Can I go to the dentist when I’m pregnant?

It’s an old wives’ tale that going to the dentist while pregnant is risky for developing babies and moms-to-be. In fact, just the opposite is true – good dental hygiene is part of a healthy lifestyle for everyone. The mouth is a major gateway to the blood vessels and digestive system. As such, your oral health can be a good indicator of your overall health.

Still, many pregnant women have questions about whether dental care during pregnancy is safe. It’s understandable – moms want to do everything right for their babies, and there’s a lot of misinformation out there. In fact, our office gets so many questions that, with input from local dentists, we put together a standard letter that addresses patients’ concerns.

With the help of guest contributor Wandana Mistry, D.D.S. (a dentist and a UT Southwestern Ob/Gyn patient), I’ve answered seven of the most common questions we get about dental care during pregnancy. Take a look – we hope it helps you feel confident in getting the care you need.

7 common questions about dental care during pregnancy

1. Why is dental care important during pregnancy?

Hormone changes and certain medications can increase the risk of periodontal disease and dry mouth, so we advise patients to brush and floss twice daily during pregnancy. That might sound like a lot, but it can prevent cavities after eating craved sweets and reduce the risk of gum erosion. Also, vomiting related to severe morning sickness can cause acid erosion of the teeth and, rarely, pregnancy hormones can cause benign growths in the mouth that are not necessarily dangerous but can be annoying.

Additionally, a baby's teeth start to develop during the third to sixth month of pregnancy. It is important that pregnant women monitor their diets to support healthy teeth in their babies. Pregnant patients might have a hard time brushing due to a strong gag reflex. Patients can try using a smaller toothbrush or using different flavors of toothpaste to make brushing easier.

2. I’m in my second trimester of pregnancy. Can I get my teeth cleaned?

Treatment during every trimester is safe. However, the second trimester is the safest trimester in which to get dental treatment. The third trimester is safe, but the patient might have a hard time laying back for extended period of time.

For the most part, there is no medical need to defer most common dental treatments until after pregnancy. In fact, some experts believe there might be an association between periodontal disease and poor pregnancy outcomes, such as preterm birth and preeclampsia. Some providers will encourage women to wait for dental care until after the first trimester to reduce the risk of miscarriage. In our opinion, there is no increased risk for miscarriage with dental care and we don’t recommend delaying needed treatment.

If major dental work or elective orthodontics is planned, patients might wish to consider waiting until after delivery. This is our general recommendation with most medical procedures. If it’s necessary for your health, have the procedure. If it’s elective or it can wait, that’s often the safest choice.

3. If I need oral surgery or a procedure, what types of anesthetic are safe?

Local anesthetics such as bupivacaine, lidocaine, and mepivacaine are safe during pregnancy. If your dental provider feels something stronger is necessary, discuss it in advance with your Ob/Gyn or certified nurse midwife.

4. Are dental X-rays safe during pregnancy?

Modern digital radiography has made radiation concerns almost negligible. X-rays for the diagnosis of dental disease during pregnancy are of very little risk to the developing fetus – especially when you consider the infections and pain that can develop if you don’t have them. However, it’s important that you tell your dentist you are pregnant before X-rays are done so the staff can provide a special garment or device to shield your pelvis and abdomen from exposure.

5. Which antibiotics can I take to prevent or treat a tooth infection?

Penicillin and amoxicillin are safe choices during pregnancy, as are cephalosporins, such as cephalexin. Avoid tetracycline because it can cause tooth staining in the fetus.

6.  What can I take for pain control after a dental procedure?

Acetaminophen in combination with a narcotic drug, such as codeine or hydrocodone, is commonly prescribed and is safe during pregnancy. We encourage patients to use as short a course of such drugs as possible following procedures to reduce the risk of opioid dependency. Patients should be counseled to transition to non-narcotic pain relievers, such as plain acetaminophen, as soon as possible. As such, dentists should not prescribe a 30-day supply of any opioid drug. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are not recommended during pregnancy.

7. What about dental care after the baby is born?

After childbirth, continuing with your own dental care and your baby’s is very important. Continue brushing your teeth regularly and purchase an infant toothbrush and infant toothpaste without fluoride to keep the baby’s gums and budding teeth healthy. We also advise new parents to avoid putting babies to bed with bottles because it can lead to tooth decay.

Schedule your baby’s first dentist appointment at six months or when the first tooth comes in. The dentist will check for tongue-tie and other oral issues that can delay speech and other functions. Also, seeing a dentist regularly will help the baby get used to it and potentially reduce the fear of seeing a dentist later in life. Remember, good dental health is key to overall wellness, and pregnancy is an optimal time to establish healthy habits. If you’re concerned about an upcoming trip to the dentist during pregnancy, call your Ob/Gyn for recommendations and clarification.

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