Is It Safe To Perform Tooth Extraction during Pregnancy?

Tooth Extractions During Preganancy- Is It Safe?

Medically Reviewed By
Dr. Sabiha Anjum (Gynecologist/Obstetrician)
View more Gynecologist/Obstetrician Our Panel of Experts

Hormonal fluctuations during pregnancy can make your gums sensitive and lead to a host of dental problems. However, during this sensitive time, many women wonder if a tooth extraction is safe. Keep reading to know more.

Is a Tooth Extraction During Pregnancy Safe?

Dentists usually refrain from tooth extraction when a woman is pregnant. That’s because it can lead to excessive pain, and stress, which is harmful for your growing baby. However, in case of an infection or gingivitis, an emergency tooth extraction may be considered.

Common Oral Problems During Pregnancy

Hormonal secretion can cause or worsen dental problems in expecting women. Here are some common oral problems that you may face during pregnancy:

1. Gingivitis

Gingivitis makes your gums tender and causes inflammation and swelling. You may also notice bleeding gums when you brush or floss. Visit your dentist regularly for teeth cleaning.

2. Tooth Decay

An increased intake of carbohydrates can contribute to tooth decay during pregnancy. Morning sickness associated with acid reflux and vomiting can also increase the level of acid in your mouth and cause the enamel to wear off, leading to tooth decay.

3. Pregnancy Tumors

Occurring in 5% of pregnancies, pregnancy tumours, also called pyogenic granuloma, can cause an extra growth of tissues between the teeth. These are usually caused due to excess plaque and are known to reduce after delivery.

Symptoms That Indicate the Need for a Tooth Extraction

If you notice the following symptoms during pregnancy, your tooth may have to be extracted.

• Intense pain in the gums and tooth
• Decay or infection in the tooth
• Trouble eating food
• Swollen or inflamed gums
• Trouble speaking
• Bleeding gums

It’s always best to avoid a tooth extraction done during pregnancy, if possible.

Pregnant woman at dentist

When Can a Tooth Extraction Be Done?

Most dentists don’t perform a tooth extraction procedure during pregnancy unless it’s an emergency. However, in the case you need one, wait for the right time to get the procedure done.

1. First Trimester

Since the first trimester is a crucial time for the development of your baby, no dental procedures are carried out during this time. In case you have a serious tooth condition, the best course of action is to take home remedies and avoid drugs.

2. Second Trimester

The second trimester is considered the safest time to opt for tooth extraction, as most of your baby’s organs would have developed by this time. However, you should put off any advanced procedures. If you experience a syncope (temporary or partial loss of consciousness) or dizziness, your dentist will turn you onto your left to alleviate the pressure. You may experience a Supine Hypotension Syndrome (drop in blood pressure) when you are seated in a reclined position, due to the pressure exerted by the fetus on a large vein called inferior vena cava. In such cases, the dentist will elevate your hip to about 10 to 12 cm on the chair.

3. Third Trimester

Since you may find it hard to sit in a stationary position for a long time, dental procedures are not recommended. Stress due to pain can also lead to premature childbirth. If you experience intense pain that makes a tooth extraction inevitable, the first month of the third trimester is usually considered safe. Otherwise, it’s better to wait until after delivery.

Safety Precautions

Here are some safety precautions that should be taken if you opt for a tooth extraction during pregnancy:

1. During the Procedure

Since X-rays and anaesthesia are administered, certain precautions need to be taken to avoid adverse effects on the foetus.

•During the X-ray, a lead sheet should be used to cover your upper body to prevent any harm to the baby due to radiation.
• Local anaesthesia like Novocaine or Lidocaine should be used on pregnant women. These are category B drugs that get filtered out of the placenta before reaching the fetus. 

2. Medication

Any medication given after the procedure should be safe for both you and your baby.

•Penicillin, clindamycin, and amoxicillin are considered safe for pregnant women. Erythromycin is also prescribed to women who do not have any adverse reaction to it. Ensure to keep your doctor informed if you are allergic to any of these medicines so that an alternative can be prescribed.
• In order to relieve post-procedural pain, you may be prescribed opioid pain medication like hydrocodone, codeine, etc. Certain non-steroidal anti-inflammatory medications like ibuprofen, naproxen, and aspirin may be prescribed for short-term use (72 hours). However, these should be avoided in the first and the third trimesters.

Medicines You Should Avoid

Avoid taking these medicines during pregnancy:

•Tetracycline, doxycycline, and minocycline should be avoided both for topical use and as a pill, as these can stain your baby’s teeth.
• Fluoroquinolones like levofloxacin, ciprofloxacin, and moxifloxacin should also be avoided.
• Certain retinoids and teratogenics like thalidomide can cause cleft lips and other abnormalities in the baby and hence should be avoided.

What If the Wisdom Tooth Needs to Be Removed?

Gum problems during pregnancy can also lead to the aggravation of the pain caused due to the wisdom tooth. Infection, plaque build-up, or abnormal growth may worsen this pain. In such cases, the wisdom tooth extraction follows the same precautions as normal tooth extraction. 

Does Pregnancy Lead to Tooth Loss?

Although pregnancy can increase sensitivity in the gums and lead to gingivitis, you don’t have to worry about tooth loss.

How to Prevent Dental Procedures in Pregnancy

Following proper dental hygiene and exercising precautions can rule out the need for dental procedures during pregnancy altogether. Here are some things you could do to prevent them:

• Prevent plaque build-up by regularly visiting your dentist.
• Reduce the intake of sweet foods to prevent swelling and inflammation of the gums, as it attracts bacteria.
• Use toothpaste that contains fluoride and floss every day. Avoid using a mouthwash that contains alcohol.
• Use a brush with smooth bristles to prevent irritation to the gums.
• Dental grafting during pregnancy can aggravate gum bleeding.
• Smoking is also one of the common causes of periodontal problems.

Dental care is important throughout life and, more so, during pregnancy. Ensure you maintain proper dental hygiene and visit a dentist regularly to track your dental health.

Also Read: Appendicitis in Pregnancy

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