Treatment of caries during pregnancy in the second trimester. Causes and treatment of caries during pregnancy

Special causes during pregnancy are associated with gestation:

• Decreased calcium and fluorine content in saliva and blood. Some of these microelements are spent on the developing embryo. Calcium from teeth is not used for the development of an unborn child, contrary to popular misconception. However, the remineralization and strengthening of enamel that occurs due to the properties of saliva slows down or stops during pregnancy. Weakened enamel becomes easily damaged and vulnerable to oral diseases, incl. caries.
• Hormonal changes. They lead to changes in the composition of the saliva of a pregnant woman. The result of such processes is a decrease in the bactericidal properties of saliva. The bacteria that contribute to the appearance and development of caries become less vulnerable.
• Diet changes. Often, expectant mothers abuse sweet, salty, starchy foods.
• Toxicosis. Hydrochloric acid, contained in vomit, contributes to the destruction of enamel.
• Failure to attend preventive examinations. A common belief about the undesirability of dental treatment during pregnancy leads to advanced oral diseases.

During pregnancy, teeth are most susceptible to caries.

What is dangerous

• premature birth;
• Small birth weight.

Contribute to these events cariogenic bacterium Actinomyces naeslundii. They provoke the production of substances that cause uterine contraction and expansion of the cervical canal - anti-inflammatory cytokines. The expansion of the cervical canal is accompanied by the destruction of the fetal membranes. These processes lead to premature birth.

Harm from caries complications

Caries can harm the unborn child

Complications accompanying neglected caries can also bring harm to the unborn child. The affected area reaches the neurovascular area of ​​the tooth, as a result of which pulpitis or periodontitis may develop. Inflammation of the dental pulp and the development of a purulent focus of inflammation in the region of the root apex leads to the release of toxins. They enter the bloodstream and are carried with it throughout the body. This may entail:

• Temperature increase body (the need to take antipyretics);
• Aggravation toxicosis;
• crashes in system operation digestion.

Toothache that occurs with pulpitis and periodontitis, - traumatic psychological factor for the woman's body. Pain can cause changes in some systems and organs and the average person. Such phenomena affect the developing embryo.

How to relieve a toothache

Self-treatment should only be done as a last resort!

The first step is to carefully examine the tooth. If food particles remain in the hole, they must be carefully removed with tweezers or a toothpick. After that, you need to brush your teeth and rinse your mouth. You can rinse with a decoction or infusion of medicinal herbs or a solution of soda with salt.

The most reasonable solution in such a situation is to contact a dentist. If it is impossible to make an immediate visit, you can use medicinal or folk remedies. Folk remedies are considered safer.

Folk remedies

• rinses decoction of sage, chamomile, plantain, St. John's wort, calendula with salt or soda;
• table clove(seasoning). The powder should be sprinkled on the inflamed gums.
• Garlic. It must be cleaned, finely chopped and wrapped in a bandage or gauze. The resulting is applied to the wrist, where the pulse is felt.
• plantain leaf. The leaf must first be squeezed out so that it starts up the juice. After that, roll it into a flagellum and put it in the ear (you need to take into account the location of the pain center). You can also thoroughly wash, chop and squeeze the fresh leaves of a medicinal plant, then rub the gum with juice every two hours. You can rinse your mouth with two tablespoons of juice, diluted glasses of boiled water.
• Aloe, Kalanchoe, Pelargonium. A leaf of one of these plants can be applied to an inflamed gum.
• Lard. The product is purified from salt, if required. The slice is placed between the tooth and the cheek. After 15-20 minutes, the pain should stop.

At home

Medicines that can relieve toothache during pregnancy:

No-shpa - effective and safe

• No-shpa;
• Drotaverine (analogue of No-shpa);
• Grippostad (cautious use in the first trimester of pregnancy is acceptable);
• Paracetamol (will help with mild pain);
• Tempalgin (half a tablet);
• Pentalgin (half of a tablet);
• Kalgel (apply to the inflamed gums);
• Ketanov;
• Nurofen;
• Ibuprofen ( forbidden to use in the 3rd trimester).

Accept more than one tablet any of these medicines strictly prohibited. A cotton ball can be placed in the hole of the tooth (if any). The material can be moistened in advance in tooth drops, clove or mint oil. When taking any medication, remember a few rules and features of the body during pregnancy:

• More than anything the fetus is vulnerable in the first trimester. At the end of the third month, the embryo is protected by the placenta, which weakens the effect of drugs on it.
• You must always remember about dosage.
• Medicinal products may only be used if emergency.
• Rinse with cold water forbidden.

Treatment - danger and consequences if not treated

If you start caries, you can lose your teeth (not all, of course). In addition, carious processes will negatively affect the child. It is better to treat caries immediately, while it is safe for the child and mother.

Features of treatment

Features of treatment in pregnant women

Treatment begins with anamnesis. The duration of pregnancy plays an important role, which will be discussed a little later. The dentist carefully studies the history of past pregnancies (if any) and related diseases (hypertension, eclampsia, diabetes, etc.). Often the patient should consult with an obstetrician-gynecologist. This allows you to fully assess the risk of complications after dental treatment.

The carious process during pregnancy proceeds rapidly. If you ignore it at the stage of the chalk stain, there is a risk of losing a tooth. Usually they have time to catch caries in the middle stage, but it is more difficult to treat. The dentist selects the method of treatment according to the body and the duration of the patient. Most often, this is excision of the carious area and filling. Complicated caries is very difficult to cure, it is carried out under local anesthesia.

Whether it is possible to treat?

It is possible and necessary. Each of the trimesters of the term is assigned its own type of medical actions.

