Is it possible to have dental prosthetics during pregnancy?

Dental implantation is a responsible operation, the recovery period after which is associated with the use of medications. For this reason, implantation during pregnancy is contraindicated. In addition, hormonal changes during pregnancy weaken the body, which has to adapt to new working conditions.

Dental problems often appear during pregnancy. Hormonal changes in the body also negatively affect dental health. A woman should definitely undergo a medical examination.

Dental implantation is prohibited for pregnant women, even if it is necessary to restore 1 or 2 teeth.

Removable prosthetics with complete edentia are also prohibited. Pregnancy should be planned after implantation.

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.

When is it permissible to have dental surgery during pregnancy?

We all understand that during pregnancy, a woman’s body undergoes colossal hormonal changes, immunity sharply decreases, and chronic diseases worsen. This period should proceed as calmly and comfortably as possible. Therefore, everything related to health and medical intervention is best decided before the woman enters this time. But there are situations when, for example, a tooth collapsed suddenly or prosthetics were planned at a time when nothing was known about pregnancy. What to do in this case?

Experts advise focusing on the type of intervention required and the set of accompanying manipulations, its urgency, the woman’s condition and the trimester of pregnancy:

1st trimester: for the first 12 weeks, there can be no talk of any types of dental treatment or prosthetics unless there is an emergency (severe pain, an inflammatory process that cannot be controlled with conservative methods, a threat to the woman’s life). It is during this period that the baby’s internal organs are actively developing, so any anesthesia, stress and anxiety suffered during treatment will directly affect the fetus,
2nd trimester: from approximately 14 to 26 weeks, thanks to progress, a woman can easily cure caries using safe types of anesthesia (for example, Ultracaine), carry out professional oral hygiene, and install a filling made of photopolymers. Here, during the normal course of pregnancy, the baby is not in danger,
3rd trimester: treatment and intervention is possible only in emergency situations, all other cases must be postponed until delivery, otherwise there is a high risk of miscarriage or premature birth.

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 have teeth removed during pregnancy?

Tooth extraction is a surgical operation that carries a psycho-emotional burden for any patient. And for pregnant women, such an operation should not be performed unless there is an urgent need.

During pregnancy, a tooth can be removed if:

Deep caries, causing inflammation, pus and fever;
The presence of a cyst with a diameter greater than 1 cm;
Fracture of the crown or root of a tooth;
Acute toothache, when conservative treatment does not bring results.

Please note that wisdom teeth cannot be removed during pregnancy. The consequence of the operation may be inflammation of the tooth socket, which can only be treated with antibiotics.

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.

Features of treatment

Fortunately, pregnancy is not a contraindication to the treatment of dental pathologies, especially if they cause severe pain and discomfort in the expectant mother. It is very important, even before starting any manipulations, to warn your doctor about your situation and the approximate duration of pregnancy, then he will be able to select the best option for the drugs to be used.

The main indications for emergency treatment are: carious tissue damage, periodontitis, any inflammation in soft tissues, pulpitis, etc. For the restoration of destroyed hard tissues, any composites can be used: chemically and light-curing. However, it is best to avoid enamel whitening procedures for a while.

General anesthesia is contraindicated in this position. It is also worth noting that before treating any pathologies, an x-ray examination of the oral cavity is required. This can be quite harmful for the baby; the safest time for this procedure is the second trimester. In this case, it is very important to cover the surface of the abdomen and thighs with a thick, protective apron.

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).

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.

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 is prosthetics

Dental prosthetics is a procedure through which the patient can solve various problems: improve the aesthetics of a smile, restore the shape and color of a damaged tooth, restore lost functionality to the dentition.

Important! Conventionally, all methods of prosthetics can be divided into several types. Removable and non-removable: removable is carried out in the absence of one or many teeth, fixed can be carried out on your natural teeth or, again, with edentia. Macro- and microprosthetics: in the first case, it means the installation of crowns and bridges, removable dentures, and dentures on implants. In the second - lumineers, veneers, inlays.

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.

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To install a crown, certain operations are performed:

Grinding the enamel;
Depulping;
Root canal treatment.

Safe anesthesia must be used.

To obtain an x-ray, you should use a device with a low radiation dose.

If prosthetics are performed on the front teeth, you can install ceramic crowns, which do not cause irritation, since the material does not contain metal components.

Paracetamol is used as an anti-pain drug.

In practice, prosthetics for pregnant women are performed only according to strict indications, taking into account the possible risks from the use of medications.

Postponing the installation of crowns is also not the best solution, because the absence of a tooth causes changes in the entire oral cavity. This manipulation is usually performed in the second trimester of pregnancy.

Planning a pregnancy requires certain preparations, including dental treatment. If there is a need for treatment during pregnancy, it is not recommended to postpone it for a long time, since the development of infection will negatively affect the health of the child and mother.

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.

Why is implantation prohibited during pregnancy?

The operation itself, in which a titanium root prosthesis is installed into the bone (takes place with anesthesia), is prohibited for expectant mothers. After the operation, the doctor prescribes anti-inflammatory and pain medications, most of which should not be used by pregnant women.
If complications arise during the period of osseointegration, additional therapy will be required, and this will negatively affect the child’s health. Any worries during pregnancy can have negative consequences.
During pregnancy, the immune system is weakened, so the inflammatory process, which under normal conditions can be quickly cured, can last for a long time in a pregnant woman.

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)

Is it possible to install a crown or bridge?

No, it is highly undesirable to do this, especially if you can wait a little.

A crown is used when it is necessary to restore a badly damaged tooth. The bridge fills the “gap” in the row and is fixed to the adjacent supporting teeth. These structures restore not only the aesthetic component, but also the much-needed functionality of the tooth, allowing it to once again fully participate in chewing food.

Moreover, the crown preserves and prolongs the life of the tooth, which is very important for pregnant women, because... If there is a problem, their teeth begin to decay at a rapid rate. It would seem that the option is ideal, but doctors clearly state: the rules for installing crowns and bridges do not allow prosthetics during pregnancy.

“For a long time I was interested in how dental prosthetics are done for pregnant women, because... I am in the same position and want to get a crown. But my doctor immediately refused me, but my friend had a ceramic crown done at the twentieth week, because... she already had a tooth without a nerve right away, there was no need to depulpate it - everything went fine and without complications.”
Arina, baby.ru

Let's look at the features of prosthetics with such designs:

First, the doctor must carry out a complete sanitation of the oral cavity: i.e. the specialist needs to cure carious cavities, eliminate the inflammatory process on the mucous membrane (which, as mentioned above, is very difficult to do during pregnancy), remove damaged and irreparable teeth (here for pregnant women the risk of bleeding increases, which will be difficult to stop). No one will take such risks without the need, and otherwise there is a high risk of getting an infection under the same crown,
you need to prepare the tooth for installation of a crown or support under a bridge: for this, the doctor must depulpate the supporting teeth, which is unlikely to be done without the use of serious anesthesia and stress on the part of the pregnant expectant mother. Next, the specialist grinds the support from all sides.

Important! If the expectant mother experiences stress and is nervous at the thought of visiting the dentist, then it is better to postpone prosthetics until the birth of the baby, even if the pregnancy proceeds without complications. Also, any type of prosthetics cannot be performed on women who suffer from hypertension, diabetes, or diseases of the cardiovascular system.