick teeth negatively affect the fetus

When can you treat

The question of when can a pregnant woman have her teeth treated is quite relevant. Nowadays, pregnancy is divided into three periods of approximately equal duration, or trimesters.

In each of these trimesters, processes important for the growth and formation of the fetus occur. The list of dental services that a woman can use depends on them.

First trimester

The entire first trimester of pregnancy is the most unfavorable time for dental treatment. The period from the moment of fertilization of the egg until its implantation into the uterine cavity is especially dangerous.

But even in the period up to 13 weeks of pregnancy, when all the internal organs and tissues of the fetus are formed, it is undesirable to carry out dental treatment on the expectant mother. The exception is cases when emergency intervention is necessary due to purulent inflammatory conditions or acute pain.

Regardless of the stage of pregnancy, you should consult a doctor as soon as possible if there are signs of acute periodontitis or pulpitis, as well as exacerbation of chronic dental diseases.

All other diseases that are not accompanied by acute inflammatory symptoms should preferably be treated at other times. Thus, you will avoid disruption of fetal formation at its initial stage, significantly reducing the risk of spontaneous abortion.

Second trimester

The second trimester of pregnancy is characterized by increased growth of the already formed fetus. During this period, almost all the vital organs of the unborn child are fully formed, which makes it possible to carry out dental treatment of teeth with minimal risk of damage.

However, it is also necessary to take into account the possible influence of antibacterial or anesthetic agents used in dentistry. medicines.

The list of procedures permitted for the second trimester includes hygienic teeth cleaning in the dental office and caries treatment.

The decision on the need to treat a particular tooth is made by the attending physician based on the individual characteristics of each patient. As a last resort, if the carious defect is not progressive, treatment can be postponed to the postpartum period.

Video: dental treatment during pregnancy

Third trimester

The third trimester is characterized by an increase in the weight of the growing fetus, which can complicate dental treatment.

This is due to the fact that all dental procedures are performed in a special chair, where the patient is in a reclining position. This increases fetal pressure in the aorta and inferior vena cava, leading to a decrease in cardiac output. This process may be accompanied by tachycardia, a sharp decrease in blood pressure and even loss of consciousness of the patient.

During the third trimester, the sensitivity of the uterus to the influence of external factors increases sharply, which can provoke premature birth.

Therefore, during this period, treatment of diseases requiring urgent intervention is considered. In this case, the pregnant woman is placed in a chair tilted to the left at an angle of 15 degrees. This position will reduce the pressure of the fetus on the mother's internal blood vessels.

Video: is it possible to treat teeth during pregnancy?

Features of diagnosis and treatment during pregnancy

Diagnosis and treatment of caries in pregnant women begins with collecting a medical history. The expectant mother should inform her doctor about the history of previous pregnancies, as well as all related diseases.

These may include preeclampsia, eclampsia, diabetes, hypertension, etc. Under no circumstances should details of illnesses be concealed, since this information will help the specialist choose the optimal tactics of medical intervention.

In some cases, the degree of possible complications of dental treatment can only be assessed through consultation with the patient’s obstetrician-gynecologist. As for the dental procedures themselves, the most common questions raised are the appropriateness of the choice of anesthesia and the use of radiography.

Radiography

Routine X-ray examinations, which carry a risk of exposure to the fetus, are strictly contraindicated for pregnant women. But if she needs to take a picture, a woman can use modern highly sensitive equipment, which has a significantly lower radiation level.

At the same time, she will be asked to wear a special lead apron to protect the abdominal area.

Despite the increased safety of modern equipment, X-ray examinations are prescribed to pregnant women extremely rarely, especially during the first trimester.

The procedure is justified in cases where the risk from it is significantly lower than the development possible consequences from an existing disease.

Anesthesia

Many women are concerned about the choice and safety of anesthetics used for dental treatment during pregnancy. Today, there are a number of topical preparations based on articaine.

This is a synthetic substance that does not penetrate into the blood of patients and through the placenta. It provides high-quality pain relief without the risk of harm to the fetus.

Prevention during pregnancy

There are several effective ways prevention of caries during pregnancy.

• Preliminary examination and treatment of caries at the planning stage of pregnancy. It will help avoid the need for treatment during pregnancy.
• Careful oral hygiene. Brushing your teeth after every meal and regularly using dental floss will help reduce the risk of developing caries, gingivitis and the formation of hard dental deposits - tartar.
• Prevention of the development of dental erosions. It involves using a solution of baking soda after each episode of vomiting, which is so typical in the first trimester. The principle of action of soda is to neutralize the hydrochloric acid contained in vomit, which negatively affects tooth enamel. After rinsing, you need to wait about half an hour and then brush your teeth.
• Developing good eating habits. It is necessary to avoid frequent consumption of sour and sweet foods or drinks. You should also avoid frequent snacking between meals.

The health of the unborn baby largely depends on physical condition mother during the period of gestation. Therefore, one should not refuse qualified treatment for fear of harming the child. Moreover, modern equipment and medications used in dentistry reduce this risk to a minimum.

Pregnancy is not only a wonderful period in the life of any woman, but at the same time it requires special attention. Due to the current situation, the body must undergo very dramatic restructuring, which entails an increased risk of developing various diseases.

Changes in hormonal levels, metabolism, all this negatively affects the protective functions of the body.

Main causes and dangers

Among other diseases, the risk of developing caries increases significantly during this period. Moreover, its appearance can be very active and acute. Therefore, the excitement of expectant mothers regarding the possibility of treating this problem and its impact on the condition of the fetus and the woman herself is understandable.

Most pregnant women are wary of visiting dentists because they are scared by stories about the negative effects medical procedures for the fruit This is a very serious problem.

Failure of expectant mothers to understand the need for timely treatment of caries ultimately leads to serious complications after childbirth.

The main reasons for the development of the disease:

• the composition of saliva changes as a result of hormonal imbalance, as well as its protective properties;
• insufficient or ineffective oral hygiene;
• malnutrition, which is common cause shortage essential vitamins and minerals;
• changing food culture, frequent snacking;
• addiction to sweets, flour, sour;
• vomiting due to toxicosis, destroying tooth enamel.

Impact on maternal and fetal health

The most common myth among pregnant women is that the fetus requires large quantity calcium, phosphorus, and takes it away from the mother’s body.

Although it has long been scientifically proven that during gestation the level of calcium in the female body does not change. For its growth, the fetus takes all the necessary elements from the gastrointestinal tract.

Why is caries dangerous for a pregnant woman?? Firstly, the bacterium Actinomyces naeslundii, which causes its appearance, can cause premature birth and the birth of a child with low body weight.

Among other dangers it is worth noting:

• Such bacteria stimulate the production of anti-inflammatory cytokines, which contract the cervical canal and uterus. The more they accumulate, the more likely the protective membrane of the fetus is to be destroyed.
• If complications of caries are allowed, for example, the appearance of pulpitis and periodontitis, then due to the formation of even a local purulent focus, toxins will reach the fetus through the blood.
• Constant toothaches will greatly affect the psycho-emotional state of a woman. And this also negatively affects the child.
• Infectious lesions of the oral cavity are a common cause of intrauterine infection, which in turn can lead to delays in fetal development and cause miscarriage.
• An increase in temperature, which is very dangerous in this condition.

It is quite easy to start the disease, but solving this problem in the later stages is extremely dangerous. Therefore it is best carry out complete sanitation of the oral cavity during pregnancy planning.

Although this does not mean that after conception it is too late. Modern dental methods offer very gentle technologies and means.