1 trimester

It is conditionally divided into two periods:

• From the moment of fertilization to the implantation of the egg. This time is unfavorable for dental treatment. The fetus is extremely sensitive to the effects of various drugs, stress and toxins. High risk of miscarriage.
• From the 18th day - the beginning of the formation of organs and tissues of the embryo. This period is characterized by frequent fainting, nausea, vomiting, heartburn, increased salivation, increased gag reflex. Treatment at this time is undesirable, as this may affect the developing fetus.

At 6-7 weeks, the child just lays the rudiments of temporary teeth. Treatment procedures can disrupt this process, which will further lead to trouble. Problems may arise later in the 1st trimester. It is impossible to treat caries during the 1st trimester. During this period, an exception is made only for urgent cases, accompanied by suppuration, acute pain syndrome. Such cases are:

• Pulpitis;
• Exacerbation of chronic periodontitis.

2 trimester

"Fruitous" period. At this time, the embryo is growing rapidly. The risk of negative consequences of dental treatment is reduced, but be aware of the toxicity of medical drugs (anesthesia, antibacterial agents).

At this time, it is necessary to prevention diseases of the oral cavity. At this stage of pregnancy, dental treatment is carried out, on which caries can worsen in the third trimester. Sometimes the dentist decides to leave dental treatment for the postpartum period if there are no possible foci of exacerbation.

3rd trimester

In the 3rd trimester, treatment is indicated only in urgent cases.

At this time, the mass of the unborn child increases. Along with it, pressure on the aorta and inferior vena cava increases. This leads to a woman's heart palpitations, a rapid decrease in pressure, loss of consciousness. This is an important factor, since patients in the treatment of teeth are reclining.

The sensitivity of the uterus to the influences of the outside world in the later stages increases, which can even cause premature birth. Also, this period is accompanied by increasing anxiety, fatigue of a woman, which can also affect the treatment. Medical intervention at such times is desirable only for urgent cases. The future mother on the chair should be located slightly on the left side (the angle is about 15 degrees) in order to reduce the pressure of the fetus on the inferior vena cava and aorta.

Anesthesia, anesthesia, anesthesia: can it be used?

Local anesthesia is used to treat complications of caries (periodontitis, pulpitis, etc.). Sometimes injections of anesthetic drugs are given for acute pain that occurs during treatment. To treat caries painlessly, you need to visit the dentist regularly. General anesthesia is contraindicated for pregnant women!

At 14-15 weeks, the use of special anesthetic drugs is allowed. For anesthesia are used:

• Ultracain;
• Septanest;
• Ubistezin;
• Scandonest.

x-ray

As a diagnostic method contraindicated during pregnancy. An alternative is films and sensors with ultra-sensitivity. They require ten times less X-ray radiation than conventional films. Also used protective equipment (lead apron). Sometimes x-rays are still used in emergency situations, but this is an undesirable procedure. It is strictly forbidden to use radiography in the 1st trimester.

How caries affects fetal development

Chronic inflammation in the oral cavity can lead to:

• The occurrence of intrauterine infection;
• Delay in the development of the fetus;
• miscarriage;
• Premature birth.

Treatment of caries in a pregnant woman is carried out very carefully. Pain and discomfort (with acute complications of the disease) can harm the unborn child. The fetus is harmed by any infectious focus in the oral cavity, because toxins directly affect it (the fetus).

Caries due to breastfeeding

From night feedings

From this practice, caries can occur in a baby. Doctors recommend stop night feedings after six months, as this often leads to the development of early caries. Caries in the mother can also occur during lactation.

Features of treatment

A contraindication to the treatment of caries by a breastfeeding mother can only be severe stress or fatigue. Before a dental procedure feed the baby and express milk for next time (optional). All drugs will be excreted from the body after 3-6 hours. After treatment, it is necessary to express milk and pour it out. After that, you can safely continue breastfeeding your baby.

X-rays during the GV period are not prohibited, but the use of protective equipment is mandatory. If the filling of the mother's teeth is safe for the child, then taking antibiotics rules out breastfeeding. Also, during lactation it is impossible to carry out implantation of teeth.

Possibility of anesthesia

Pain relief during breastfeeding is relatively safe. For pain relief during lactation, mepivacaine, lidocaine, ultracaine are used.

Caries and childbirth

caries can negatively affect the birth of a child. It can be premature birth, as well as miscarriage. Also, intrauterine infections caused by caries will affect the health of the unborn baby.

Prevention of caries in pregnant women

• Pretreatment of teeth. Planning for pregnancy includes a visit to the dentist. It is better to treat your teeth right away than to put yourself and your baby at risk during pregnancy.
• Careful oral hygiene. You should brush your teeth (avoid horizontal movements) after eating, use dental floss. You can also use an irrigator to rinse hard-to-reach parts of the mouth.
• Don't brush your teeth immediately after vomiting. It is necessary to rinse the mouth with a solution of baking soda, after which you can brush your teeth. Brushing your teeth is possible no earlier than in half an hour.
• Diet control. You should reduce the number of snacks and the use of sugary foods. You also need to eat foods rich in vitamins and minerals (cottage cheese, spinach, etc.).
• Regular visits to the dentist. The doctor conducts a complex to protect teeth from caries. These are professional teeth cleaning, gum massage, preventive examinations.

FAQ

Can there be a miscarriage due to caries?

Yes maybe.

Can you get pregnant with dental caries?

Of course. But it is better to cure caries first so that no problems arise.

Can caries be the cause of a miscarriage?

Yes, severe forms of caries can cause this phenomenon.

Is tooth decay transmitted from mother to child?

It's possible. If a mother with caries used a cutlery for food, and then fed a child from the same appliance, caries can also occur in a child.

Caries of the wisdom tooth during pregnancy - to treat or remove?

