Tooth extraction during pregnancy - is it possible to remove teeth in position?

01.12.2019

If unexpected pulpitis occurs during gestation, there is nothing left to do but immediately go to the dentist for help. Many women are anxiously wondering how safe arsenic can be during pregnancy. In the process of dental treatment for pregnant women, two doctors should take part - a dentist and an obstetrician-gynecologist who monitors the course of pregnancy.

Is it possible to remove teeth in position?

Since many medications are prohibited during pregnancy, expectant mothers refuse to have their teeth treated or removed and endure pain until childbirth. But in many cases such a measure is not justified. It is possible and necessary to carry out treatment or extirpation, the main thing is to do it correctly.

Anesthesia is done using local drugs that have minimal side effects and do not have a negative effect on the fetus. However, the operation is performed only if there is an urgent need.

Indications for extraction:

pulpitis, periodontitis, in which neighboring tissues become infected;
deep carious lesion affecting the root;
cyst or malignant neoplasms;
growth of a figure eight, complicated by inflammation or if it presses on an adjacent molar;
tooth root fracture;
rapid development of periodontal disease, which is not amenable to therapeutic treatment.

If a pregnant woman experiences pain when chewing, she will not be able to eat properly, which leads to a deficiency of nutrients. This situation negatively affects her body, the formation and growth of the fetus.

The doctor considers each case individually. If possible, reschedule the operation for a more convenient time.

Arsenic in the tooth during pregnancy: composition of arsenic paste

“Pure” arsenic is an extremely aggressive substance. A dosage exceeding 5 - 50 mg can kill a person. To minimize all possible risks, arsenic in homeopathic doses is added to special pastes. The remaining mass fraction of the product is allocated for the following components:

anesthetic substance that relieves toothache (dicaine, novocaine);
an antiseptic substance that destroys harmful microbes in the cavity of a diseased tooth (thymol, camphor);
astringent tannin, which increases the period of use of the paste.

The finished drug is equipped with a convenient dispenser, which helps the doctor correctly calculate the dosage. After placing arsenic paste into the tooth, a temporary filling is placed. When treating single-rooted teeth, the application time for such a filling is 24 hours; for any other units, this figure increases to 48 hours. The maximum possible and safe duration of action of the arsenic substance is strictly limited to 72 hours.

We remind you that the use of paste with arsenic during pregnancy is rather an exceptional case. This method of pain relief is necessary if the expectant mother is intolerant to other anesthesia drugs, and the treatment of a diseased tooth cannot “wait”.

How does the timing of tooth extraction affect pregnancy?

In case of severe inflammation and pain, it is not always possible to postpone surgical intervention. If there are indications for extraction of a dental unit, then the possibility of carrying out the procedure must be agreed with the therapist and gynecologist. In this case, the period of bearing the child is important. Each trimester has certain restrictions and possible complications for the mother and fetus.

Possibility of extirpation according to timing:

First trimester. The placenta is being formed, the organs and systems of the child are being formed, so any medical manipulations are performed with extreme caution and only according to strict indications. During this period, most drugs are contraindicated, and surgery without them is impossible. Medicines, x-rays, and computed tomography have a negative effect on the fetus, causing various abnormalities. Some medications cause miscarriage. Even treatment of deep caries can be postponed to a later date. However, there are situations that do not allow you to avoid removing a diseased tooth. If there is severe pain and inflammation, this leads to hypertonicity of the uterus, nervous breakdowns, spread of infection to other organs, and infection of the fetus. In this case, the dentist can perform the operation despite contraindications.
Second trimester. After 3 months, the fetus is formed and the placenta is well protected. During this period, many types of treatment are allowed, including extraction, except for complex cases with a figure eight. Mother's stress and medications do not have such a strong effect on the child and pregnancy. Local anesthetics can be used safely. Before a CT scan or X-ray, a woman puts on a special protective apron.
Third trimester. Surgical intervention is highly undesirable. Although the fetus has become physically stronger, by this time the placenta is thinning and protects it less well. In addition, the period is dangerous for premature birth. Stress and pain can cause uterine contractions. Starting from the thirty-fourth week, almost any treatment is stopped.