Anesthesia and X-rays: can they be used?

Pregnant women are allowed only local anesthesia, drugs general strictly prohibited. It is better to administer anesthesia only in case of acute pain syndrome, or for the treatment of serious diseases such as pulpitis, periodontitis.

Special pain relief products are allowed at 14-15 weeks.

Among the approved drugs:

• Ultracaine;
• Ubistezin;
• Septanest;
• Scandonest.

As for radiography, this diagnostic method is contraindicated for pregnant women. As an alternative, modern films and ultra-sensitive sensors are used, which use radiation that is several times less. It is strictly forbidden to take x-rays in the first trimester.

Diagnostics and therapy at different periods

During pregnancy, caries develops rapidly, so it is necessary to fight it even at the stage of formation of a chalk spot. Otherwise, there is a very high risk of tooth loss.

You should definitely see a dentist, but treatment will depend on the stage of pregnancy. To begin with, the specialist must collect an anamnesis, determine the reduction in the increase in intensity, and study in detail the history of previous visits and other diseases.

Treatment tactics are based on the duration of pregnancy, and paths are chosen that will minimize the risk of impact on the fetus.

Is it possible to do something and how to treat caries during pregnancy, watch the video:

For each of the three trimesters has its own list of medical actions.

First trimester

For dental intervention This period is considered the most undesirable.

Moreover, it can be divided into two stages:

• From the moment of conception until the implantation of the egg. These days, the embryo reacts extremely sharply to all kinds of drugs, toxins, and psychological aspects. Due to the high risk of miscarriage, any intervention is prohibited.
• From the 18th day, tissues and organs begin to actively form in the fetus, so performing any therapeutic measures also undesirable.

The dentist can make an exception if there is an urgent need, for example, suppuration, severe pain due to pulpitis, acute or chronic periodontitis.

Second trimester

It is during these three months that it is recommended, if necessary, to carry out treatment and prevention of caries. The risks of negative consequences during this period are insignificant, but still do not forget about the dangers of some medications.

Preference is given to gentle methods.

The dentist will decide which teeth are best treated in this moment, and which ones can endure until the postpartum period.

Third trimester

Dental treatment in recent months also undesirable unless we are talking about urgent cases.

Since the weight of the child has increased significantly and because of this the load on the vena cava has increased, the woman has to cope with a rapid heartbeat and sudden surges in pressure. Loss of consciousness is very likely.

In addition, in the last trimester, the sensitivity of the uterus to all kinds of external interventions increases significantly. female body. This is fraught with premature birth.

The expectant mother begins to worry more and more, worry, and get tired, which can have a bad effect on the results of treatment.

If intervention cannot be avoided, then the woman should, at a minimum, sit correctly and comfortably on a chair. It is best to lie on your left side to relieve some of the pressure on the vena cava.

How to relieve pain?

First, you should examine the tooth yourself and assess its condition, if possible. The first action that should be taken is constant brushing and rinsing.

In the latter case, you should use soda and salt, diluted in warm water, or a decoction of medicinal herbs.

Regardless of whether rinsing helped you or not, you will definitely need to visit the dentist.

At home, you can use folk remedies or medications allowed for pregnant women. It is better to give preference to the first option.

Among folk remedies, the most effective are:

• rinsing with infusions of St. John's wort, calendula, sage;
• salt and baking soda diluted in warm water;
• applying finely chopped garlic to the wrist;
• use of plantain: place the squeezed leaf in the ear, or rub the juice over the gum over the inflammation site every two hours;
• applying an aloe leaf to the gums;
• sucking lard: place a slice between the cheek and the sore tooth for 10-15 minutes.

If you prefer more modern means, then during pregnancy pain can be relieved with the following medications:

• No-shpa or drotaverine;
• Grippostad (exclusively in the 1st trimester);
• Paracetamol (if the pain is not severe);
• Kalgel;
• Tempalgin;
• Pentalgin;
• Nurofen;
• Ibuprofen (strictly prohibited in the 3rd trimester).

You should not take more than one tablet of any of the above medications. In the first trimester, it is better to stop taking medications altogether.

Always remember the dosage and take the pills only when absolutely necessary.

Prevention methods

As preventive actions for pregnant women I can recommend:

• Carry out oral treatment in advance. If pregnancy is planned, then there is nothing complicated about preliminary dental filling.
• Proper and thorough hygiene. It is enough to stick to the most simple rules: brush your teeth as many times as you eat, use dental floss, toothpicks.
• Prevention of erosion as a consequence of constant toxicosis. Vomit has a certain level of acidity, which with frequent exposure has a destructive effect on the enamel.

  To protect your health, do not rush to run for a toothbrush immediately after gagging. First you need to rinse your mouth thoroughly using a light solution baking soda. The procedure can be carried out only after half an hour.

• Proper nutrition. The most harmful to a pregnant woman’s teeth are sugary drinks and frequent snacks.

If you do not monitor your oral health and do not follow these simple recommendations, your risk of developing caries increases. And further processes can negatively affect the health of the unborn baby.

Therefore, you need to treat everything at once, or even better, prevent such problems from occurring, and then you will only enjoy your pregnancy.

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Waiting for a baby!.. What could be more wonderful!.. But this wonderful time of waiting can be overshadowed by toothache or other dental diseases.

Causes of caries in pregnant women.

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. The fetus receives calcium from the mother's blood. There is also 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 Then.

Observations show that increased tooth decay during pregnancy due to caries is associated in most pregnant women with a strong 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.

The influence 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: a study conducted by American scientists revealed a clear relationship between the amount 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.

The impact of caries complications on the fetus: the simplest complications of caries include pulpitis and periodontitis. They arise due to the fact that tooth decay reaches the neurovascular bundle inside the tooth, as a result of which the latter becomes inflamed and the tooth begins to hurt. Moreover, the effect on the fetus occurs from two sides:

• firstly, inflammation of the dental pulp (pulpitis), and even more so, the spread of inflammation beyond the tooth, causing the absorption of toxins (and even pathogenic bacteria) into the blood, which are carried with the bloodstream throughout the body. The effects of this process are quite detrimental to both the woman and the development of the fetus;
• secondly, the psycho-emotional state of a woman has a great influence on the condition of the fetus. Toothache is a psycho-traumatic factor. Pain causes changes in many systems and organs, not only in pregnant women. For example, pain leads to increased release of certain hormones and changes in hormonal status. Of course, all this also adversely affects the fetus.

Treatment of caries during pregnancy.

Dental treatment during pregnancy is possible, but only during certain periods.

At the very beginning of communication with a pregnant woman visiting a dental clinic, the doctor should pay attention to examining the patient and collecting 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.

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


• During pregnancy, X-ray examinations in which X-rays pass through or in close proximity to the fetus are prohibited. Besides. Nowadays in dentistry it is possible to use highly sensitive films and sensors, as well as protective equipment (lead aprons) that reduce the radiation load many times. However, despite this, the use of diagnostic radiography is undesirable during pregnancy, especially in the first trimester;
• When carrying out preventive and therapeutic dental measures in pregnant women, it is necessary to take into account that the woman should be in a semi-sitting position, since the horizontal position provokes an increase in intra-abdominal pressure in combination with relaxation of the smooth muscles of the gastrointestinal tract, clinically manifested by heartburn, nausea, vomiting, sternum pain . Manipulations should be carried out under the control of heart rate, heart rhythm, blood pressure, changes in which are possible during the appointment and are caused by psycho-emotional stress associated with a visit to the dentist and the expectation of pain.

