While pregnant, a woman's body goes through countless changes, and there are numerous things that can affect her health and the health of her baby. In some cases, a woman may need to have a tooth extracted during pregnancy.
Before undergoing any type of dental procedure, it's important for women to understand the potential risks and benefits associated with it.
You might need a tooth extraction for numerous reasons:
- Injury or fracture to one of your teeth
- A severely decayed tooth that cannot be repaired with a filling or crown
- A loose baby tooth that doesn't fall out on its own
- Orthodontic treatment requiring the extraction of a permanent tooth to make room for others
- Wisdom teeth extraction
On the surface, it might not look like these procedures would put much strain on you or your baby. But it's important to consult with your dentist and obstetrician prior to proceeding with any type of dental procedure while pregnant.
In this article, we'll cover the basics of when and when it isn't safe to undergo a tooth extraction while pregnant.
The Risks Of Having A Tooth Pulled During Pregnancy
Pregnancy can significantly impact your oral health. Hormonal changes that take place when you're pregnant can increase the risk of developing gum disease and other oral conditions.
As for invasive dental procedures (including tooth extractions), they are generally safe—even during pregnancy.
The concern about tooth extraction during pregnancy results from outdated ideas about dental care for pregnant women. In the past, dentists were taught to avoid treating pregnant women and would deny treatment regardless of the severity of the dental issue.
As such, pregnant women face barriers to dental care that other groups do not.
Still, timing is everything when it comes to any procedure while pregnant. Let's take a look at the differences between first, second, and third-trimester pregnancies.
The First Trimester
In the first trimester, fetal development is just beginning (and at its most critical). Any drugs and radiation used during a tooth extraction have the potential to affect the development of your baby's organs.
During the first three months of pregnancy, it is best to avoid a tooth extraction if it requires X-rays or any other type of radiation.
The Second Trimester
The second trimester is considered the optimal time for a tooth extraction. During this time, your baby's organs will already be formed so the risk of radiation or drugs affecting its development is much lower.
Between the three- and six-month marks of pregnancy, the discomfort from fetal growth and development is also lower since the baby isn't as large yet.
The Third Trimester
In the third trimester, laying still on your back for prolonged periods of time is often difficult due to the size of your baby. Your dentist may advise against a tooth extraction during this time as you will be more uncomfortable than in the earlier stages of pregnancy.
During the procedure, small kicks and movements from the baby may make it difficult for your dentist to perform the extraction.
In any case, your dental procedure must be performed if it is an emergency. Any situation involving gum infection, severe pain, or potential damage to other teeth should not be ignored even in the earliest or latest stages of pregnancy.
Performing Tooth Extraction During Pregnancy
The tooth extraction process is the same whether you are pregnant or not. Briefly, here's what you can expect:
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Your first consultation: During this visit, your dentist will assess the condition of your teeth and discuss all the possible treatment options.
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Pre-extraction: X-rays may be taken to help guide your dentist in making sure that they remove the exact tooth they need to.
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The extraction process: Your dentist will use a local anesthetic to numb the area of your mouth where the tooth is being extracted.
- Your final consultation: Your dentist will provide you with aftercare instructions on how to care for your mouth following the procedure.
If you are pregnant, the main difference is that you will experience higher levels of discomfort throughout the process, which involves laying down on your back for prolonged periods of time and traveling to and from the dental office on multiple occasions.
Pain Relief For Tooth Extraction While Pregnant
Pregnant women have fewer options when it comes to pain relief during a tooth extraction procedure.
Let's take a look at the different options available and whether or not they are safe during pregnancy.
Non-steroidal Anti-Inflammatory Drugs (NSAIDs)
The FDA recommends avoiding NSAIDs such as ibuprofen, naproxen, and aspirin. They reduce the amount of amniotic fluid in the uterus and can cross the placenta to your baby, leading to an increased risk of complications.
Opioids
Opiate medications such as oxycodone are usually prescribed for severe pain relief after wisdom tooth removal.
Although oxycodone does not pose a significant threat to fetal development, heavier use of opiates can cause severe complications.
In general, it is best to avoid opioid medications during pregnancy if possible.
Local Anesthetics
Your dentist will administer local anesthetics to numb the area of your mouth where the extraction is occurring. These are generally considered safe during all stages of pregnancy, as they do not travel far enough to affect the fetus.
General Anesthesia And IV Sedation
Unlike local anesthesia, general anesthesia and IV sedation can sometimes affect the fetus if they are administered in large quantities.
In most cases, they are generally regarded as safe—since the anesthetic leaves the baby's body at around the same time it leaves the mother's, the risk of long-term harm is relatively low.
Some forms of anesthesia and IV sedation cause problems in later stages of pregnancy. Your surgeon or orthodontist will be able to discuss the implications of these treatments with you during your initial consultation.
The Ideal Time For Tooth Extraction While Pregnant
As previously mentioned, the best time to have a tooth extraction while pregnant is in the second trimester. During this stage of pregnancy, the risk of radiation damage to the fetus is relatively low, as is the level of discomfort patients can expect throughout the procedure.