At any time, extraction is carried out for purulent inflammation, which cannot be cured by therapeutic methods. In addition, if a pregnant woman suffers severe pain and is constantly under stress, this can have a bad effect on the child’s psyche.

In what form is arsenic administered?

Arsenic can be found everywhere. There is nothing superfluous in nature. The uniqueness of this chemical element from the periodic table is that it can be found everywhere:

in rocks;
in minerals;
in drinking water;
in animal and plant tissues.

Arsenic is rightly called the “ubiquitous” element. It is distributed throughout all continents of the planet due to its volatility and ability to quickly dissolve in water. In surface waters, from 3 µg/liter to 10 µg/liter of the substance is observed. Arsenic is contained in the human body in adults up to 15 milligrams. It “lives” in the cells of the liver, lungs, and epithelium of the small intestine. Absorption of the substance occurs in the stomach and large intestine.

In ancient times, high doses of arsenic were used to kill rodents, as a result of which the element still has such a “telling” name. Arsenic has unique properties. In small doses, it performs a number of useful functions for vital processes in organs and tissues. And in large doses it is very toxic and leads to cell death of any etiology. Arsenic takes part in metabolic processes and protein synthesis, promotes the absorption of phosphorus and nitrogen, stimulates hematopoietic function, and weakens oxidative processes in the body.

In dental practice, arsenic is not used in its pure form. It is the main component of arsenic pastes, which the doctor places into the tooth cavity formed as a result of destruction for complete necrosis of the nerve and subsequent painless cleansing of the dental canal. The devitalizing paste contains the following ingredients:

pain reliever (30%);
arsenic aldehyde (35%);
antiseptic (5%);
tannin (1%);
preservatives.

Arsenic paste impairs trophism at the cellular level of any tissue and stops the blood supply to the pulp, which ultimately completely interrupts the transmission of nerve impulses from nerve cells. Thus, the toothache subsides, the doctor is able to completely clean the canal and fill it with filling material.

Wisdom tooth removal during pregnancy: risks and complications

Surgery on the third molar is the most difficult. The procedure itself has a high probability of developing complications, especially in the lower jaw. Extracting the root of a lower extreme molar requires cutting into the gum and removing part of the bone, which is a more traumatic surgical procedure than a simple procedure.

After extirpation of the figure eight, body temperature may rise, severe pain in the jaws, head, neck, throat, swelling of the face and other negative phenomena may occur. The recovery period is long and painful. For these reasons, surgery is performed only in extreme cases: if there is a risk of infection spreading, or if there is severe, ongoing pain.

If it is possible to wait until childbirth or at least until the 2nd trimester, then the extraction of the figure eight is postponed.

Indications for dental treatment during pregnancy

Toothache is one of the most unpleasant sensations a person can experience. In terms of intensity, it can only be compared with the torment that the patient undergoes when the stones leave the renal pelvis. A high level of discomfort is caused by destructive processes inside the tooth. In order not to lose it altogether, you need to promptly seek help from specialists.

The following symptoms indicate the presence of inflammation in dental tissue:

acute pain when chewing food;
piercing pain when eating sweet, sour, hot and cold foods;
painful throbbing when lying down;
bleeding gums;
gum hyperemia;
the presence of swelling on the gums and jaws;
feeling of echoes of toothache in the ear or maxillary sinus;
discharge of pus from the open pulp;
high body temperature.

Only a specialist can eliminate this kind of pain. On your own, unpleasant sensations can only be temporarily alleviated with the help of analgesics, but this option is not relevant for pregnant women, for whom all more or less effective painkillers are simply prohibited. Medicines that relieve pain have a vasoconstrictor effect, which can have a bad effect on the development of the fetus. It is especially dangerous to take any pills in the early stages of pregnancy, when the baby's place is not fully formed.

Be that as it may, the aching tooth will still have to be treated, since the progressive inflammatory reaction will not go away on its own. In addition, it was noticed that in expectant mothers, caries and other dental damage are multiple and lightning-fast in nature, as well as a high tendency to complications.

Removal of tooth nerve during pregnancy

Depulpation is done for deep caries, when pathogenic microflora has penetrated the root canal and affected the pulp. Treatment requires local anesthesia, so the procedure is not recommended in the 1st trimester.

