Is it possible to have dentures during pregnancy?

During pregnancy, the expectant mother needs to listen more carefully to her body. Oral problems during pregnancy are not uncommon. Teeth and gums react very sensitively to changes occurring in a woman’s body; enamel is more susceptible to destruction and can react sharply to environmental influences. Many women think that dental treatment during pregnancy is impossible. In fact, dental treatment during pregnancy is an important and necessary procedure. After all, the condition of the teeth and the unborn child largely depends on the condition of the mother’s teeth.

Main dental problems and what causes them

According to statistics, during pregnancy, 30% of women have problems with their gums (gingivitis, periodontitis) and 90% with their teeth (caries, pulpitis), and 80% have increased sensitivity of the enamel and a weakening of its mineralization (susceptibility to chipping). The reasons for this are hormonal changes in the body and changes in metabolism.

After all, not only does the baby “take” useful macro- and microelements, the body is also preparing for childbirth, so the bones soften (including the jaw bone, but very little). Also, against the background of all the mentioned processes, problems with immunity may arise - both general and local in the oral cavity. Therefore, the body is susceptible to various infections, which must be eliminated so as not to complicate the course of pregnancy - but, at the same time, not to harm the child.

Good to know! It is very dangerous to underestimate gum inflammation, because... untreated gingivitis (manifested by bleeding and swelling of the mucous membranes) develops into periodontitis - this is inflammation that covers the deep areas of the gums and the bone around the roots. And periodontitis increases the risk of pregnancy complications 8 times - miscarriage, preeclampsia, premature birth and low birth weight of the child.

Safe anesthesia for pregnant women

To treat deep caries, pulpitis, and periodontitis, pain relief is necessary. More recently, anesthesia was not possible, and expectant mothers endured severe pain during immediate treatment. However, the strong emotional state of women at this moment led to a malfunction of the central nervous system, metabolism, and other disorders.

Lidocaine and other adrenaline-based drugs are toxic, cause muscle weakness, cramps, lower blood pressure, and provoke the development of allergies. If the concentration of adrenaline is insignificant, then the product can be used.

While carrying a child, pain relief is carried out:

• alfacaine, ubistezin, artifrin based on anticaine;
• ultracaine - safe and non-toxic;
• primacaine with a short half-life.

All medications are used at the local level, that is, to anesthetize the tissues around the tooth and pulp.

Contraindications to medications and examinations

The first thing that is not recommended for pregnant women is an X-ray examination, be it a regular targeted X-ray or a computed tomography scan, because harm to the fetus may outweigh the benefit to the mother. The fact is that even when treating pulpitis, you need to take at least 2 pictures; during prosthetics and implantation, you also need to undergo x-ray diagnostics several times. As for toothache tablets, you can take them only after consulting a doctor, because Some drugs sharply lower blood pressure.

The use of antibacterial drugs, which are prescribed after tooth extraction and implantation, when treating gums, can be dangerous for the baby. Moreover, in a number of situations the patient needs to take several antibiotics at once, affecting different forms of bacteria. And doctors prescribe such drugs strictly according to indications - independent use is prohibited. By the way, cephalosporin antibiotics (cefazolin, for example) are considered the most “harmless” during pregnancy. Also, during treatment and prosthetics during pregnancy (and not only) there are contraindications for anesthesia - a regular “freezing” injection, sedation or anesthesia (we will discuss this in more detail later).

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Is it possible to install completely removable dentures?

It is undesirable to do this during the period of bearing a child for the reason that the gums of expectant mothers are almost always slightly swollen due to gingivitis. And removable prosthetics requires full contact of the prosthesis itself with the gum so that it stays securely in the mouth, but with a structural change in the alveolar process of the jaw, this is impossible.