First trimester of pregnancy: Dental treatment is not recommended and only emergency interventions should be performed. Since this period is characterized by significant mitotic activity of the embryo and its sensitivity to toxins, and, as a consequence, a high probability of spontaneous abortion. Also in the first trimester, the formation of organs and tissues in the embryo occurs, and treatment during this period can lead to disruption of their formation.

Second trimester of pregnancy: the risk of undesirable effects of dental treatment on the fetus in this trimester decreases, however, here it is necessary to take into account the toxic effects of drugs used in dentistry (anesthesia, antibacterial and other drugs). During this period, it is necessary to carry out a program for the prevention of dental diseases - professional hygiene, as well as treatment of 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.

Third trimester of pregnancy(7, 8 and 9 months of pregnancy): during this period, the pregnant woman experiences increasing fatigue and anxiety. 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. In the later stages of the third trimester, the sensitivity of the uterus to external influences increases, which can lead to premature birth.

Therefore, during this period, it is advisable to carry out only emergency interventions.

Prevention of dental caries in pregnant women has a dual goal: to improve the dental status of women and to carry out antenatal prevention of dental caries in children.

The health of the mother during pregnancy affects the development of the child's teeth, especially during the 6-7th week, when the process of developing teeth begins. Studies of tooth buds have shown that during a pathological pregnancy, the mineralization of fetal tooth enamel slows down.

Features of the intrauterine period of development of the cervical system:

4 – 5 week– the formation of the fetal jaw bones and soft tissues of the face occurs. Exposure to aggressive factors leads to the formation of clefts.

6 – 7 week– laying of the rudiments of temporary teeth, teeth may not develop or supernumerary teeth.

17 – 18 weeks– the formation of the rudiments of permanent teeth begins. Edentia or supernumerary teeth may develop.

Week 20– mineralization of the deciduous incisor rudiments begins. The enamel may be weakly mineralized, and future teeth are susceptible to caries. Non-carious lesions such as enamel hypoplasia may form.

Week 28– the rudiments of primary canines and molars begin to mineralize. There is active mineralization of the fetal skeleton.

32 – 34 weeks– mineralization of the rudiments of the first permanent molars begins.

Week 38– the beginning of mineralization of the first permanent incisors.

Scheme for the prevention of dental diseases in pregnant women:

OBSTETRIC-GYNECOLOGIST

• At the first visit to the antenatal clinic, refer the woman to the dentist;
• Explain the need for training in rational oral hygiene, dental treatment, and professional hygiene.

DENTIST

• Examination of the oral cavity, individual recommendations for dental care;
• Training in rational oral hygiene;
• Professional hygiene at intervals of 2-3 months;
• Motivating women to care for their children’s teeth immediately after they erupt;
• Recommendations for limiting sugar in children's diet to 20 g per day and using pacifiers.

PEDIATRICIAN

• Promotion of breastfeeding;
• Recommendations on diet, limiting sugar consumption to 20 g per day;
• Motivating parents to regularly visit the dentist, starting from the age of 6 months.

I would like to note that only with the cooperation of a doctor and a pregnant woman can good results be achieved in the prevention of dental caries.

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What preventive measures are being taken

Caries and pregnancy are closely related, and it is at this time that the risk of pathology increases. Preventive measures should be carried out even before conception occurs. At the stage of pregnancy planning, a woman should visit a dentist, undergo treatment of all problem teeth, sanitation of the oral cavity, and removal of tartar. After which it is necessary to be observed by a specialist during the entire period of gestation.

Often, expectant mothers are interested in whether professional hygiene is allowed at this time. There is a list of conditions or diseases for which ultrasonic (US) teeth cleaning and the Air Flow device are not recommended or prohibited:

• epilepsy;
• presence of a pacemaker;
• nasal breathing disorders;
• asthma;
• chronic lung diseases in exacerbation;
• HIV and hepatitis;
• venereal diseases;
• changes in blood sugar or diabetes;
• colds;
• herpes;
• tumor processes.

This is due to the use of an aerosol when brushing teeth from plaque and tartar. A cloud of wet dust and infection can cause respiratory failure in a pregnant woman, and high blood sugar can lead to the risk of prolonged bleeding from the gums during traumatic manipulation. In certain situations, the possibility of treating a disease in a pregnant woman can be determined with a related specialist (gynecologist, endocrinologist, therapist, ENT doctor, oncologist).

Tartar removal is contraindicated in the first trimester.

Preventive measures for pregnant women include following the rules of oral hygiene:

• brush your teeth after every meal, preferably with toothpastes selected by your dentist (in extreme cases, at least just rinse your mouth);
• after random acts of vomiting due to toxicosis, rinse your mouth with a soda solution to neutralize the acids from the vomit;
• proper nutrition, exclusion of sweets, flour products and chocolate (which contain a high content of carbohydrates that are harmful to teeth);
• compliance with all doctor's orders.

Proper oral hygiene and a normal diet are highly likely to protect against caries.

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The culprits of the disease

Like other patients, caries in pregnant women is caused by pathogenic bacteria in the mouth. They provoke fermentation of leftover food. This leads to the creation favorable conditions for the development of the disease - to softening of the hard tissues (enamel) of the tooth.

But for bacteria to pave the way for carious lesions, several prerequisites are necessary. Irregular brushing of teeth, lack of rinsing, heredity, lack of preventive examinations at the dentist - all this can affect the occurrence of the disease.

There is an additional connection between pregnancy and tooth decay. To bear a child, a woman spends most of the body’s vitamin and mineral reserves. The occurrence of a deficiency of nutrients affects the composition and viscosity of saliva, which protects the enamel from bacterial activity. The development of the disease is accelerated by hormonal imbalances, changes in the acid-base balance in the mouth due to toxicosis, frequent snacks, especially at night, and abuse of sweets and flour products.

The harmful effects of toxins

It was previously thought that oral bacteria could enter the bloodstream and harm the fetus. But the likelihood of this is extremely low - even if bacteria penetrate the membrane of the placenta, they will not be able to survive in the fetal tissues. It is this fact that many women explain their refusal to visit the dentist, making a big mistake.

For the reasons mentioned above, caries during pregnancy can progress rapidly. Without treatment, it risks developing into pulpitis or periodontitis. Toxic substances cause inflammation of the soft tissues of the tooth and gums underneath. Through the stomach, these substances enter the blood, which carries them throughout the body. In this way, toxins can enter the fetus’s body and harm its development.

Pills, discomfort and pain

With inflammation, the temperature often rises, which must be brought down with antipyretics and sometimes antibiotics. Toxicosis may also worsen and the functioning of the gastrointestinal tract may be disrupted.

Due to possible discomfort, appetite disappears. Often, during the development of caries, pain is experienced that traumatizes the psyche. All this can have a bad effect on the bodies of mother and baby.

The negative impact of caries on the fetus is obvious, but is it possible to treat it while pregnant? Naturally, however, treatment should be carried out taking into account the patient's position. The list of dental services that a woman can use depends on the stage of pregnancy at which she is. Pregnancy is divided into three trimesters, three months each.

Careful collection of information

Before starting treatment for caries during pregnancy, the dentist must carefully interview the patient: collect information about the development of the disease, previous illnesses, the presence of chronic pathologies (diabetes, epilepsy, bronchial asthma, heart disease), hereditary signs, and so on.

To assess the risk of possible complications, the doctor may need to consult an obstetrician-gynecologist who is registered with the patient.