At the first sign of the onset of the disease, you should consult a dentist. If you find caries of the wisdom tooth at an early stage, it is possible to get by with the treatment of the pocket with the help of special liquid preparations. This will allow you to postpone the surgical intervention for a suitable time. Otherwise, the hood is excised. In order to avoid complications, you need to contact the doctor in time.

In a future mother, teeth can be destroyed not only for common reasons. During the period of bearing a child, many changes occur in the female body, which negatively affect the condition of the teeth.

Poor oral hygiene. Dental plaque and food debris contribute to the active reproduction of pathogenic microorganisms. Uncontrolled consumption of sweets. Lack of fluorine and calcium in saliva, which occurs due to pregnancy. These trace elements are necessary for the formation of the fetus. Calcium consumption from the teeth does not occur, but these substances decrease in saliva. The process of strengthening the enamel due to the action of saliva slows down or stops, which makes it vulnerable to the vital activity of bacteria. Hormonal disorders in the body of the expectant mother, which also affect the composition of saliva. Eating disorders associated with the restructuring of the body and the desires of the expectant mother.

Symptoms

It is not always possible for a future mother to recognize the disease on her own.

If caries affects the front teeth, then the first signs of the manifestation of the disease will be clearly visible. If the teeth that are out of sight are damaged, the expectant mother will be able to determine the onset of caries in the later stages, when pain appears. At the first stage of caries, a white spot appears on the surface of the tooth. It may darken over time. But outwardly, the enamel does not suffer and retains its smoothness and shine. If the destruction of the upper layer of tooth enamel occurs, this indicates the development of a superficial form of caries. But this does not damage the dentin. The damaged tooth becomes more sensitive, and pain may occur when eating hot or cold food. With medium caries, the destruction process affects the upper layers of dentin. Usually there is pain not only when chewing, but also in a calm state of the dental jaw. There is also bad breath. A deep form of caries indicates a strong destruction of the tooth. At this stage, the deep layers of dentin, which are close to the pulp of the tooth, are affected. Usually at this stage, a nursing mother feels unbearable pain. Putrid breath is another sign of tooth decay.

Diagnosis of caries during pregnancy

A dentist will be able to diagnose pathology in a future mother. A specialist can diagnose caries at an early stage during an external examination. During pregnancy, the X-ray method is not used because of the danger of radiation exposure to the fetus. In extreme cases, after the first trimester, the doctor may refer the expectant mother for x-rays using a visiograph. This method is safer during pregnancy.

Complications

How dangerous is the disease for the future baby and mother?

The disease does not adversely affect the development of the fetus. Constant pain causes discomfort to the expectant mother, affecting her emotional state. Lack of appetite, bad mood, sleep disturbance - all these factors negatively affect the development of the unborn baby. For a future mother, caries is a dangerous disease. If left untreated, there is a chance of complete destruction of the tooth. Caries can cause the development of periodontal and other diseases of the oral cavity. Also, for the future baby, the danger of caries lies in the negative impact of painkillers during treatment.

Treatment

What can you do

It is impossible to treat caries on your own during pregnancy. There is an opinion that caries should be treated after childbirth. But this is an erroneous opinion. Therefore, the expectant mother should not be delayed with the treatment of pathology. When the first signs of the destructive process of the tooth appear, the expectant mother should consult a dentist for a speedy cure. You can take an anesthetic on your own for acute unbearable pain. But the drug must be approved for use during pregnancy. But if possible, it is necessary to endure the pain and come to a specialist for an appointment.

What does a doctor do

Usually, the doctor decides on the treatment of caries from the second trimester. This is due to the harmful effects of medications used during treatment. But if the expectant mother has medium or deep caries, a decision may be made to treat the tooth without waiting for the start of the second trimester. Treatment of caries at any stage usually begins without the use of pain medications. The injection is performed if the expectant mother begins to feel pain. For this, medications are used that are allowed during pregnancy. But pain usually occurs when the damaged areas of the dentin are excised. By the third trimester, the complexity of caries treatment increases. The expectant mother should not be in a supine position. Since the load on the inferior vena cava and aorta increases. Therefore, the patient should take a position on the side. But in the last trimester of pregnancy, the use of anesthesia is not so dangerous for the unborn baby. With the help of tools, the doctor removes the damaged area of ​​​​enamel and dentin. The resulting hole in the tooth is sealed by the dentist with a filling.

Prevention

It is possible to prevent the development of caries during the period of bearing a baby. The expectant mother must take preventive measures even at the stage of pregnancy planning.

Before you become pregnant, you need to visit a dentist to check all teeth for integrity, remove plaque and hard dental deposits. During pregnancy, the removal of these deposits is difficult. During pregnancy, the expectant mother should periodically visit the dentist to control the appearance of caries. The expectant mother should brush her teeth twice a day: in the morning and in the evening. After each meal, you should rinse your mouth with a special solution or use dental floss. After an attack of vomiting, you need to rinse your mouth with soda solution. It helps to neutralize the acidity in the mouth after bouts of vomiting. Expectant mother should watch her diet. In the diet, it is necessary to limit sweet products, carbonated drinks. Eat more fresh vegetables and fruits, dairy and fish products.

Pregnancy is a special period in a woman's life. In the womb there is a fetus, the vital activity of which is closely connected with the body of the pregnant woman. Nutrients, energy carriers, the fetus receives from the mother's blood. If the diet of the expectant mother does not contain trace elements, macronutrients, vitamins in sufficient quantities for two, problems develop in both the fetus and the woman. The future mother's hair begins to fall out, her nails exfoliate, her mood worsens, sleep is disturbed, and hemoglobin decreases. Last but not least, there are problems with dental health.