On a note! The inflammatory process is dangerous not only for the expectant mother and the health of her teeth, but also for the baby. Thus, scientists claim that foci of untreated infection in 30%1 of cases lead to some kind of damage to the fetus, and children of such mothers are more often born with low immunity, they also more often have impaired gastrointestinal tract activity than babies whose mothers are pregnant had no problems. Therefore, even during pregnancy there is a reason to consult a doctor, but not for prosthetics, but for the prevention and adequate treatment of inflammation in the oral cavity, be it sore teeth or gums.

In addition, wearing removable dentures is associated with a rather long and difficult period of adaptation, during which painful sensations, severe rubbing of the mucous membrane, and a gag reflex are possible - for a pregnant woman this is a stressful and very dangerous situation, fraught with complications.

What help can a dentist provide?

The peculiarities of treatment and prosthetics during pregnancy include the fact that all procedures are carried out using gentle methods. The doctor must always correctly assess the overall picture, because the benefits of treatment must outweigh the expected harm. According to the indications - if the pain is very strong, there are signs of negative dynamics of non-invasive treatment (from minor interventions), then a pregnant woman can have pulpitis cured and the tooth removed - even a complex extraction. But these are all emergency situations. Basically, the dentist offers the following treatment:

• elimination of initial and intermediate caries,
• installation of fillings made of photopolymers,
• restoration of gum health with hypoallergenic drugs that do not penetrate the bloodstream and do not harm the fetus,
• removal of tartar and bacterial plaque,
• professional teeth cleaning,
• remineralization: strengthening the enamel with useful minerals - calcium, fluorine, phosphorus,
• vitamin therapy: vitamins B, C, PP are useful for oral health - but the prescription of any drugs is carried out with the participation of a gynecologist,
• some types of prosthetics: we’ll talk about this later.

Emergency help

If before pregnancy there were signs of periodontal caries, demineralization of the cervical area of ​​the teeth, and inflammation of the soft tissues, the disease is highly likely to progress.

For acute pain, help is provided at any stage of pregnancy:

• 1st trimester – for chronic pulpitis and apical periodontitis, devitalizing pastes without arsenic are used, the root canals are sealed with temporary fillings based on calcium hydroxide. Treatment is carried out in 2-3 doses.
• 2nd trimester – completion of treatment started in the 1st trimester;
• 3rd trimester – the duration of the intervention is no more than 15 minutes. Temporary fillings are installed. Treatment is completed after childbirth.

Nuances of treatment and prosthetics in pregnant women

Dentists recommend doing oral sanitation, i.e. elimination of all dental diseases, even at the stage of pregnancy planning. But if this condition occurs unexpectedly in a woman’s life, then it’s worth knowing when it’s best to see a dentist:

• in the first trimester - up to 12-13 weeks: the fetus develops all the vital organs, and the woman often feels unwell (weakness, dizziness, nausea). Therefore, dental intervention is necessary only for really serious indications - which include toothache, bleeding gums,
• in the second trimester - 14-26 weeks: the most suitable period for the treatment of caries (even if there is no pain, but there is a carious cavity), professional hygiene and, if necessary, prosthetics. Because the main “laying in” of the child’s organs has already occurred, and the well-being of the expectant mother has improved,
• in the third trimester - after the 27th week and before childbirth: here, in addition to noticeable changes in the figure, which creates inconvenience during a long stay in the dental chair, pregnant women often experience hypertension and increased blood glucose levels. Therefore, it is better to postpone planned dental treatment until the postpartum period, but in emergency cases it is better not to postpone a visit to the dentist.

After childbirth, dental treatment and prosthetics may also have contraindications due to the fact that the child is breastfed - and various drugs can pass into milk. And do not forget that calcium enters milk from the mother’s body, so the bones of the woman herself at this time are not yet strong enough. Therefore, it is also recommended to postpone planned treatment until 3-4 months after completion of lactation.

Is it possible to combine dental implants and pregnancy?