What diagnostic methods can a dentist use?

To detect caries during pregnancy, the dentist must conduct visual inspection using a special mirror and tapping with a button probe. If carious lesions are hidden from view, the doctor uses a sharp probe.

It is also possible to use thermal diagnostics - testing tooth sensitivity to temperature changes. Water at 18 and 60 degrees is suitable as a catalyst.

X-rays should not be taken during the first trimester of pregnancy. X-rays may pass dangerously close to or through the fetus. X-rays are allowed from the third month of pregnancy and only in in case of emergency when a woman suffers from acute and prolonged pain, and the dentist cannot make an accurate diagnosis.

Mandatory conditions: the radiographer must have highly sensitive films, sensors that reduce the size by ten times x-ray. The pregnant patient should also be given a protective lead apron.

From the third month of pregnancy, if there is an urgent need, the doctor can use a visiograph - a modern diagnostic device with an intraoral camera.

The method of treatment depends on the level of development of the disease

The development of the disease according to its depth has four levels of development: spot stage, superficial, medium, deep.

It is simple and painless to treat caries in the early phase, when the lesions have not yet destroyed the enamel. You can find out how the procedure for getting rid of the disease goes in the article “Treatment of caries at the spot stage.”

In the article “Manifestation of deep caries,” we described step-by-step treatment, which is also suitable for the superficial or middle phase of the development of the disease. In such cases, the dentist’s actions may cause pain, so it is possible to use anesthesia to reduce the sensitivity of the diseased tooth.

Using anesthesia: is it possible or not?

Treatment of caries in pregnant women using anesthesia carries a certain risk: all painkillers are absorbed into the blood and can have a bad effect on the fetus. To treat the patient, the dentist can use articaine anesthetics:

• "Ultracaine DS" diluted 1 to 200,000;
• "Ubistezin" at a dilution of 1 to 200,000.

These drugs have a low rate of absorption into the blood and are eliminated from the body after three hours, thereby reducing the risk of their penetration into the placenta.

Treatment tactics in different trimesters

In the first three months of bearing a child, the development of its important organs occurs, so treatment of caries can either disrupt their development or provoke a miscarriage. An exception may be diseases that occur with acute, prolonged pain and the possibility of inflammation with pus. For example, acute pulpitis or periodontitis. In such cases, urgent dental intervention is necessary.

Treatment of caries during pregnancy in the second trimester is possible, since the adverse effect on the rapidly growing fetus is reduced. However, the dentist treats only those lesions that may worsen in the third trimester.

In the third trimester unborn child becomes so large that it begins to put pressure on the aorta. This increases the woman's heart rate and reduces blood pressure. To avoid losing consciousness, the patient must lie in the dental chair on her left side. Combined with increasing fatigue and anxiety, this reduces the effectiveness of treatment. Any irritant can provoke premature birth, so in the final stages only emergency cases need to be treated.

How to escape from pain if dental treatment is undesirable

If there is pain, but there is no suspicion of acute or purulent development of the disease, you can reduce the sensitivity of the tooth at home. Folk remedies are suitable: rinsing with a decoction of chamomile or sage, compresses of garlic with vegetable or olive oil, usage alcohol tincture from propolis and calamus. You can find effective recipes in the article “How to treat caries at home.”

Painkiller tablets are also suitable: “No-spa”, “Paracetamol”, “Nurofen”, “Ibuprofen”. Before using medications or folk remedies, be sure to consult a dentist and gynecologist.

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Causes

Typical causes of caries:

• Poor oral hygiene;
• Constant snacking between meals;
• Excessive consumption of sweets.

Special reasons during pregnancy are associated with gestation:

• Decreased calcium and fluoride levels in saliva and blood. Some of these microelements are spent on the developing embryo. Calcium from teeth is not used for the development of the unborn child, contrary to popular misconception. However, the remineralization and strengthening of enamel, which occurs due to the properties of saliva, slows down or stops during pregnancy. Weakened enamel becomes easily damaged and vulnerable to oral diseases, incl. caries.
• Hormonal changes. They lead to changes in the composition of a pregnant woman's saliva. The result of such processes is a decrease in the bactericidal properties of saliva. Bacteria that contribute to the appearance and development of caries become less vulnerable.
• Diet changes. Often, expectant mothers abuse sweet, salty, and flour foods.
• Toxicosis. Hydrochloric acid contained in vomit contributes to the destruction of enamel.
• Failure to attend preventive examinations. The widespread belief that dental treatment is undesirable during pregnancy leads to advanced oral diseases.

How dangerous

• Premature birth;
• Small birth weight.

Contribute to these phenomena cariogenic bacterium Actinomyces naeslundii. They provoke the production of substances that cause contraction of the uterus and dilation of the cervical canal - anti-inflammatory cytokines. The expansion of the cervical canal is accompanied by the destruction of the membranes. These processes lead to premature birth.

Harm from caries complications

Complications that accompany advanced caries can also cause harm to the unborn child. The affected area reaches the neurovascular portion of the tooth, as a result of which pulpitis or periodontitis may develop. Inflammation of the dental pulp and the development of a purulent focus of inflammation in the area of ​​the root apex leads to the release of toxins. They enter the blood and are carried throughout the body. This may entail:

• Temperature increase body (the need to take antipyretics);
• Exacerbation toxicosis;
• Crashes in the operation of the system digestion.

Toothache, which occurs with pulpitis and periodontitis - traumatic psychological factor for the woman's body. Painful sensations can cause changes in some systems and organs of an ordinary person. Such phenomena will affect the developing embryo.

How to relieve toothache

The first step is to carefully examine the tooth. If there are food particles left in the hole, they must be carefully removed with tweezers or a toothpick. After this, you need to brush your teeth and rinse your mouth. You can rinse with a decoction or infusion medicinal herbs or a solution of soda and salt.

The most reasonable solution in such a situation is to consult a dentist. If it is not possible to make an immediate visit, you can use medications or folk remedies. Folk remedies are considered safer.

Folk remedies

• Rinse a decoction of sage, chamomile, plantain, St. John's wort, calendula with salt or soda;
• Table carnation(seasoning). The powder should be sprinkled on the inflamed gum.
• Garlic. It must be peeled, finely chopped and wrapped in a bandage or gauze. The result is applied to the wrist, where the pulse is felt.
• plantain leaf. The leaf must first be squeezed to release the juice. After this, roll it into a flagellum and place it in the ear (you need to take into account the location of the source of pain). You can also thoroughly wash, chop and squeeze fresh leaves medicinal plant, then rub the juice on the gums every two hours. You can rinse your mouth with two tablespoons of juice diluted with a glass of boiled water.
• Aloe, Kalanchoe, Pelargonium. A leaf of one of these plants can be applied to the inflamed gum.
• Lard. The product is cleared of salt, if required. The slice is placed between the tooth and cheek. After 15-20 minutes the pain should stop.

At home

Medicines that can relieve toothache during pregnancy:

• No-shpa;
• Drotaverine (analogue of No-shpa);
• Grippostad (cautious use in the first trimester of pregnancy is acceptable);
• Paracetamol (will help with mild pain);
• Tempalgin (half a tablet);
• Pentalgin (half a tablet);
• Kalgel (apply to the inflamed gum);
• Ketanov;
• Nurofen;
• Ibuprofen ( prohibited for use in the 3rd trimester).