In order to leave the dental unit alive, they try to cure the nerve. If most of the pulp is affected, it is completely removed. If the nerve is treated with a therapeutic method, then the pregnant woman should regularly visit the dentist, as a relapse of the disease is possible.

Modern clinics do not use arsenic, which is absolutely contraindicated for pregnant women. For treatment, safe drugs with natural ingredients are used.

Methods of anesthesia in the treatment of pulpitis

Perhaps no area in practical medicine is developing as rapidly as dentistry. Modern methods of treating carious teeth make it possible to completely eliminate the use of arsenic pastes.

A wide range of painkillers of different pricing policies, produced in the form of injection solutions, solves the problem of pain relief in dental procedures of any complexity. The most common drugs for local anesthesia are available to every modern dentist: Ultracain, Ubistezin, Septanest, Scandonest, Mepivastezin and others.

However, not all therapeutic actions can be performed without resorting to arsenic paste. For example:

inability to perform anesthesia due to health reasons (tendency to hypertension, previous myocardial infarction);
individual intolerance to strong analgesics;
heart failure;
bronchial asthma;
autoimmune diseases;
the impossibility of expanding and cleaning curved or tartar-filled canals.

When, for various reasons, it is not possible to relieve high sensitivity with the help of anesthetics, the doctor uses devitalizing pastes containing arsenic anhydride.

Tooth extraction during pregnancy: anesthesia and medications

Anesthesia is required for surgery. General anesthesia is not acceptable. Anesthesia with lidocaine and similar anesthetics with adrenaline is also not carried out for pregnant women. The drugs can cause cramps, muscle weakness, severe allergic reactions, and lower blood pressure.

Modern painkillers contain a minimum of adrenaline and do not contain vasoconstrictor components that cause uterine hypertonicity. When applied topically, they are practically not absorbed into the blood, therefore they are safe for the fetus.

Among the acceptable medications, the safest ones can be identified:

Ultracaine;
Alfacaine;
Artifrin;
Primacaine;
Ubistezin.

During forced surgery, you do not have to endure pain, as happened several decades ago. Today, extraction is done absolutely painlessly.

If gum tissue is cut during surgery, antibiotic therapy is necessary. Pregnant women are usually prescribed Amoxiclav, which has an antibacterial and bactericidal effect. To reduce fever, a minimum dosage of Paracetamol may be prescribed.

Chlorhexidine, Miramistin, Romazulan - safe antiseptics - are used for mouth rinsing.

What to do after tooth extraction during pregnancy

Even if the procedure was successful, without pain, complications may develop during the recovery period. It is very important that after extirpation a blood clot is formed and firmly attached. It protects the resulting cavity with exposed bone and nerve endings from infection by bacteria and food.

The natural “plug” may come off in the following cases:

sticking to a cotton swab (placed after surgery) if held for too long;
licking the hole with the tongue;
using a drinking straw;
newly opened bleeding.

If the blood clot falls out, a new surgical intervention will be required. Otherwise, an inflammatory process will occur, which can lead to complications.

It is not recommended to get tired on the day of surgery. After the procedure, you need to go home and rest. You can eat after 3 - 4 hours. Food should be at a comfortable temperature, soft or liquid. Spicy, rough foods that injure soft tissues should be excluded. You should not smoke, as nicotine constricts blood vessels and interferes with healing.

You can rinse your mouth on the second day. As an antiseptic, pharmaceutical preparations, decoctions of medicinal plants, and an aqueous solution with salt and soda are used. Medicines will prevent the development of infection and speed up wound healing. Rinsing should be gentle and not intense, otherwise the blood clot will come off.

When brushing teeth, the surgical site is bypassed. You should use a toothbrush with soft bristles.

Until the wound heals, you should not overheat the body or exert physical stress. Otherwise, bleeding may resume.

Safety rules for using arsenic

How long the devitalizing paste will act in the tooth depends on the important characteristics of the body:

patient's age;
condition of the jaw apparatus;
the presence of diseases of the oral cavity and nasopharynx.

The usual time for “working” of arsenic paste is a day, but when treating several canals simultaneously and the thickness of the overgrown area in the canal, it can be individually extended up to 48 hours.

