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| Oral Surgery & Pregnancy |
Pregnancy (apart from other problems) can cause
significant effects in the mouth and can affect dental
management.
Oral Effects
Management Considerations
Occasionally, recurrent oral ulcers (aphthæ) resolve during
pregnancy but may worsen due to iron / folate anæmia.
Receiving dental treatment during pregnancy is not
considered to be taboo any more. However, surveys of
obstetricians show that they prefer dental treatment to
take place during the second trimester, if possible.
Oral Surgery or elective dentistry should be postponed
until after the baby is born, or, in extremis, in the second
trimester.
During the first trimester, organ development of the fœtus
is taking place. During the third trimester, it can be
uncomfortable for the mother to lie back in the dental chair,
especially for an extended period of time. In addition, if it
is a particularly stressful situation for the mother, there is
the slight possibility that premature labour may be induced.
Local anæsthesia is generally safe.
Possible Hazards to the Fœtus from Dental Procedures
The main risks of fœtal abnormalities comes from drugs
and radiation; the hazard is greatest during the first
trimester.
Useful Websites:
www.dentalhealth.org.uk/faqs/leafletdetail.php?
LeafletID=23
http://hcd2.bupa.co.
uk/fact_sheets/html/qanda/wisdom_teeth_removal_qanda.
html#3
significant effects in the mouth and can affect dental
management.
Oral Effects
- Aggravated gum disease (gingivitis) and the
development of ‘stalked’ gum tissue (epulis formation) - Variable effect on recurrent oral ulcers (aphthæ)
Management Considerations
- Risk of low blood pressure and fainting when laid flat
- Possible raised blood pressure of pregnancy
- Possible anæmia (iron / folate deficiency)
- Vomiting especially with General Anæsthesia (GA)
Occasionally, recurrent oral ulcers (aphthæ) resolve during
pregnancy but may worsen due to iron / folate anæmia.
Receiving dental treatment during pregnancy is not
considered to be taboo any more. However, surveys of
obstetricians show that they prefer dental treatment to
take place during the second trimester, if possible.
Oral Surgery or elective dentistry should be postponed
until after the baby is born, or, in extremis, in the second
trimester.
During the first trimester, organ development of the fœtus
is taking place. During the third trimester, it can be
uncomfortable for the mother to lie back in the dental chair,
especially for an extended period of time. In addition, if it
is a particularly stressful situation for the mother, there is
the slight possibility that premature labour may be induced.
Local anæsthesia is generally safe.
Possible Hazards to the Fœtus from Dental Procedures
- X-rays are hazardous especially in first trimester
- Reduced drive to breathe due to sedatives
- Staining of teeth due to the use of certain types of
antibiotics (such as doxycycline or tetracycline) - Theoretical risk of depressed vitamin B12 metabolism
by nitrous oxide (‘laughing gas’, used in GA) - Prilocaine and articaine (local anæsthetics) may
cause methæmoglobinæmia (raised levels of
methæmoglobinæmia that can cause tissues to be
deprived of adequate oxygen) which can lead to blue-
baby syndrome - Theoretical risk of womb (uterine) contraction caused
by felypressin (a component of some local
anæsthetics) - Fœtal malformation risk from certain drugs such as
thalidomide (now used for certain immune disorders),
retinoids (used for certain skin conditions), etretinate
(used experimentally for certain types of ‘white
patches’ in the mouth), azathioprine (used for certain
immune disorders including Behçet's syndrome) and
possibly other drugs - Aspirin may cause bleeding in the newly born
The main risks of fœtal abnormalities comes from drugs
and radiation; the hazard is greatest during the first
trimester.
- The risk from dental X-rays are small but only
essential radiographs should be taken, the minimal
radiation exposure should be given and the patient
should wear a lead apron.
- Few drugs are known to cause fœtal malformations
for humans and in many cases, the risk is no more
than theoretical or results only from prolonged high
dosage.
Useful Websites:
www.dentalhealth.org.uk/faqs/leafletdetail.php?
LeafletID=23
http://hcd2.bupa.co.
uk/fact_sheets/html/qanda/wisdom_teeth_removal_qanda.
html#3