Accept more than one tablet any of these medications is strictly prohibited. You can place a cotton ball in the hole of the tooth (if there is one). The material can be moistened in advance with dental drops, clove or mint oil. When taking any medications, remember several rules and characteristics of the body during pregnancy:

• More than anything the fetus is vulnerable in the first trimester. After the third month, the embryo is protected by the placenta, which weakens the effect of medications on it.
• We must always remember dosage.
• The use of medicines is only permissible if emergency.
• Rinse with cold water absolutely forbidden.

Treatment - dangers and consequences if left untreated

If you start caries, you can lose your teeth (not all of them, of course). In addition, carious processes will negatively affect the child. It is better to treat caries immediately, while it is safe for the child and mother.

Features of treatment

Treatment begins with anamnesis collection. The duration of pregnancy plays an important role, which will be discussed a little later. The dentist carefully examines the history of past pregnancies (if any) and associated diseases (hypertension, eclampsia, diabetes, etc.). Often the patient should consult with an obstetrician-gynecologist. This allows you to fully assess the risk of complications after dental treatment.

The carious process during pregnancy occurs rapidly. If you ignore it at the chalk stain stage, you risk losing the tooth. Usually they manage to catch caries at the middle stage, but it is more difficult to treat. The dentist selects a treatment method according to the patient’s body and age. Most often this is excision of the carious area and filling. Complicated caries is very difficult to cure; this is done under local anesthesia.

Is it possible to treat?

It is possible and necessary. Each trimester is assigned its own type of medical action.

1st trimester

Conventionally divided into two periods:

• From the moment of fertilization until the implantation of the egg. This time is unfavorable for dental treatment. The embryo is extremely sensitive to the effects of various drugs, stress and toxins. High risk of miscarriage.
• From the 18th day - the beginning of the formation of organs and tissues of the embryo. This period is characterized by frequent fainting, nausea, vomiting, heartburn, increased salivation, and an increased gag reflex. It is not advisable to carry out treatment at this time, as this may affect the developing fetus.

At 6-7 weeks, the baby begins to develop the rudiments of temporary teeth. Treatment procedures can disrupt this process, which will further lead to trouble. Problems may also arise later in the 1st trimester. It is impossible to treat caries during the 1st trimester. During this period, an exception is made only for emergency cases accompanied by suppuration and acute pain. Such cases are considered:

• Pulpitis;
• Acute periodontitis;
• Exacerbation of chronic periodontitis.

2nd trimester

"Fruit" period. At this time, the embryo grows rapidly. The risk of negative consequences of dental treatment is reduced, but remember the toxicity of medications (anesthesia, antibacterial agents).

At this time it is necessary to carry out prevention diseases of the oral cavity. At this stage of pregnancy, they treat teeth where caries may worsen in the third trimester. Sometimes the dentist decides to leave dental treatment for the postpartum period if there are no possible areas of exacerbation.

3rd trimester

During this period, the weight of the unborn child increases. Along with it, the pressure on the aorta and inferior vena cava increases. This leads to a woman’s rapid heartbeat, rapid decrease in blood pressure, and loss of consciousness. This is an important factor, since patients are reclining during dental treatment.

Sensitivity of the uterus to influences outside world in later stages it increases, which can even cause premature birth. Also, this period is accompanied by increasing anxiety and fatigue of the woman, which can also affect the treatment. Medical intervention at such times is advisable only in urgent cases. The expectant mother on the chair should be positioned slightly on her left side (the angle is about 15 degrees) to reduce the pressure of the fetus on the inferior vena cava and aorta.

Pain relief, anesthesia, anesthesia: can it be used?

Local anesthesia is used to treat complications of caries (periodontitis, pulpitis, etc.). Sometimes injections of anesthetic drugs are given for acute pain that occurs during treatment. To treat caries painlessly, you need to visit the dentist regularly. General anesthesia is contraindicated for pregnant women!

At 14-15 weeks, the use of special anesthetic drugs is allowed. For pain relief the following are used:

• Ultracaine;
• Septanest;
• Ubistezin;
• Scandonest.

X-ray

Radiography as a diagnostic method contraindicated during pregnancy. An alternative is films and sensors that are ultra-sensitive. They require ten times less X-ray radiation than conventional films. Also used protective equipment (lead apron). Sometimes x-rays are still used in emergency situations, but this is not a recommended procedure. It is strictly forbidden to use radiography in the 1st trimester.

How caries affects fetal development

Chronic inflammation in the oral cavity can lead to:

• The occurrence of intrauterine infection;
• Delayed fetal development;
• I will have a miscarriage;
• Premature birth.

Treatment of caries in a pregnant woman is carried out extremely carefully. Pain and discomfort (with acute complications of the disease) can harm the unborn child. The fetus is harmed by any infectious focus in the oral cavity, because toxins directly affect it (the fetus).

Tooth decay due to breastfeeding

From night feedings

This practice can cause caries in the baby. Doctors recommend stop night feedings after six months, as this often leads to the development of early caries. Caries in a mother can also occur during lactation.

Features of treatment

A contraindication to the treatment of caries for a breastfeeding mother can only be severe stress or fatigue. Before a dental procedure you need feed the baby and express milk for next time (preferably). All drugs will be eliminated from the body after 3-6 hours. After treatment, you need to express the milk and pour it out. After this, you can safely continue breastfeeding your baby.

X-rays during breastfeeding are not prohibited, but the use of protective equipment is mandatory. If filling the mother's teeth is safe for the child, then excludes taking antibiotics breast-feeding . Also, dental implantation cannot be performed during lactation.

Possibility of using anesthesia

Pain relief during breastfeeding is relatively safe. For pain relief during breastfeeding, mepivacaine, lidocaine, and ultracaine are used.

Caries and childbirth

Caries can negatively affect the birth of a child. This could be premature birth or miscarriage. Also, intrauterine infections caused by caries will affect the health of the unborn baby.

Prevention of caries in pregnant women

• Preliminary dental treatment. Planning a pregnancy includes visiting the dentist. It is better to treat your teeth right away than to put yourself and your baby at risk during pregnancy.
• Careful oral hygiene. You should brush your teeth (avoid horizontal movements) after eating and use dental floss. You can also use an irrigator to rinse hard-to-reach parts of the mouth.
• Do not brush your teeth immediately after vomiting. It is necessary to rinse your mouth with a solution of baking soda, then you can brush your teeth. Brushing your teeth is possible no earlier than half an hour later.
• Diet control. You should reduce the number of snacks and consumption of sugary foods. You also need to eat foods rich in vitamins and microelements (cottage cheese, spinach, etc.).
• Regular visits to the dentist. The doctor carries out a complex to protect teeth from caries. This includes professional teeth cleaning, gum massage, and preventive examinations.

FAQ

Can there be a miscarriage due to caries?

Yes maybe.

Is it possible to get pregnant with dental caries?

Of course. But it is better to cure caries first so that no problems arise.

Can caries cause a missed abortion?

Yes, severe forms of caries can cause this phenomenon.

Is tooth decay transmitted from mother to child?

It's possible. If a mother with caries uses a cutlery to eat and then feeds her child using the same utensil, the child may also develop caries.

Wisdom tooth caries during pregnancy - treat or remove?

At the first signs of an illness, you should contact your dentist. If wisdom tooth caries is caught at an early stage, it is possible to get by with treating the pocket using special liquid preparations. This will allow postponing surgery the right time. In another case, excision of the hood is performed. To avoid complications, you need to consult a doctor in a timely manner.

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Does caries affect the fetus?