• During pregnancy, the immune system is weakened, so it takes longer to recover, and infections develop quickly.
• Any surgical intervention is stressful for the body and is strictly contraindicated for pregnant women.
• The preparatory stage includes a mandatory x-ray examination, which is undesirable for the unborn baby.
• Pregnant women should not be given anesthesia or take anti-inflammatory drugs.
• Treatment of possible complications after implantation will also require medication.
• If surgery is already planned and the woman finds out she is pregnant, the surgery should be cancelled.

Implantation in the first trimester of pregnancy is dangerous. All vital organs are formed in a woman’s body, and the operation will not only negatively affect this process, but can provoke an interruption.

Immediately after childbirth, implantation is also undesirable, since the body needs time to recover. About a year.

Features of the use of anesthesia

Many popular anesthetic drugs contain the hormone epinephrine (adrenaline), which prolongs the effect of the anesthetic itself by constricting blood vessels and slowing blood flow at the injection site. But adrenaline also penetrates into the blood - and can provoke uterine hypertonicity, increase blood pressure, and disrupt the formation of internal organs in the fetus (if this hormone was taken before the 12th week of pregnancy).

Therefore, in the treatment and prosthetics of teeth during pregnancy, other substances are used for anesthesia. For example, “Ultracaine D” (which contains only non-toxic articaine) or “Primacaine” with articaine and a minimum concentration of epinephrine (10 mcg). Also, pregnant women can use the anesthetic "Sevoran" - but only under the supervision of an anesthesiologist-resuscitator. The effect of articaine is about 20 minutes, and in combination with epinephrine – up to 45 minutes.

After considering all the important features and limitations when providing dental treatment to pregnant women, we will tell you how prosthetics are done during pregnancy, with what dentures and according to what rules (indications and features).

What pain relief is safe?

When treating teeth in pregnant women, preference is given to articaine anesthetics with a minimal amount of adrenaline. They are distinguished by their high analgesic strength and long-lasting effect, and are effective for purulent inflammation when other painkillers are ineffective. Drugs that are safe, including for children: Articaine, Ubistezin.

General anesthesia is strictly contraindicated, since in any case it negatively affects the condition of the fetus. The use of anesthesia is justified only in situations that threaten the life of the expectant mother.

Table of drug effects (by trimester)

Types of dentures

Dentures can differ in the time of fixation - temporary and permanent, in the type of installation - removable and fixed, on your own teeth and on implants, as well as in size (how many teeth they replace). Orthopedic structures are also classified by material - acrylic, nylon, polyurethane, with and without metal inclusions (nickel, gold, titanium), ceramic, glass-ceramic, zirconium dioxide and others.

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What prosthetics are allowed during pregnancy and when?

Crowns and bridges supported by your own teeth - installed in rare cases

Prosthetics with crowns and bridges are usually not performed during pregnancy. Because it is necessary to prepare the supporting teeth - grind, remove nerves, install a retraction thread under the gum, take impressions of the dentition. It may also be necessary to remove decaying teeth or roots. Of course, some of these manipulations are carried out with anesthesia and evaluation of the intervention performed using x-rays.

Temporary crowns or adhesive bridges can be placed in almost any case where permanent dentures are required, but this is not yet possible. For example, when a tooth is destroyed by more than 50% and the installation of a conventional filling is already contraindicated, but at the same time it is necessary to preserve the remains of the tooth for subsequent permanent prosthetics (which will be done after childbirth).

Implantation – installation of implants: not carried out

Implantation is currently considered a fairly ordinary procedure with a minimum of contraindications, of course, with the participation of an experienced dentist-implantologist. But during pregnancy, no doctor will undertake it, since dental implantation is not a vital operation (and surgical interventions are performed for pregnant women only for serious reasons). During implantation, the pressure may “jump” and the woman may become worried. Again, you need to do anesthesia - local or general.

A computed tomography scan of the jaw is also necessary before implantation, and after it a panoramic image or targeted radiography is taken. And do not forget that the bone substance of the jaw does not receive calcium in a normal volume, so the implant may not achieve primary stability. And against the background of gingivitis and periodontitis in pregnant women, peri-implantitis or implant rejection may begin.