In the first trimester, the risk of radiation damage is higher. In the third trimester, the discomfort experienced by patients is sometimes too much for them to bear.
Outside of this window, patients sometimes opt to postpone their non-emergency tooth extractions until after their pregnancy.
When You Shouldn't Postpone A Tooth Extraction
If you are pregnant, there are a few situations in which you shouldn't postpone your tooth extraction:
- The tooth is infected. If the infection spreads to other parts of your body, it can cause serious health problems for both you and your baby.
- The tooth is causing pain or discomfort. If the sensation is so severe that it affects your ability to perform everyday tasks, you should consider having the tooth removed as soon as possible.
- The tooth is impacting other teeth in your mouth. If this is the case, then not having it extracted could cause further complications down the line.
- Your jaw has shifted out of alignment. Jaw misalignment can lead to TMJ disorder, which is a painful and potentially dangerous condition.
- The tooth is broken. If the tooth is in pieces, then it may need to be extracted before it causes further damage in your mouth.
- Your broken tooth shows an exposed root or nerve. Exposing the root or nerve can cause serious infection (and pain), so it should be addressed immediately.
It is also important to note the unpredictable nature of dental and medical conditions. If you decide to postpone treatment until after giving birth, there is no guarantee that your condition won't worsen during this time.
If you are willing and able to carry through with your procedure despite your pregnancy and it is safe to do so, it is best to get it out of the way as soon as possible.
Dental Care During Pregnancy
To ensure that your dental health remains in top condition during pregnancy, follow these steps:
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Brush your teeth twice a day with a soft toothbrush and fluoride-containing toothpaste.
- Floss daily to remove plaque and food particles from between your teeth.
- If you have sensitive teeth due to pregnancy, try a toothpaste that
contains potassium nitrate to help reduce the discomfort.
- Visit the dentist for regular checkups, even if you are pregnant.
- Rinse with an antibacterial mouthwash once a day to reduce bacteria in your mouth.
- Avoid foods and drinks that damage your teeth to prevent tooth decay.
When caring for your teeth, avoid using any whitening products if you experience additional gum sensitivity or bleeding. Whitening your teeth while pregnant can exacerbate these problems and cause pain and discomfort.
Why Regular Dental Care Is Vital During Pregnancy
During pregnancy, your oral care routine is just as important (if not more). Some common dental issues are more common in pregnant women thanks to the impact of hormonal changes on the mouth area.
Canker sores during pregnancy, for example, are more common than usual. Other issues include dry mouth, gingivitis, and periodontal disease.
Is It Safe To Have Anesthesia During Your Tooth Extraction?
Anesthesia is generally safe for pregnant women who undergo tooth extraction procedures. There are some general anesthetics that aren't safe for pregnant women, but your dentist can advise you on the best option.
Local anesthetics and numbing solutions are also safe and your dentist will almost certainly have to use them to minimize the pain and discomfort associated with the extraction.
The Takeaway
In general, tooth extraction is safe during pregnancy. The main problem isn't usually with the extraction itself, but rather with the discomfort a patient experiences in the chair.
In the first trimester, radiation poses a slight risk for developing fetuses. When dental and medical personnel take X-ray images of your teeth, the radiation might pass through your body and reach the fetus in small amounts. After the first trimester, however, dental X-rays are considered safe for pregnant women.
In later stages, the main concern is discomfort—not safety. If the developing fetus kicks or moves unexpectedly, it could cause you to experience additional pain during the procedure.
In all cases, an emergency cannot be ignored, no matter the circumstances.
Want to learn more? These are the questions our customers ask us the most.
Are Wisdom Teeth X-rays Safe During Pregnancy?
Generally, the amount of radiation used in a round of X-ray imaging is not enough to affect a developing fetus. With proper use of shielding, wisdom teeth X-rays are safe during all three trimesters of pregnancy.
What Can A Dentist Do For A Toothache While Pregnant?
There are plenty of toothache remedies that are safe during pregnancy, including:
- Homemade baking soda paste
- Clove oil
- Warm salt water rinse
- Garlic
- Aloe vera
If a toothache persists, it is best to visit a dentist to diagnose or rule out any potential underlying causes.
Can A Dentist Pull An Infected Tooth While Pregnant?
A dentist certainly can (and should) pull an infected tooth while pregnant. Untreated infections in the oral cavity lead to more serious health issues and spread to other parts of the mouth and body. Tooth extraction is generally safe for pregnant women, but it is an absolute must in the case of an oral infection.
Which Trimester Is Best For Tooth Extraction?
The second trimester is the best time for a tooth extraction. During this time, the risk for radiation exposure and fetal movement is minimal. In the third trimester, frequent movements and a larger fetus make it more uncomfortable to lie down for a dental procedure. In the first trimester, radiation and fetal development risks are greater.
Is Dental Anesthesia Safe For Pregnant?
Dental anesthesia is usually safe for pregnancy. Anesthetics pass through the developing baby's body just as they would with the patient, so the risk is either minimal or nonexistent. There are a few kinds of anesthesia that are not safe for fetal development, but dentists can easily identify and avoid these.