The effect of arsenic is painless, therefore, if pain occurs during the period of exposure to the paste, you must urgently go to the doctor, who will remove the temporary filling covering the dental canal and completely remove the arsenic.

Before placing the paste into the dental canal, it is customary to take an x-ray to obtain a clearer picture of the condition of the tooth and eliminate possible complications. In the case of pregnant women, another obstacle arises here. The need for an x-ray should be finally agreed upon with the doctor and the safest decision made.

Modern X-ray machines apply a point method to the area under study, which allows pregnant women to take pictures. If a clinic or private dental office does not have equipment of this level, you need to refuse the image and take it elsewhere.

Arsenic paste is installed quickly and easily. A ball of paste the size of the eye of a pinhead is placed into the previously cleaned cavity preceding the dental canal. Next, the preparation is covered with a camphor or phenolic tampon, which prevents the penetration of infections, and sealed with temporary filling material.

If the patient, for some subjective reasons, was unable to “remove” arsenic in time, serious complications may begin, ultimately leading to tooth extraction.

How to prevent tooth extraction during pregnancy

A full examination and treatment by a dentist should be done at the planning stage of conception. But even in this case, there is no guarantee that dental problems will not appear during pregnancy. After registration, a pregnant woman should regularly visit the dentist. If diseases are detected early, they can be treated safely and painlessly.

It is necessary to remember and carefully follow all the doctor’s recommendations for the prevention of diseases of the dental system. After conception, the composition of saliva and hormonal levels change, causing a deficiency of macro- and microelements and vitamins. Gingivitis is often diagnosed, which develops against the background of loose gums and reduced immunity. At this time, it is very important to eat right and maintain good oral hygiene.

In the second trimester, identified problems can be safely eliminated. After professional hygiene at the dentist, dental protection improves significantly, so do not neglect this procedure.

Diseases that require treatment during pregnancy

Once in the dentist's chair, if you are taking medications, let them know. This will help you choose the safest treatment tactics.

During pregnancy, adhere to hygiene, use toothpastes containing fluoride, and no toothpastes with a whitening effect!

If you have tooth decay?

Caries can be treated simply, without painkillers, but the process should not be started, even if the pain is tolerable, otherwise tooth decay will reach the pulp and then removal of the nerve cannot be avoided, therefore, more serious treatment. In the process of treating caries, there are no restrictions on the fillings used; you can use conventional or photopolymer fillings.

Often one of the reasons for the development of caries during pregnancy is frequent toxicosis. For example, using toothpaste with flavoring additives when brushing your teeth can provoke vomiting. And the acid contained in vomit is dangerous for tooth enamel. Therefore, it is recommended to rinse your mouth with plain water as often as possible.

Gingivitis or stomatitis

Inflammation of the gums (gingivitis) during pregnancy can occur in a hypertrophied state due to constantly occurring hormonal imbalances in the pregnant body. If gingivitis occurs, you must immediately seek professional help from a dentist; under no circumstances should you self-medicate or use folk remedies.

. Ignoring the problem will lead to a complex form of periodontitis, which will negatively affect not only the health of the mother, but also the health of the child. Thus, recent studies have shown that periodontitis poses a threat of miscarriage or even the occurrence of pathologies in newborns.

In case of a quick visit to the dentist, a mouth rinse will be prescribed, an application to gradually relieve inflammation, and the doctor will carry out professional cleaning of the oral cavity.

The weakened immunity of a pregnant woman contributes to the occurrence of stomatitis in the oral cavity. Swelling and small ulcerative lesions bring discomfort in the oral cavity, so it is better to consult a dentist. Most likely, he will recommend a spray that is harmless during pregnancy.

Some statistics...
45% of pregnant women come into contact with a problem such as gingivitis. Their gums swell and bleed, discomfort and bad breath appear. For most of them, these problems go away on their own after childbirth if they followed the recommendations of specialists.

Periodontitis or pulpitis

Pulpitis is a direct consequence of advanced caries, which leads to inflammation of the nerves, and periodontitis is the process of inflammation around the root tissues. In both cases, the resulting inflammation must be treated using anesthesia and x-rays. True, modern devices have low-power radiation, which allows treatment to be carried out practically without causing harm. In such cases, it is better to contact paid dental clinics, or clinics that have modern equipment and consumables.