Many pregnant women are wary of visiting the dentist, even with severe pain. They worry and think about what will harm the fetus more - treatment or illness? Is it possible to postpone the treatment of caries for the period of breastfeeding? At what period can caries during pregnancy be cured with minimal risk to the fetus? What causes caries?

Causes

Undoubtedly, there are "special" causes of development during pregnancy.

Active "consumption" of calcium and fluorine by the fetus leads to a decrease in their content in the blood and saliva of a pregnant woman. This makes the tooth more vulnerable to pathogenic flora.

In the mother's body, the immune system adapts to the presence of the fetus. A complex process of hormonal adjustment leads to a decrease in the bactericidal properties of saliva.

Important! The period of gestation is often accompanied by manifestations of toxicosis - nausea and vomiting. Vomit has a pronounced acid reaction and favors the destruction of tooth enamel.

During pregnancy, women experience various taste preferences, sometimes they are forced to snack instead of eating well. One way or another, the acidity of saliva, oral hygiene are disturbed, and prerequisites are created for the development of caries.

Dangers in the treatment of caries during pregnancy

Attention should also be paid to reliable potential complications in the process of caries treatment:

• the effect of local anesthetic on the fetus;
• complications after caries treatment, the need for more extensive interventions, the use of analgesics, antibiotics;
• soreness of the procedure (medical contraindications for).

How to minimize possible complications?

When deciding, the information that there are more and less dangerous periods of pregnancy for intervention is very useful.

The time of attachment of the embryo to the uterus, the laying of the placenta. Up to 17 days after fertilization, the embryo is sensitive to the action of drugs, toxins (alcohol, nicotine). Any of the causes of imbalance can lead to spontaneous abortion.

From 9 weeks, the unborn child begins to be called a fetus. Elements of the nervous system appear, the kidneys begin to work.

Important! During the first trimester of pregnancy, the fetus is vulnerable to the action of drugs, adverse changes in the mother's body.

The use of anesthetics is contraindicated. But if you experience acute pain, you need to visit. Treatment can be carried out only with the threat of severe complications. A competent specialist will consider all the pros and cons and offer the best solution.

- the period of active development of the life support systems of the fetus, the development of the bone marrow, the central nervous system. At 21-24 weeks, the fetus is already actively moving. The process of "maturing" of the lungs continues, but the fetus still breathes through the placenta.

Important! The risk of affecting the fetus in the second trimester is reduced. The doctor has the opportunity to routinely treat compromised teeth, conduct professional oral hygiene, and, if necessary, prescribe drugs that do not penetrate the placental barrier.

The third trimester marks the preparation of the fetus for birth. The nervous system improves, the sense organs begin to function. The fetus can hear, taste. The connection between the state of the fetus, the tone of the uterus, changes in the mother's body is becoming ever closer. In turn, the body of a pregnant woman experiences an increasing load, the work of internal organs changes due to the presence of an enlarged uterus in the abdominal cavity.

Important! There is an increased risk of drugs affecting the tone of the uterus, their penetration through the placenta.

A feature of the state of pregnant women during this period is the syndrome of aorto-caval compression. In the supine or reclining position on the back on a hard surface (couch, dental chair), the pregnant uterus compresses the inferior vena cava, leading to the development of weakness, dizziness.

After considering all possible options, the doctor may postpone treatment for the period after the birth of the child. Invasive procedures are performed only for emergency indications.

Preventive examinations by a dentist will allow you to diagnose at an early stage, plan treatment in a safe period, or treat caries without anesthesia.

How does pregnancy caries affect the fetus?

On one side of the scale is the risk of complications of dental intervention, on the other - the possibility of harming the fetus.

The human oral cavity functions through active contact with the external environment. On the mucosa, gums there are always microcracks, abrasions. Due to the bactericidal properties of saliva, they do not pose a danger.

Important! During pregnancy, the intensity of immune protection changes, pathogenic pathogens enter the bloodstream and cause inflammation, including caries.

When considering the danger from a carious lesion, it is necessary to distinguish between:

• the effect of caries directly on the fetus;
• the impact of caries complications on women's health and pregnancy.

Medical specialists assess the risk of penetration of caries pathogens through the placenta as minimal. However, the waste products of bacteria that cause caries affect the tone of the uterus, contribute to the destruction of the membranes of the fetal egg. This, in turn, can lead to spontaneous abortion in the early stages, a decrease in fetal weight.

Important! The most formidable complications of caries are the spread of inflammation, the involvement of adjacent healthy tissues in the process.

Symptoms of local inflammation (pain in the tooth, swelling and gums, impossibility) in combination with general ones (body temperature, weakness, chills, fluid imbalance, depression) significantly worsen the condition of the pregnant woman and require serious procedures.

There is a need to sanitize the purulent process, the use of anesthetics, antibacterial drugs. The process of eating is difficult, the daily routine is disturbed. The course of toxicosis may worsen. The pain syndrome can cause a cascade of reactions: autonomic (increased blood pressure, tachycardia, tachypnea), metabolic (activation of metabolic processes).

The degree of influence of caries on a woman and fetus depends on the form of the disease.

caries classification

The classifications of caries are based on different factors:

• an independent disease or a consequence of another process (dental caries);
• the location of the lesion;
• process depth;
• stage of the disease;
• the presence or absence of complications;
• the rate of development of caries.

Important! When diagnosing caries in pregnant women, a classification based on the depth of damage to the tooth tissues is more often used.

The stages of caries are described in the table.

A characteristic feature of the development of caries in pregnant women is the rapid spread of the process to deep tissues. As a rule, patients apply at the stage of medium caries, since the superficial stage is asymptomatic. In the best case, the process is detected during a preventive examination.