When restoring 1-2 teeth after a long absence, osteoplasty may be necessary - bone augmentation surgery, because there is not enough of its own to place the implant (it has atrophied without the load it previously received from the root). This manipulation is contraindicated for absolutely all pregnant women. Indeed, in addition to the obvious trauma and long tissue healing, the implanted bone may simply not take root, i.e. The operation was done in vain. It would be fair to add that even in non-pregnant women and men, osteoplasty is ineffective in 40% of cases - and it has to be done again.

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Prosthetics on implants: can be performed (according to indications)

If implants were installed before pregnancy, but prosthetics were not performed, then it is not always possible to do it at the moment. This is due to the fact that when implants are installed to replace 1-2 teeth, they are covered with gum on top and left alone for 3-6 months until complete engraftment. And in order to place abutments on the implants (support for a prosthesis, crown, bridge), the gums will have to be cut. Moreover, anesthesia is first administered, and then in a number of situations, stitches are applied and antibiotics are prescribed.

If, before pregnancy, a woman had abutments and temporary crowns (removed from the bite) or other temporary prostheses placed on implants, then there are no contraindications for the installation of permanent orthopedic structures. And if the patient feels well, they are allowed to be placed.

“I had an implant in my lower jaw, and they were supposed to put a crown, but then the test showed two stripes)) I, of course, went to my dentist. He said that I could get a crown in a couple of months if I felt okay. So after the toxicosis ended successfully, I went to get prosthetics. And there were no special problems while the crown was being installed.” Alina, review from baby.ru

Veneers and inlays: can be done

It is possible to get veneers for a pregnant woman, because... Preparation in this case is minimal - the dentist will slightly grind the enamel of the front teeth, and there is no need for anesthesia. But doctors recommend, if possible, postponing microprosthetics until the postpartum period, because In expectant mothers, tooth sensitivity increases, and grinding without anesthesia before taking impressions can be uncomfortable. Or you can install ceramic composite veneers or lumineers, for which turning is not always necessary.

Read on the topic: “Hollywood veneers” or Lumineers – what are their advantages and disadvantages.

As for restorative inlays, they can be placed provided that there is no need to first remove nerves from the teeth and fill the root canals (after all, these procedures are carried out with anesthesia and x-rays). Or carry out microprosthetics in the second trimester of pregnancy when treating pulpitis in a diseased tooth. Restorative inlays are the best replacement for a conventional filling, because... they fit more tightly to the tooth walls and last about 15 years, while a filling will last 5 years maximum.

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Removable dentures: can be carried out

Removable1 dentures rest mainly on the gums – which are already swollen during pregnancy. Also, the installation of removable structures, especially long ones with massive artificial gums or palates, is associated with severe discomfort. The woman will experience more nausea and dry mouth - i.e. saliva washes the gums and teeth worse, and this leads to increased gingivitis or provokes caries. Another disadvantage is that the denture moves while chewing food. That is, increased rubbing of the gums occurs again, and it becomes necessary to attach the denture to a special cream (Protefix or Coregu, for example).

Therefore, removable dentures are not recommended for the expectant mother, even as a temporary option; it is better to replace them with temporary fixed ones. An exception is when a woman does not have a large number of teeth, for example, many sick teeth had to be removed during pregnancy or shortly before it, and implants were not placed in time. And here you should choose either lightweight Quattro Ti or hypoallergenic Acry-free. Moreover, they should be worn only under the supervision of a doctor - i.e. You will have to visit your dentist regularly to evaluate your oral health.

Don't know what type of prosthetics to choose?

We will help in the selection, advise where to read more information and compare types of prosthetics.
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Is it possible for pregnant women to have microprostheses installed?

Let's talk about whether microprosthetics of teeth can be done during pregnancy.

