Protocol for Seeing the Dentist During Pregnancy

Pregnancy Dilemma

Pregnancy affects your whole body and your oral health is no exception. For instance, hormonal changes can make your teeth and gums more sensitive during pregnancy. They may also cause your gums to become tender and bleed more. Going to the dentist might be the last thing on your mind during these 9 months.  Of course if you end up with an unexpected toothache, that can quickly changes things. So what is the best thing to do? Is it better to rely on pain killers to see if the pain subsides and hold off on treatment until after childbirth? Or should you consider seeing a dentist for a more definitive treatment right away?

What is the correct protocol for seeing a dentist during pregnancy?

Try to avoid changing dentists if at all possible

Avoid switching dentists during this time period if at all possible. Your existing dentist should have some recent X-rays on file, this way they won’t have to take unnecessary radiographs. Even though dental X-rays expose you to minimal radiation, you still want to avoid any unnecessary exposure if at all possible. Switching dentists complicates matter, since your new dentist can’t do much without having recent X-rays on hand. As such, try to either go to a dentist you’ve previously visited or request that your previous dentist send your X-rays to your new dentist.

Avoid Shopping for a New Dentist During Pregnancy!

Dental cleanings are allowed, in fact encouraged, during pregnancy

Not only are you allowed to get a cleaning during pregnancy, but it’s actually encouraged to do so, especially if your gums are bleeding more than they normally do. If your gums are bleeding or if you’ve been diagnosed with gum disease in the past, going for over nine months without receiving a dental cleaning could harm your teeth. It’s best to try and squeeze in a dental cleaning during these 9 months. The ideal time for your cleaning is the second trimester. Your child develops the least during this trimester which makes it safer to get treatment. Additionally, a cleaning midway during your gestation period reduces the time in between your dental cleanings by cutting it right in half.

Dealing with a bad toothache for several months may not be as easy as you think!

You want to avoid taking any unnecessary X-rays and invasive dental treatments during pregnancy. Of course, an emergency toothache is an exception. If you’re experiencing pain and your due date is nowhere in sight, then you have no choice but to seek emergency dental care. Again, the second trimester is typically the best time for seeking invasive dental treatment.

You CAN seek dental treatment during pregnancy.

There’s a specific protocol for seeking emergency dental treatment during pregnancy. You must follow these steps correctly if you want to receive treatment, otherwise chances are your dentist will refer you right back to your physician without rendering any actual treatment. Here is the check list of what’s required before seeking dental treatment during pregnancy:

Obtain a medical clearance letter in advance

Dentists always ask for a medical clearance letter from your physician before they perform any invasive treatment throughout your pregnancy. After you obtain this letter, your dentist is now permitted to treat you. So what is a medical clearance letter? This is a letter that your physician writes to instruct your dentist what to do and what not to do. The letter gives your dentist permission to take radiographs, administer anesthesia and perform emergency care. If you obtain your medical clearance letter in advance, you’ll save a lot of time and headache. Otherwise, it is likely that you will not receive any actual dental treatment.

Ask you physician for pain medicine, not your dentist

Dentists typically refuse to prescribe any painkillers or other medication for pregnant patients. If you want prescription medications, such as antibiotics or painkillers, it is best to ask your physician instead. Your dentist will most likely recommend an over-the-counter painkiller such as Tylenol and refuse to give you anything else.

Take extra precautions during your appointment

Minimize Your X-rays During Pregnancy

If you and your dentist follow proper protocol, there are minimal risks to seeking dental treatment during pregnancy. Here are some hints on what you and your dentist need to pay attention to during treatment throughout your pregnancy period:

  • Take as few X-rays as possible, ideally only one or two X-rays of the area that you’re having problems with. Avoid taking a full set of X-rays and only focus on where the pain is. Standard dental X-rays have very little radiation and the radiation is nowhere near your abdomen. Still, you want to reduce radiation exposure as much as possible whenever you can.
  • Stick with regular dental X-rays it at all possible. Panoramic radiographs, chest X-rays and other types of X-rays have lots and lots of radiation and should be avoided.
  • Make sure you’re double shielded when taking your X-rays. This means that you are wearing two X-ray shields for extra protection.
  • Avoid being in a fully supine position for long periods during treatment. Ideally, have your dentist should place you at a 30 or 45 degree angle your sitting in the dental chair.
  • Stay away from epinephrine at all cost as it can be risky during pregnancy. This means that you should receive special anesthesia that doesn’t have epinephrine in it. Epinephrine is found in anesthetics such as Novocaine and Lidocaine while anesthetics like Carbocaine and Mepivacaine typically don’t have any epinephrine in them.
  • Avoid sedation treatment with IV sedation, anti-anxiety pills or even Nitrous Oxide gas.

What treatments can I receive during pregnancy?

The treatment that you will receive is mostly based upon your dentist’s comfort level in dealing with pregnant patients. If your dentist is comfortable treating pregnant patients, you may be able to receive root canal treatments or even extractions. However, many dentists refuse to offer extensive treatments to pregnant patients . If you end up needing a root canal or tooth removal, often times you will find yourself being referred out to a dental specialist such as an oral surgeon or an endodontist for treatment. Specialist are better suited to handle specialized dental treatment during pregnancy, so this may not be a bad idea.

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