Complications of caries during pregnancy

The development of a carious process during pregnancy is often accompanied by complications.

Due to the rapid destruction of tooth tissues, it develops. This is an inflammation of the neurovascular bundle located inside the dental canal.

Symptoms of acute pulpitis:

• severe throbbing pain, aggravated in the prone position, with cold or hot irritation, radiates to the jaw, ear;
• the pain may be prolonged;
• the frequency and duration of attacks increases.

Symptoms of chronic pulpitis:

• a feeling of fullness in the area of ​​​​a carious tooth;
• sharp short-term pain when irritated by solid particles, cold or hot.

Periodontitis develops when caries spreads to the tissues that hold the tooth root in the jaw.

Symptoms of acute periodontitis:

• complaints of pain in the tooth with pressure;
• with purulent periodontitis - the pain is intense, sharp, shoots in the jaw, ear;
• swelling and hyperemia (redness) of the gums;
• facial asymmetry from local soft tissue edema;
• the general reaction of the body to inflammation (weakness, chills, hyperthermia, swollen lymph nodes).

Important! Periostitis develops when the periosteum of the body or the process of the jaw is involved in the inflammatory process.

In acute serous periostitis, changes are observed that have developed near the cause - a carious tooth. This is hyperemia and swelling of the mucosa, swollen and painful lymph nodes.

With purulent periostitis, in addition to local signs (dense painful swelling with softening in the center, swelling of the soft tissues of the face), alarming signs of general intoxication develop - subfebrile body temperature, headache, general weakness, chills.

With the generalization of the infection (getting into the general bloodstream), a septic condition develops that threatens the woman's life.

Severe complications - timely diagnosis.

Diagnosis of caries in pregnant women

Pregnancy involves the exclusion of x-rays in the diagnosis. Absolute contraindication for the first trimester, in all other cases the issue is resolved individually.

Electroodontodiagnostics of the tooth

The method is based on measuring the current strength at which a response develops from the side (warmth, burning). The deeper the tissue lesion, the greater the current required. For example, the electrical excitability of the pulp of healthy teeth is 2-6 μA. With deep caries, the electrical excitability of the pulp decreases to 12-15 μA.

Dental transillumination

In a darkened room, a cold beam of light is passed through the tooth using an organic glass light guide.

The characteristic pattern of shadows helps to identify caries, pulpitis. The most convenient method when working with front teeth. The absence of harmful effects allows you to examine pregnant women.

Laser diagnostics

A laser beam is used to detect caries in hard-to-reach places (under a filling), at early stages.

The device measures the characteristic of the reflected laser beam and converts it into an acoustic signal. The degree of caries is determined by the tone of the signal.

Important! One of the goals of diagnosis is to identify dental disease with similar symptoms. For example, initial caries differentiates with enamel hypoplasia.

According to the results of the research, consultations of a periodontist, a specialist in maxillofacial surgery, can be prescribed.

Treatment of caries in pregnant women

The presence of the fetus in the body of a pregnant woman brings a number of characteristic features to the treatment.

The gestational age, the dynamics of the development of caries or its complications, localization, the severity of the process, the individual characteristics of the patient (age, allergic history) are taken as the basis.

In the stage of initial caries (stage), remineralization is carried out. The damaged area of ​​enamel is covered with a special gel with a high content of calcium, phosphorus and zinc. You can use the technique in relation to healthy teeth for prevention.

Important! Icon technology is used for the same purpose: an etching gel is applied to the carious spot, which is then washed off. The area is pre-dried and covered with a liquid filling.

With superficial, medium, deep caries, filling of the carious cavity is indicated.

The canal is opened and processed beforehand.

The best option is cavity preparation, which is harmless to pregnant women.

The use of anesthesia for pregnant women

Local anesthetics in their composition contain adrenaline, which constricts blood vessels and prolongs the effect of anesthesia, has a hemostatic effect. However, this drug crosses the placental barrier of the fetus, causing an increase in blood pressure, heart rate in women.

Important! If there is a need to use local anesthesia, dentists choose drugs with a minimum content of adrenaline: "Primakain", "Ultrakain".

General during pregnancy is carried out only for emergency reasons, in exceptional cases, when there is a threat to the woman's life.

The use of analgesics for severe toothache

The potential danger of pain medication to the fetus and pregnant woman is well known:

• teratogenic effect for the fetus (malformations of intrauterine development);
• side effects in relation to the mother (exacerbation of hyperacid conditions, changes in blood pressure, allergic, disturbances in water and electrolyte balance).

In the instructions for the drug, the manufacturer describes in detail the action during pregnancy and lactation.

A dentist, an obstetrician-gynecologist will help you figure out the minimum safe terms of use for each drug.

Folk remedies for toothache in pregnant women

1. Infusion of fresh lemon balm leaves for rinsing the mouth.
2. Pharmacy tincture of valerian. A cotton pad is impregnated and applied to the aching tooth.
3. Medicinal decoction for rinsing from oak bark from ready-made raw materials.
4. Baking soda rinse solution. Dissolve a teaspoon of baking soda in a glass of warm water.
5. Fir oil. Moisten a clean cotton pad and apply to the gum for 10 minutes. You can repeat after two hours. Oil can only be used externally!

Prevention of caries in pregnant women

Preventing a disease is always easier than dealing with the consequences! It's always nice to make sure after a visit to the doctor that everything is in order. In the case of a patient expecting a child, it is doubly pleasant - for herself and the baby.