First of all, it is worth noting that dental caries usually manifests itself as a result of the influence of harmful bacteria and microbes that accumulate on the gums, tongue, and enamel. Typically, these bacteria enter the dental tissue through various microcracks.

But the likelihood of this happening is quite low. Penetration of microbes through the structure of the placental barrier occurs very rarely. In addition, pathogenic organisms cannot survive in the tissues of the embryo and have any negative effect on it. Only viruses have high survival rates. But still, if the initial stages of caries suddenly appear during pregnancy, then it is imperative to follow a number of hygiene procedures and perform the necessary oral care.

If you believe the statistics, then you can highlight important data that you need to take note of:

• dental caries is detected in almost 91.4% of women with a normal pregnancy. In almost 94% of cases, this pathological process is detected during toxicosis;
• the average intensity of dental damage in pregnant women ranges from 5.4 to 6.5. This figure is very high;
• Almost 79% of women carrying a child have a high degree of enamel sensitivity.

It is worth considering that pregnancy and carious lesions are connected only through physical factors. Often, severe pain from a carious lesion causes a woman to have problems eating food, she cannot eat normally, and she experiences a general deterioration in her emotional state. All this can negatively affect the development of the child.
If caries appears with complications, it can have a bad effect on the woman’s condition.

But it is worth highlighting the greatest danger of carious lesions - this is its transition to an aggravated stage. In the acute form, there is increased damage to several teeth at once and their loss in short time. It follows from this that carious lesions are more dangerous for the mother than for the child.

Factors causing caries during pregnancy

When carrying a child, a woman is most susceptible to the occurrence of various infectious lesions, which can subsequently quickly spread throughout the entire oral cavity.
There is a widespread belief that dental diseases in an expectant mother occur when there is a deficiency of calcium and phosphorus in her body. But this is not so; the body receives a large number of useful components from the food consumed. Carious lesions during pregnancy can occur for completely different reasons, which can only sometimes be associated with a lack of useful components.
The main provoking factors of caries lesions during pregnancy include:

1. Often, carious lesions occur due to frequent snacks between meals, as well as eating foods high in carbohydrates. Therefore, a woman should carefully monitor the quality of the food she eats. Be sure to rinse your mouth and brush your teeth with dental floss after each meal;
2. During the first trimester of pregnancy, a woman develops toxicosis, in which many people vomit. After this unpleasant process, it is important to thoroughly disinfect the oral cavity, because the vomit contains a large number of harmful microorganisms that accumulate on the surface of the enamel. It is recommended to rinse your mouth warm water and after an hour, clean your teeth with toothpaste;
3. Eating a lot of food that contains high level Sahara. Eating foods high in sugar greatly increases the risk of developing caries. Sugar also provokes the active spread of fungal infections and various pathogenic bacteria. Therefore, it is recommended to reduce the consumption of sweets;
4. Increased consumption of soda and sugary drinks. Carbonated water and sweet juices contribute to the active spread of infection. Ultimately, this leads to the development of carious lesions. Therefore, it is best to drink plain water;
5. Due to the fact that pregnant women experience hormonal activity, they are often exposed to various stresses. Stress is the main irritating factor in the active development of fungal infections. For this reason, pregnant women should avoid stress and rather engage in other activities to improve their mood.

How to treat pregnancy caries at different stages of pregnancy

Many women, when carrying a child, think that caries treatment can negatively affect the development of the child, but this is not so. Most likely, if it is not treated, then you can harm your health and the health of your unborn baby. Many dentists recommend starting its treatment immediately after the first symptoms of the development of the pathological process. Timely treatment for some pregnant women may be the only way to prevent caries from becoming more generalized.

Some of these antiseptic pain medications may have a negative impact on the development of the embryo.
For this reason, it is very important to see your dentist regularly throughout your pregnancy. If this pathological process is detected on early stages its development, it can be eliminated without the use of anesthesia. Typically, at the initial stage of caries, remenirization is used, which does not require anesthesia and the use of a drill. But it is very difficult to treat an advanced process without painkillers.
You cannot do without pain relief if a pregnant woman has pulpitis or periodontitis. Otherwise, the patient may experience painful shock.

How is caries treated in the first trimester?

It is worth noting that the period of the first trimester of pregnancy is considered the most unfavorable period for the treatment of various pathological processes. The thing is that any therapeutic therapy can adversely affect the development of the unborn child.
There are two stages of the first trimester:

• the period from the moment of fertilization, which lasts until the third week of pregnancy. During this period, the embryo experiences increased sensitivity to various toxic substances and chemicals. Any treatment with medication can cause miscarriage;
• From the third week of pregnancy, the child begins the process of forming internal organs. The woman has a state of toxicosis, increased heartburn and severe salivation. If treatment with medications is used during this period, this may have a bad effect on internal organs child.

Since any treatment using medications is contraindicated during the first trimester, it should be postponed for a while.

But there are exceptions, when caries is severely advanced, severe inflammation, increased body temperature and pain are observed. In these cases, the risk to the fetus from dental disease will be much higher than the risk that medications may cause.

How is caries treated in the second trimester?

During the second trimester, active growth of the fetus is observed. During this period the risk negative impact maternal oral diseases are reduced.
At this time, it is recommended to carefully monitor the cleanliness of the oral cavity and avoid contact with various irritating factors of infection.
If a carious lesion is detected on early stages, then its treatment can be postponed until the baby is born. The doctor can also use remineralization. This procedure is very quick and painless. For this reason, painkillers are not used during it, and the cavity is not cleaned with a drill.

If caries is at an advanced stage, then it is necessary to carry out treatment, otherwise the woman may develop severe inflammation and fever. Deteriorating health of a pregnant woman can also negatively affect the child. There are also a number of medications that can be used during pregnancy.

How to treat caries in the third trimester

The period of the third trimester is considered the final stage of bearing a child. At this time, the child is actively gaining weight, for this reason there is an increase in pressure on the woman’s genital vein area. This can cause increased or decreased blood pressure, fainting and increased heart rate.

At the late stage of pregnancy, various dental diseases have virtually no effect on the child’s condition. But medical therapy or the use of various medications that irritate the oral cavity can cause premature birth.
During treatment, a woman may experience severe fatigue, overwork, and a feeling of anxiety. All this often causes an increase in the tone of the uterus.

It is advisable to resort to treatment in the third trimester when severe damage with inflammation, pain and fever is observed. Otherwise, this condition can have a bad effect on the health of the woman and the unborn baby. The doctor should ensure that the woman is in the most comfortable position so that the child does not put strong pressure on the pudendal vein and aorta.

Prevention of caries during pregnancy

Since it is not desirable for caries to appear during pregnancy, you should carefully follow all the recommendations of your doctor. You also need to do important rules that relate to oral hygiene:

1. If you are planning a pregnancy, then it is worth treating all diseased teeth in advance. Teeth with lesions or caries must be filled in advance. All dental diseases also need to be eliminated. The oral cavity must be healthy;
2. It is necessary to clean your teeth not as usual twice a day - morning and evening, but after each meal. Due to this, you can reduce the risk of spreading infection and various pathogenic microbes;
3. During the period of toxicosis after vomiting, you must wait 30 minutes. After this, you need to clean your teeth. This will prevent the enamel from being erased. You can also rinse your mouth with a solution of baking soda;
4. It is advisable to avoid snacking. But many dentists still advise refraining from snacking; it is best to eat a large meal and then rinse your mouth or brush your teeth with toothpaste.

