Tooth Extraction While Pregnant – Signs & Precautions to Take

Pregnant woman at dentist

The hormone fluctuations that you go through during pregnancy can cause your gums to become sensitive. Inflammation of the gums can also make them bleed giving rise to a host of dental problems. Gums around the wisdom tooth may also be a cause of worry during this time, requiring frequent visits to the dentist. Sometimes, the condition may get worse enough and make tooth extraction a necessity.
Neglecting dental care during this time can aggravate these issues. However, in case you require procedures like tooth extraction, you will need to consider the health of your baby and discuss with your doctor before opting for a procedure.

Is Tooth Extraction in Pregnancy Safe?

Dentists or oral surgeons usually refrain from tooth extraction during pregnancy and only do it in case of emergencies. This is because getting a tooth pulled during pregnancy can lead to excess pain, which will put your body under stress. This can be harmful to your growing baby. However, in case of infections or gingivitis, which may also lead to harm to the baby, an emergency tooth extraction is considered.

Common Oral Problems in Pregnancy

Pregnancy hormones can cause or worsen tooth problems that you already have. Also, a bacterial infection may lead to certain other periodontal diseases due to increased sensitivity in the gums. Here are some of the other common oral problems that you may face during pregnancy.

1. Gingivitis During Pregnancy: Gingivitis makes your gums tender and causes them to get inflamed and swell. You may also notice bleeding gums as your brush or floss them. Here, you will need to visit your dentist frequently to get your teeth cleaned to prevent any further infections.
2. Tooth Decay: An increased intake of carbohydrates can contribute to tooth decay during pregnancy. Morning sickness can also increase the level of acid in your mouth and cause the enamel to wear off leading to tooth decay.
3. Pregnancy Tumours: Common during the second trimester, pregnancy tumours can cause an extra growth of tissues between the teeth which appear like little red tumours. These are usually caused due to excess plaque and are known to reduce after delivery.

Symptoms That Indicate the Need for Tooth Extraction

In the event that you notice the following symptoms during pregnancy, you may need to consider having your tooth extracted.

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

Despite the symptoms, it is always best to wait for the right time to get your tooth extraction done during pregnancy in order to prevent any harm to the fetus.

Pregnant woman at dentist

Right Time for Tooth Removal

Most dentists do not perform a tooth extraction procedure during pregnancy unless absolutely required. However, in case that you need one, you will need to understand when the right time to get the procedure would be and discuss this with your dentist.

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 during this time is to protect you from infection without administering any drugs.

2. Second Trimester

The second trimester is considered the safest time to opt for a tooth extraction as most of your baby’s organs are developed well by this time. However, it is advised that you put off any advanced procedures.

Even during this time, the dentist will take the following precautions to avoid any complications and keep you a comfortable as possible.

• If you experience a syncope (temporary or partial loss of consciousness), your dentist will turn you onto your left to alleviate 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 will find it hard to sit in a single position for a long time during the third trimester, any dental procedures are not recommended. Stress caused due to pain can also lead to premature birth.

If you are experiencing intense pain which makes tooth extraction inevitable, then the first month of the third trimester is usually considered safer. Otherwise, it is better to wait until after your baby is born.

Safety Precautions to Take During Extraction

Here are some safety precautions that should be taken in case you are going through a tooth extraction during pregnancy.

1. Safety During the Procedure

Since X-rays and anaesthesia are required during the process, certain precautions need to be taken to avoid adverse effects on the fetus:

• 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.
• A local anaesthesia like Novocaine or Lidocaine should be used in pregnant women. These are category B drugs that get filtered out of the placenta before reaching the fetus.

2. Safety Of Medicines

Any medication given after the procedure should be harmless to both you and the 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 to Avoid

Certain medicines should be avoided after a tooth extraction during pregnancy. These include:

• 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.

Wisdom Tooth Removal

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.

Is It True That Pregnancy Leads to Tooth Loss?

Although pregnancy can increase sensitivity in the gums and lead to gingivitis due to excess release of progesterone hormones, you do not have to be worried about tooth loss.

How Can You Prevent Dental Procedures in Pregnancy?

It is better to follow proper dental hygiene and exercise precautions in order to rule out the need for such dental procedures during pregnancy altogether. Here are some things you could do to prevent them.
• Prevent plaque build-up on your teeth through regular visits to the dentist.
• Reduce the intake of sweet food items to prevent swelling and inflammation of the gums.
• Use toothpaste that contains fluoride and floss every day. Avoid using any mouthwash that contains alcohol in it.
• Use a brush with smooth bristles to prevent irritation to the gums.
• Do not get any dental grafting done during pregnancy as it could aggravate gum bleeding. Also, it is recommended that you avoid dental bling.
• Smoking is also one of the common causes of periodontal problems. Stop smoking during pregnancy.

Dental care is important throughout your life and more so during pregnancy as hormones make you susceptible to many more oral problems. Always ensure that you maintain proper dental hygiene to prevent getting into a situation where you may need emergency procedures during pregnancy. Visit a dentist regularly to track your dental health.

Also Read: Appendicitis in Pregnancy