1. Condition of the oral cavity. Preventive examinations by a dentist during pregnancy are recommended to be performed at least three times. This is not only an examination of the oral cavity, but also professional recommendations from a doctor, answers to questions, a discussion of the schedule of visits at various stages of pregnancy. With a planned pregnancy - sanitation of the oral cavity before conception.
2. Balanced diet. The diet of a pregnant woman is a source of raw materials for the development of a healthy fetus. The responsibility of the expectant mother for everything she eats or refuses is doubly increased. Products must contain the entire line of essential vitamins, microelements, macroelements, taking into account the composition of water and soil in a given area (for example, the content of iodine and fluorine).
   An important issue is fluid balance. During the period of gestation, the load on the urinary system increases, which in turn can manifest itself as renal failure (toxicosis of the second half of pregnancy).
   In addition to the fact that products are a source of useful substances, they also have direct contact with the oral cavity and teeth. What affects the composition of saliva, its bactericidal properties, the state of tooth enamel.
   The nutritional behavior of the expectant mother should be thought out and integrated into everyday life, because most women continue to work until they go on maternity leave.
3. Oral hygiene. To maintain an active lifestyle, correctly entering the nuances of pregnancy into it - this is oral hygiene.

Important! Rational oral hygiene is the maintenance of teeth, gums, and mucous membranes in a healthy state. It is personal and professional.

Individual oral hygiene includes:

• removal of plaque at least twice a day;
• selection of the type of toothbrush (during pregnancy, the gums become loose, easily injured);
• the use of additional means to remove plaque from hard-to-reach places (dental, special dental, brushes, irrigator);
• selection of toothpaste (hygienic, treatment-and-prophylactic);
• the use of chewing gum, dental elixirs.
• rinsing the mouth with water after eating (especially sweet, sour), after vomiting with toxicosis.
teeth, protective varnish).

Important! Prevention methods, including the use of drugs (a complex of vitamins, immunomodulators, mouthwashes), are prescribed by an obstetrician-gynecologist or dentist, taking into account the duration of pregnancy and the individual characteristics of the woman.

Maintaining the health of the oral cavity, the expectant mother from the moment of conception passes the baton of health to the child. Pregnancy, the birth and upbringing of a child is also work, responsible, inspiring. Caries during pregnancy is a problem that, according to Hippocrates, is easier to prevent than to treat.

Video - Komarovsky about dental treatment during pregnancy

Pregnancy is a long-awaited event in a woman's life, however, it can also be overshadowed by such a nuisance as caries. Often, expectant mothers begin to panic because they do not know if caries can be treated during pregnancy. A large number of myths and horror stories have been created around this problem, so it's time to figure out whether dental treatment is dangerous for women in an "interesting" position.

Why does caries appear?

During the bearing of a child, a woman's body is seriously rebuilt. Many vitamins and minerals go to the development of the little man, leaving the mother without protection and support. Therefore, it is during these nine months that a woman is most vulnerable to diseases, including pathogenic microorganisms.

Among the main causes that cause this pathology, the following can be distinguished:

• malnutrition, which leads to a deficiency of trace elements in the female body,
• hormonal changes that affect metabolism, including the composition of saliva, which is responsible for protecting enamel from microbes,
• during toxicosis, gastric juice or bile is thrown into the oral cavity, which disrupt the acid balance in the oral cavity and aggressively affect the enamel,
• poor oral hygiene due to frequent snacking,
• rare visits to the dentist, as mothers are either too keen on preparing for childbirth, or they are afraid to treat their teeth and believe that dental preparations are harmful to the fetus.

Why caries is dangerous for expectant mothers

Any process that destroys body tissues creates a stressful state and negatively affects the general well-being of both mother and fetus. Bacteria that cause the destruction of enamel enter the stomach with saliva, and from there into the woman's blood. This is how their negative influence begins. In some cases, the concentration of bacteria can cause uterine tone and, as a result, miscarriage. It's in the early stages. In the later - lead to premature birth.

Important! Microorganisms, entering the bloodstream of the fetus, can slow down its development or cause various pathologies. In addition, a baby from a young age will be at risk of developing tooth decay, since bacteria will already multiply in his body.

Also, do not forget that caries can lead to more serious diseases - pulpitis, periodontitis, gingivitis, and so on. For a woman carrying a child, any inflammatory process can be dangerous, so you should take care of prevention. In addition, a complication of caries causes toothache, and taking analgesics for pregnant women is strictly contraindicated.

Diagnosis of caries in pregnant women

How to identify caries in expectant mothers, if X-ray is categorically contraindicated for them? Yes, and a visual examination is not always informative, because caries can develop in hard-to-reach places, for example, under a filling. However, modern medicine has found safe ways to diagnose dental diseases.

1. Electroodontodiagnostics of the tooth

This method is based on passing a weak current through the tooth, and the electrical excitability of the nerve endings signals damage to the dentin. A healthy pulp responds to a slight irritation with a current strength of only 2-6 μA. But the excitability of the inflamed nervous tissue decreases, so discomfort can occur at a current strength of 7-50 μA. The higher the current required for the response, the stronger the damage to the tissues of the tooth.

2. Dental transillumination

This method is essentially similar to shadow theater. The doctor turns off the main lighting in the office and shines through the teeth with a special light guide that emits cold light. Affected areas will cast characteristic shadows. This method is completely safe, but it has the only drawback: the molars are too wide to let light through, so this diagnostic is effective only in examining the anterior teeth.

3. Laser diagnostics

Another light method that studies the nature of a reflective surface by how it interacts with the beam. Due to its excellent penetrating power, the laser can “feel” caries even under a filling or in other places that are hard to reach for visual inspection. Reflected from the surface, the beam enters the device, which transforms the light signal into sound. By the nature of this sound, the doctor understands whether there is any damage to the tissue.