It is important to carefully monitor oral hygiene during pregnancy; careful adherence to it will help avoid the development of caries. If all of these caries are detected at the time of pregnancy, then it is better to adhere to all the important recommendations of the attending physician. Many dentists typically wait to treat tooth decay until after the baby is born. Still, the drugs used can negatively affect the development of the child.

Before planning a baby, it is recommended to undergo a comprehensive examination of the body and treatment of diseases. Since hormonal changes occur during pregnancy, there may be an exacerbation of chronic diseases, changes in metabolism, inflammation of the soft tissues of the oral cavity, tooth decay with loss of minerals.

Causes of caries development during pregnancy

Caries during pregnancy can occur due to various reasons:

• Changes in metabolism and saliva composition (the level of protective factors decreases).
• Hormonal changes that affect the condition of the oral cavity.
• Insufficient dental care.
• Use of unsuitable hygiene products.
• Lack of calcium, potassium, fluorine, vitamin D, and minerals in the body.
• Poor diet, frequent snacking.
• Eating large amounts of carbohydrates, sweet and starchy foods.
• Toxicosis and vomiting ( hydrochloric acid has a detrimental effect on enamel).
• Delayed visit to the doctor.
• The presence of a pathological process in the teeth before pregnancy.
• Bad habits.
• Stress and emotional tension.

In addition to the usual causes of the disease, expectant mothers are also affected by additional factors that are associated with the restructuring of the body. Therefore, during pregnancy, you should carefully monitor your health, adhere to hygiene rules, visit a doctor for the purpose of prevention, treatment, etc.

Is it possible to treat caries during pregnancy?

Caries in a pregnant woman has some peculiarities: the process develops quickly, can affect several teeth, is practically asymptomatic and appears only when the nerve is inflamed. Therefore, if you suspect any disease, you should consult a specialist.

Treatment can and should be carried out, but many nuances must be taken into account. To avoid additional stress, you need to start therapy as early as possible - in the initial stages less serious manipulations will be required, and it will be easier for the patient to tolerate them.

During therapy, the following features must be taken into account:

• Fear of the dentist, emotional tension and stress due to treatment . Many people are afraid of dental treatment; for pregnant women, emotional stress can be more dangerous than the treatment itself. To cope with the problem, they conduct a conversation, find out the cause of the fear and try to eliminate it. If necessary, prescribe the use of sedatives before procedures: tincture of motherwort, valerian, medications.
• Carrying out an X-ray examination . X-rays are strictly contraindicated for pregnant women, as their rays have an adverse effect on the body and the child. In case of emergency, a picture is taken using a radiovisiograph. When treating caries, X-ray examination is not mandatory.
• Anesthesia . Some medications cannot be taken by pregnant women, and pain relief with toxic anesthetics cannot be administered. During treatment, the use of anesthesia is not necessary and is advisable only in the presence of deep caries or pulpitis. If necessary, drugs are used that do not pass the hematoplacental barrier and do not have a negative effect.
• Doctor's recommendations . In order for the treatment to be successful and to avoid complications, you must strictly adhere to the doctor’s recommendations.

We can conclude that proper and responsible treatment will not harm to the expectant mother and the child.

Why is caries dangerous during pregnancy?

Caries is a source of chronic infection in a woman’s body. Bacteria from the oral cavity enter the gastrointestinal tract and spread throughout the body. Experts have conducted a lot of research to understand how caries during pregnancy affects the fetus. Scientists have proven that bacteria practically cannot pass the hematoplacental barrier and harm the embryo, but can contribute to the exacerbation of chronic diseases and the development of complications in the mother.

The bacterium Actinomyces naeslundii, which is found in diseased teeth, can cause premature birth and the birth of a low birth weight baby. In addition, bacteria can produce substances that contract the cervical canal and uterus and can destroy the protective membrane of the fetus.

Caries contributes to the destruction of hard tissues and the spread of infection deeper. If this occurs, treatment with radiography and anesthesia is necessary. These diseases cause acute pain symptoms, contribute to the disruption of the general condition, require medications and urgent treatment.

In the absence of therapy, the inflammation passes into the purulent phase, exudate is formed, which will seek a way out. In the best case, the pus will come out through the tooth or gum, in the worst case it will spread to the jaw, causing periostitis or an abscess. Toxins from the source of the disease spread throughout the body and to the child, and can provoke the development of intrauterine infection.

With pulpitis and periodontitis, the woman’s condition is significantly disturbed. There is acute pain in the tooth, swelling of the gums, malaise, headache, fever, and swollen lymph nodes. To avoid complications, examination and treatment should be carried out in a timely manner.

Why is caries dangerous during pregnancy? We can conclude that the disease is not very dangerous, but is undesirable. After all, it can lead to disruption of the normal state, the spread of infection and its toxins.

Which doctor should I contact for dental caries during pregnancy?

If oral diseases occur, you should contact your dentist. You need to choose a specialist who is competent and responsible, since the results of treatment will depend on him. When visiting a doctor, be sure to warn about pregnancy, tell how it is progressing and how far along it is.

There is no need to be afraid to consult a doctor and undergo treatment. Indeed, in its absence, complications will arise and more serious measures will have to be taken. If necessary, you can consult your gynecologist, who constantly monitors your health and manages your pregnancy.

Diagnostics

Diagnosis of the disease begins with an examination of the oral cavity. The doctor collects anamnesis of life, illness and pregnancy. Decides which treatment tactics to use depending on the stage of pregnancy and the manifestations of pathology. A responsible dentist strives to provide a successful and comfortable treatment that will not cause adverse effects. If necessary, the specialist can consult with the attending obstetrician-gynecologist.

Additional research methods are rarely used in pregnant women. Radiography is performed only in the most extreme cases and is used very rarely during the treatment of caries.

Treatment of caries during pregnancy

Treatment of caries during pregnancy depends on several factors:

• gestational age;
• development of the disease;
• severity of symptoms;
• presence of indications for therapy;
• general health;
• presence of allergies and contraindications.

In the early stages

Dental treatment cannot be performed during the first trimester. During this period, the mother’s body is very sensitive and can react negatively to any stress.

First, implantation of the egg occurs, and then the formation of fetal organs. If during this period there is emotional stress, a violation of the psychological state, or taking unwanted medications, there is a risk of losing the child. The dentist can make an exception and carry out treatment in emergency situations when the gums have become suppurated or acute pulpitis has occurred. In other cases, the doctor will conduct an examination and reschedule treatment for a more appropriate period.

Doctors recommend treatment in the second trimester of pregnancy. During this period, almost all the baby’s organs have formed, and the risk of harm is minimal. The decision to conduct therapy is made by the doctor individually in each situation based on the general condition of the patient. During the appointment, the specialist selects the most gentle and optimal methods, takes into account all the features, and uses only safe medications.

In the later stages

It is also not advisable to carry out treatment in the third trimester, except in emergency situations. During this period, treatment can negatively affect a woman’s body. After all, as the baby’s body weight increases, the load on the mother’s body increases.

If you spend a long time in the dentist's chair, you may experience rapid heartbeat, increased blood pressure, and loss of consciousness. Premature labor may occur due to stress and medical procedures. If therapy is necessary, the woman should sit in the doctor’s chair as comfortably as possible.

Prevention

Prevention of caries in pregnant women includes the following points:

• dental sanitation before planning a child;
• regular preventive examinations;
• professional cleaning;
• careful dental care - it is necessary to use it in the morning and evening, before bedtime, and rinse the mouth after eating;
• avoiding excessive consumption of carbohydrates;
• taking a complex of vitamins, minerals and trace elements;
• proper nutrition;
• See a doctor when the first symptoms occur.