If you really want to transform your smile with the help of veneers or lumineers, then in general there are no absolute contraindications to this procedure, especially if the woman feels well and the pregnancy is easy. After all, installing onlays on the front part of the teeth in most cases does not involve significant intervention, surgical manipulations, anesthesia, does not require radiography and strong grinding of the enamel - all that can disturb the emotional background of a woman and negatively affect the fetus. But most dentists will still prefer to postpone the procedure until after the baby is born.

“According to statistics, every third pregnant woman is diagnosed with a disease such as gingivitis. Simply put, this is inflammation of the gums and their swelling, increased bleeding. Moreover, in most of them, in 79% of all cases, also against the background of hormonal changes, the enamel becomes very fragile and sensitive. And 90% are diagnosed with caries, which requires treatment. And all these are indicators of women with a normal pregnancy. It is simply not possible to carry out even microprosthetics in such conditions with high quality and without health consequences,” adds Vasin Yu.A., orthopedic dentist.

What can we say in the end? To use prosthetics or not?

Dental prosthetics during pregnancy is possible, but each case should be considered individually, since for expectant mothers there are many contraindications for certain manipulations and examinations. There are also favorable and unfavorable periods for dental treatment. However, this does not mean that if you have a toothache or problems with your gums, you need to wait until the 13th week or until childbirth. On the contrary, this is considered a direct indication for immediate contact with the dentist - the sooner the problem is eliminated, the lower the risk of complications. After all, a child needs a healthy mother.

When is the best time to treat teeth?

• 1st trimester. The fetus is forming, the bone structure is taking shape - the skeleton, the nervous system. Any interference with the natural process can cause delay in fetal development. If your teeth begin to hurt at this time, it is better to postpone treatment until a later time and use safe painkillers.
• 2nd trimester. The child is already fully formed, well protected by the placenta, the mother’s body has adapted to the new state, so no “conflict of interest” arises. The optimal time for dental treatment, including the use of anesthesia, is 15-22 weeks.
• 3rd trimester. A woman's body is preparing for childbirth. Pain, psychological fear, and physical discomfort can cause rapid or premature labor. It is better to postpone planned treatment at this time, taking measures to relieve pain.

The most difficult time for an expectant mother is the 1st and 3rd trimester of pregnancy, therefore, having no indication for urgent intervention, the dentist carries out only preventive measures, and postpones treatment to a more favorable period - the 2nd trimester.

Patient Questions

QUESTION Good afternoon, tell me what is the best way to proceed. I had a severely broken molar on the side. It doesn't hurt, but the tongue hurts a little. Is it possible to cure it or put a crown on it? Because I heard that it’s better for pregnant women to get their teeth done in the second trimester, but I’m now in the third. Maria

ANSWER Hello, Maria. In your case, it is better not to wait until after birth. After all, then you simply may not have enough time for treatment, and delaying it can lead to complications. The question of what is best to do - file a tooth, put a filling or a temporary crown - is best decided personally with your dentist after an examination.

1Zhulev E.N. Partial removable dentures, 2011.

Author: Dzagurova E. R. (Thank you for your help in writing the article and the information provided)

Indications for temporary dental prosthetics during pregnancy

• the onset of pregnancy in the process of preparing teeth for permanent prosthetics (completion of work in a short time - up to 6 weeks of pregnancy);
• lack of chewing function due to loss of molars;
• psychological discomfort when losing the frontal group of teeth;
• malocclusion, risk of chipping and injury to teeth during pregnancy;
• fracture of the tooth wall;
• defect in the existing permanent structure.

The use of temporary orthopedic products while expecting a child has great functional significance. The absence of teeth can lead to undesirable consequences: overload of neighboring teeth and periodontal tissues, microcracks, tooth mobility.

Elimination of the above risks is possible by normalizing fissure-tubercle contacts and distributing chewing pressure. That is why care should be taken to fill the “closing line” of the jaws in the area of ​​missing teeth using temporary structures or using a relaxing splint.