At what month of pregnancy to treat teeth

Articles on the Internet and advice on forums are replete with horror stories and advice to postpone trips to the dentist until the baby is born. The main arguments in this case are the danger of drugs for the fetus and the stressful state of the mother, which also negatively affects intrauterine development. And if we can partly agree with the second postulate, because the fear of dentists among many Russians comes from Soviet childhood, then one can argue about the first. The point here is not so much in the medications used by doctors, but in the duration of the pregnancy itself.

Let's take a closer look at each of the stages of bearing a baby.

In these weeks, the “foundation” of the future man is being laid. Organs and systems are formed in the embryo, so it is most sensitive to any kind of stress and toxins (like alcohol or medicines). It is believed that dental treatment is dangerous in early pregnancy, except when the disease seriously threatens the health and life of a woman (purulent pulpitis, periodontitis, phlegmon). And the condition of a woman in the first months is not always excellent: toxicosis, dizziness, mood swings due to hormonal changes in the body.

2. Second trimester: treatment allowed

From the 13th-14th week, a favorable period begins for visiting dentists. The fetus continues to develop, gain weight, but the main organs and systems have already been formed. In addition, a developed placenta protects the fetus from most of the toxins that enter the body of the expectant mother. Therefore, during this period, the use of certain medicines, vitamins is allowed. And women in these months, as a rule, feel good, become more stress-resistant.

It is also considered not the most favorable for dental treatment. And it's all about physiology. Since the fetus becomes large and begins to move, a woman needs to look for comfortable positions. At the same time, it becomes problematic for her to be in the same position for several minutes: the mobile baby begins to put pressure on the kidneys, bladder, diaphragm, or compress the inferior vena cava. Treatment of caries in the third trimester of pregnancy is carried out only on an exceptional basis, when there is a serious threat to the health of the mother.

Interesting! Starting from the 30th week, the fetus already begins to hear sounds, taste and feel the emotions of the mother, so unnecessary excitement must be excluded.

Features of the treatment of caries: what can be dangerous therapy

Before starting therapy, the doctor must collect a complete patient history: be aware of all chronic diseases and allergic reactions. The fact is that during pregnancy, a woman's immunity decreases, therefore, chronic diseases that the immune system restrained before pregnancy can worsen. Therefore, the doctor should start caries treatment only after a detailed study of the patient's condition.

Let's see what can be dangerous in the treatment of caries during pregnancy:

• negative effects of local anesthesia on the fetus,
• complications after treatment
• the need to take analgesics after therapy,
• stressful state due to the pain of therapy (if the use of local anesthesia is not possible),
• exacerbation of chronic diseases.

How to relieve toothache at home

The expectant mother should remember that any of her actions may affect the child, therefore, before using any drugs or herbs, you should consult with an obstetrician-gynecologist or a local therapist.

Also, do not forget that the first and third trimesters are unfavorable for drug effects on the body, so taking medication should be due to serious reasons.

Remember! Herbal infusions are also dangerous for the fetus, as they may contain allergens or toxins that are safe for an adult organism, but adversely affect the formation of a small one.

Among the main and safe ways to relieve pain are the following:

• rinsing the mouth with a weak soda solution (1 teaspoon per glass of warm water),
• applying a clove of garlic to the pulse of the opposite hand from the side of the diseased tooth,
• applying a piece of salty, but not smoked bacon to a sore tooth,
• irrigation of a diseased tooth with aloe or plantain juice,
• reception in moderate dosage and after consultation with a doctor of analgesics approved for use during pregnancy: drotaverine, pentalgin, ibuprofen.

Prevention of caries

Prevention of dental diseases should be dealt with constantly, and not only during pregnancy or when planning it. However, when a family decides to have a child, a woman should start taking care of her oral cavity in an enhanced mode. Here are some tips for caries prevention:

• in advance, before the onset of conception, undergo an examination by a dentist and cure all diseases, if they are diagnosed,
• be sure to brush your teeth twice a day and rinse your mouth with a special disinfectant solution after each meal,
• use additional products after cleaning - dental floss, irrigators, etc.,
• balance the diet by including more fiber and calcium-rich foods so that the body has enough for two,
• during toxicosis, rinse your mouth after each vomiting, and brush your teeth 4-5 times a day,
• massage the gums using anti-inflammatory toothpaste (squeeze a small amount of paste onto the thumb and forefinger and massage the gums on both sides of the tooth with them).

In general, if you undergo oral hygiene (treat problematic teeth and professionally clean them) before conception, then preventive measures can only be reduced to a proper diet and enhanced oral hygiene.

Related videos

Problems with the teeth of a woman during pregnancy are quite common. Most often, expectant mothers complain of caries. The reasons for the defeat of tooth enamel during the bearing of a child are quite commonplace: they are a lack of vitamins and trace elements, including calcium.

Naturally, faced with a problem, a woman wants to know if caries can be treated during pregnancy and how this process can affect her child?

Pregnant woman at the dentist.

Can caries be treated during pregnancy?

Important! The development of caries during pregnancy is greatly influenced by toxicosis. According to statistics, the problem often affects women prone to toxicosis and morning sickness.

It must be understood that the period of pregnancy is the time of greatest responsibility. Any wrong actions can lead to health problems in the unborn child. For this reason, treatment of caries in pregnant women should begin with a thorough examination women and collecting the necessary tests. The dentist should have an idea of ​​how the pregnancy is proceeding and whether the expectant mother has any serious diseases and abnormalities. It is important to inform the dentist about the following diseases:

• preeclampsia;
• diabetes;
• hypertension, etc.

For some problems, the dentist may need a certificate from the obstetrician-gynecologist, giving permission to carry out the necessary manipulation. These measures will allow you to choose the safest and most effective therapeutic technique.

Most of the questions in the treatment of caries arise against the background of the need to do local anesthesia or x-rays of the teeth. Usually obstetricians strictly prohibit such interventions, however, they allow procedures in cases where the possible benefit far outweighs the permissible harm.

