6* Wisdom Teeth Extraction
10 * Dental cate in pregnancey Page3
The general rule for dental care in pregnancy is: If it improves your health, it's probably good for the baby as well. Obviously, common sense dictates that elective or routine procedures that might pose a risk to the baby should be delayed until after birth. But many tests and operations are best accomplished at the time they're recommended.
Dentists rely on X-rays to determine the health of your teeth and jaw. If you report a problem or troubling symptoms, your dentist might have to use X-rays to make a diagnosis and plan your treatment. If not doing so poses a risk to your health, have the testing done; the risk of dental X-rays is minimal, since your uterus is shielded with a lead apron. The actual amount of radiation that scatters from the machine and passes through the lead apron to your uterus is negligible. Also, X-raying a breastfeeding mother won't affect the health of the nursing baby.
The same procedures for treating cavities in nonpregnant women apply to expectant mothers. If anesthesia is called for, a local injection of novocaine or lidocaine is probably your best bet--be sure to check with your obstetrician first. (Inhaled or intravenous anesthetics increase the odds of your suffering a miscarriage in the first trimester.)
If you're in significant pain and the dentist deems it necessary, you can undergo tooth extraction or root canal procedures. Again, experts recommend local anesthesia if possible.
Pregnant patients (and some dentists) often wonder what effect--if any--medications will have on them and their babies. Here are some general guidelines for the use of dental medications during pregnancy.
A good number of dental procedures require anesthesia, which generally can take place without cause for concern. Local anesthetics are relatively safe and are preferred over intravenous or inhaled agents (which may increase the risk of miscarriage in the first trimester). Novocaine and lidocaine--indeed, all of the "-caines"--can be used. Although the addition of epinephrine to local anesthetics (to make them last longer) is usually considered safe in pregnancy, women who are given this drug run a higher risk of some minor birth defects, so it's best avoided. If your dentist thinks your care requires the use of epinephrine, have her check first with your obstetric practitioner.
Acetaminophen is believed to be safe throughout pregnancy. Non-steroidals like ibuprofen generally are considered safe until around 32 weeks. If stronger pain medications are needed, narcotics such as codeine or Percodan can be used for the short term (less than a few weeks). The fetus might be "sleepy" while you're on the medication, but your metabolism quickly removes the drug from the baby's circulation. Narcotic use in pregnancy only becomes an issue when:
* It takes place long term (months). In such a case, the baby might experience withdrawal symptoms after birth.
* Large dosages are administered during labor, and the baby is born before your metabolism can remove the drug from the baby's circulation. These babies can be born sleepy and may require a medication called Narcan in order to reverse the effects of the narcotic.
* It takes place during breastfeeding, which can make some babies a bit sleepy. This effect isn't severe enough to require Narcan but might lead to feeding problems.
If you require strong pain medications while pregnant or nursing, discuss the options with your obstetrician.
Dentists often prescribe antibiotics to either treat or prevent an infection. Barring any allergies, the penicillin and cephalosporin families of medications are safe to take. Erythromycin, though sometimes hard on the stomach, also is acceptable. Metronidazole (Flagyl), which is sometimes used for serious abscesses, can be taken during pregnancy as well. Tetracycline should be avoided because it can affect the teeth and bones of a developing fetus.
Although fluoride protects developing teeth from cavities, the use of supplemental fluoride in pregnancy is controversial. Some studies have shown that children whose mothers received fluoride during their pregnancies developed fewer cavities; others found no benefit. It's not known whether fluoride poses any risk to the fetus. As a general rule, it's best not to take fluoride beyond the small amount added to city water supplies.
Caring for Your Teeth: Guidelines for Pregnant Women
Have you ever heard the old wives' tale that you lose a tooth for each child you carry? While this isn't the case, it's true that pregnancy can exacerbate dental problems, so routine dental care becomes especially important for women who are expecting.
Gingivitis (an inflammation of the gums) is a common problem, which may be the result of increased blood flow to the gums caused by pregnancy hormones. It can lead to bleeding gums and has been associated with complications of pregnancy, such as premature birth. It isn't known whether gingivitis directly causes premature labor or whether it's a marker for poor self-care and other health risks that might predispose a woman to preterm birth. It's always wise to take good care of your teeth; just consider the potential risk of preterm birth as one more reason to pay attention to this aspect of your health.
Brush your teeth with a soft-bristled toothbrush after meals, or at least twice a day, to help prevent cavities and gingivitis. Also be sure to floss regularly, as this will do much to protect your gums. Don't worry if you notice some bleeding when you first start flossing; this should subside as the health of your gums improves.
Most people would agree that teeth feel wonderfully clean after a visit to the dental hygienist. For healthy adults, dentists recommend a cleaning every six months. Pregnant women may want to have it done more frequently, however, especially if gingivitis is an issue. If you find that your gums still bleed despite regular brushing and flossing, or if you're experiencing dental pain, see your dentist. If he's unsure whether a procedure or a medication is safe in pregnancy, he can check with your obstetric practitioner.
Many expectant mothers notice that their gums bleed when they brush or floss their teeth. The culprit usually is gingivitis (from "gingiva," meaning gums, and "-itis," meaning inflammation). Food particles that get caught between the tooth and gum attract bacteria, which can lead to inflammation. This condition can plague anyone, but the hormones of pregnancy often aggravate it by causing tissues to swell and augmenting the supply of blood to the gums.
The best way to keep gingivitis at bay is by brushing and flossing regularly. Foods with hard slivers, such as popcorn, have a particular tendency to stick between the tooth and gum and should be flossed out as soon as possible or, better yet, avoided. Contact your dentist if your gums continue to bleed several minutes after brushing.
Occasionally, pregnant women experience a problem with blood clotting. If, in addition to bleeding gums, you bruise easily, have frequent or heavy nosebleeds, or experience bleeding in other parts of your body, let your practitioner know.