How does tooth decay affect pregnancy? On this question You can answer – unfavorably. The disease does not always cause problems, but is undesirable. Before planning a child, all women are recommended to undergo treatment for diseases of the oral cavity.

We can conclude that caries is not as dangerous a disease as its complications - pulpitis, periodontitis. To prevent the development of complications, you need to take preventive measures and monitor your health. In this case, the pregnancy will be much easier, and the baby will be born healthy.

Useful video about dental treatment during pregnancy

Problems with a woman's teeth during pregnancy are quite common. Most often, expectant mothers complain about caries. The reasons for damage to tooth enamel during pregnancy are quite commonplace: they are a lack of vitamins and microelements, including calcium.

Naturally, when faced with a problem, a woman wants to know whether caries can be treated during pregnancy and how this process can affect her child?

Pregnant woman at the dentist.

Is it possible to treat tooth decay during pregnancy?

Important! Toxicosis has a huge influence on the development of caries during pregnancy. According to statistics, the problem more often affects women prone to toxicosis and morning sickness.

It is necessary to understand that pregnancy is the time of greatest responsibility. Any wrong actions can lead to health problems for the unborn child. For this reason, treatment of caries in pregnant women should begin with a thorough examination women and gathering necessary tests. The dentist should have an idea of ​​how the pregnancy is progressing and whether the expectant mother has any serious diseases or abnormalities. It is important to tell your dentist about the following diseases:

• preeclampsia;
• diabetes;
• hypertension, etc.

For some problems, the dentist may need a certificate from an obstetrician-gynecologist giving permission to carry out the necessary manipulation. These measures will allow you to select the safest and most effective therapeutic method.

The most questions in the treatment of caries arise against the background of the need to do local anesthesia or dental x-rays. Typically, obstetricians strictly prohibit such interventions, but allow procedures in cases where the possible benefit far outweighs the acceptable harm.

X-ray in the treatment of caries in pregnant women

X-ray examinations using old-style devices are strictly prohibited for pregnant women. However, in exceptional cases, you can use modern highly sensitive equipment, which has much lower radiation exposure.

In addition, for additional protection, women cover their bellies with a special lead apron. Despite the additional protection, it is necessary to remember that under no circumstances should you undergo an x-ray, even in extreme circumstances, during the first trimester.

X-ray of teeth.

Anesthesia in pregnant women

Since any anesthetic can spread throughout the body through the bloodstream and enter the placenta, thereby increasing the risk of premature birth or other complications, the introduction of anesthesia is also extremely undesirable. In extreme cases, a woman may be given drugs based on articaine. This substance is synthetic and cannot penetrate the blood. Its only drawback is its short-term effect, which makes the use of the product impossible in the case of long-term dental interventions.

What are the dangers of untreated caries during pregnancy?

The main danger of caries is that it has Negative influence on the health of the mother, which directly affects the health of the unborn child. The following are examples of possible complications that the disease can cause:

• advanced caries, accompanied by severe pain, leads to the fact that a woman is deprived of the opportunity to fully eat. As a result necessary for the child vitamins and microelements begin to arrive in smaller quantities. In addition, constant pain affects the mental and emotional state of a woman;
• As a result of the inflammatory process caused by caries, body temperature often rises. In this case, the woman is forced to take painkillers and anesthetics, which can penetrate through the placenta into the blood of the fetus and cause irreversible changes in the functioning of some organs;
• development of digestive problems. Putrefactive bacteria from the oral cavity can penetrate the gastrointestinal tract of the expectant mother and cause diseases such as gastritis and ulcers. Against the background of such complications, women often develop a severe form of toxicosis.

In addition to the complications listed above, it is worth noting that fear of dental treatment and complete refusal of dental care during pregnancy threatens rapid progression of the disease and loss of teeth.

Important! Due to a lack of vitamins and microelements, caries in pregnant women develops extremely rapidly. As a result, multiple complications arise, and the disease quickly spreads to healthy teeth.

Effect on the fetus

There is an opinion that carious and putrefactive bacteria can have a direct impact on the child. Entering the circulatory system through microtraumas and bleeding gums, they reach the placenta and enter the child’s body. It is worth noting that for the most part such fear is unjustified.

Pregnant woman.

The fact is that viruses have similar qualities, while caries is caused by bacteria that quickly die outside the oral cavity. Despite this, caries can affect the fetus by worsening the woman’s condition. If we talk in simple words, That untreated caries is much more dangerous for the expectant mother than for the child.

How is caries treated during pregnancy?

Treatment of caries during pregnancy directly depends on the period. As you know, pregnancy is divided into three trimesters, each of which is accompanied by certain recommendations and contraindications.

• treatment of caries in the first trimester. During this period, the formation of all vital systems of the body occurs; therefore, any medical, including dental, intervention is considered unacceptable. If caries is in the initial stage or the woman does not suffer from pain, then it is recommended to postpone treatment until a more favorable time. It is important to understand that painful intervention or any stressful situation may cause spontaneous abortion;
• treatment of caries in the second trimester. During this period of pregnancy, increased growth of the fetus begins. At the same time, negative interference from dental treatment is reduced several times. In case of severe inflammation, a woman may be prescribed antibiotics, but only in small doses and for local use, for example, as rinses or applications;
• treatment of caries in the third trimester. IN in this case the child has almost fully formed organs and sufficient heavy weight. During treatment, you must recline in the dental chair. Prolonged sitting is not recommended, as the fetus can press on the woman's large arteries, which will cause dizziness and may cause fainting. At the final stage of pregnancy, a woman's uterus is most sensitive, so any intervention can trigger premature birth. Dental treatment at this time is possible only for emergency indications. It is possible to use approved painkillers.

Important! If a woman has an urgent need for caries treatment during pregnancy, she must remember that more than one tooth cannot be treated in one visit, and if necessary, the dentist should give the woman the opportunity to rest and walk around.

What kind of anesthesia can be used?

Before moving on to the choice of anesthetic drugs, it is necessary to understand in more detail the principle of their action. Old generation anesthetics are made on the basis of adrenaline, which, acting on the body, blocks pain receptors and stops bleeding due to the ability to constrict blood vessels.

Adrenaline may have a direct effect on the uterus, increasing its sensitivity and leading to tone. This condition is extremely dangerous, as it can provoke involuntary muscle contractions and cause premature birth.

As for modern anesthetics, much smaller dosages of adrenaline are used in their production. The most popular include:

• Articaine is a modern anesthetic with a pronounced analgesic effect. Due to its composition and properties, the drug does not penetrate the patient’s blood and acts exclusively on the area of ​​pain, blocking sensitive receptors. The only disadvantage of the product is its short-term effect, which allows the product to be used only for minor dental procedures. In addition, Articaine is quite expensive;
• Ultracaine - despite the fact that the drug can spread through the bloodstream, nevertheless, its active components are not able to overcome the placental barrier. Also, the product does not penetrate into a woman’s milk, which means it can be used to treat teeth in nursing mothers. The drug has a fairly reasonable price compared to analogues.

Important! Any drug for the treatment of caries during pregnancy should be selected taking into account the individual characteristics of the woman’s body. Despite this, you should always remember the possible risks.

In order not to have to think about treating the disease during the period of bearing a child, it is necessary, even before planning, to undergo a thorough dental examination and eliminate even the most minor carious lesions. In addition, expectant mothers are recommended to take vitamins and microelements, as well as careful oral hygiene after each meal.