X-ray in the treatment of caries in pregnant women

Carrying out X-ray examination on old-style devices is strictly prohibited for pregnant women. However, in exceptional cases, you can use modern highly sensitive equipment, which is characterized by much lower exposure rates.

In addition, for additional protection, a woman's stomach is covered with a special lead apron. Despite the additional protection, it must be remembered that X-rays, even under extreme circumstances, should never be taken in the first trimester.

Anesthesia in pregnant women

Since any anesthetic can spread throughout the body through the bloodstream and enter the placenta, thereby increasing the risk of premature birth or other complications, the introduction of anesthesia is also highly undesirable. In extreme cases, a woman may be given drugs based on articaine. This substance is synthetic and cannot penetrate into the blood. Its only drawback is a short-term effect, which makes the use of the product impossible in case of long-term dental interventions.

What threatens untreated caries during pregnancy?

The main danger of caries is that it has a negative impact on the health of the mother, which directly affects the health of the unborn child. The following examples of possible complications that the disease can provoke can be given:

• neglected caries, accompanied by severe pain, leads to the fact that a woman is deprived of the opportunity to fully eat. As a result, the vitamins and microelements necessary for the child begin to arrive in smaller quantities. In addition, constant pain affects the mental and emotional state of a woman;
• as a result of the inflammatory process caused by caries, body temperature often rises. At the same time, the woman is forced to take painkillers and anesthetic drugs, which can penetrate the fetal blood through the placenta and cause irreversible changes in the functioning of some organs;
• development of digestive problems. Putrefactive bacteria from the mouth can enter the gastrointestinal tract of the expectant mother and cause diseases such as gastritis and ulcers. Against the background of such complications, women often develop a strong form of toxicosis.

In addition to the complications listed above, it is worth noting that the fear of treating teeth and the complete rejection of dental care during the period of bearing a child threatens with the rapid progression of the disease and loss of teeth.

Important! Due to the lack of vitamins and trace elements, caries in pregnant women develops extremely rapidly. As a result, multiple complications arise, and the disease quickly spreads to healthy teeth.

Effect on the fetus

There is an opinion that carious and putrefactive bacteria can have a direct effect on the child. Getting into the circulatory system through microtrauma and bleeding gums, they reach the placenta and enter the child's body. It is worth noting that for the most part this fear is unjustified.

The fact is that viruses have similar qualities, while caries is caused by bacteria that quickly die outside the oral cavity. Despite this, caries can affect the fetus by worsening the condition of the woman. In simple terms, then untreated caries is much more dangerous for the expectant mother than for the child.

How is caries treated during pregnancy?

Treatment of caries during pregnancy directly depends on the period. As you know, pregnancy is divided into three trimesters, each of which is accompanied by certain recommendations and contraindications.

• treatment of caries in the first trimester. During this period, all the vital systems of the body are laid, in connection with this, any medical, including dental, intervention is considered unacceptable. If caries is in the initial stage or pain does not torment a woman, then it is recommended to postpone treatment until a more favorable period. It is important to understand that a painful intervention or any stressful situation can cause spontaneous abortion;
• treatment of caries in the second trimester. During this period of pregnancy, increased growth of the fetus begins. At the same time, negative interference from dental treatment is reduced several times. With severe inflammation, a woman can be prescribed antibiotics, but only in small doses and for topical use, for example, as rinses or applications;
• treatment of caries in the third trimester. In this case, the child has almost fully formed organs and a fairly large weight. During treatment, it is necessary to recline in the dental chair. Prolonged sitting is not recommended, as the fetus can compress a woman's large arteries, causing dizziness and possibly fainting. At the final stage of pregnancy, the woman's uterus is most sensitive, so any intervention can provoke a premature birth. Dental treatment at this time is possible only for emergency indications. It is possible to use approved painkillers.

Important! If a woman has an urgent need to treat caries during pregnancy, it must be remembered that more than one tooth cannot be treated at one visit, and if necessary, the dentist should give the woman the opportunity to rest and walk around.

What type of anesthesia can be used?

Before proceeding to the choice of anesthetic drugs, it is necessary to understand in more detail the principle of their action. Old generation anesthetics are made on the basis of adrenaline, which, acting on the body, blocks pain receptors and causes bleeding to stop due to the ability to constrict blood vessels.

Adrenaline can have a direct effect on the uterus, increasing its sensitivity and leading to tone. This condition is extremely dangerous, as it can provoke involuntary muscle contractions and cause premature birth.

As for modern anesthetics, much lower dosages of adrenaline are used in their manufacture. The most popular include:

• Articaine is a modern anesthetic with a pronounced analgesic effect. Due to its composition and properties, the drug does not penetrate into the patient's blood and acts exclusively on the area of ​​pain, blocking sensitive receptors. The only disadvantage of the tool is its short-term effect, which allows the use of the tool only for minor dental procedures. In addition, Artikain has a fairly high cost;
• Ultracaine - despite the fact that the drug can be distributed with the bloodstream, however, its active components are not able to overcome the placental barrier. Also, the product does not penetrate into the woman's milk, which means it can be used for dental treatment in nursing mothers. The drug has a fairly reasonable price compared to analogues.

Important! Any drug for the treatment of caries during pregnancy should be selected taking into account the individual characteristics of the woman's body. Despite this, you should always be aware of the possible risks.

In order not to have to think about the treatment of the disease during the period of bearing a child, it is necessary to undergo a thorough dental examination even before the planning stage and eliminate even the smallest carious foci. In addition, expectant mothers are recommended to take vitamins and microelements, as well as thorough oral hygiene after each meal.