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Dental Care and Pregnancy

Thinking about your baby and prenatal care is normal during pregnancy; however, thinking about your teeth and dental care may not be forefront on your mind. Women need to pay special attention to their teeth and gums especially during pregnancy to avoid the increased risk of dental problems.

Your Changing Body and Changing Dental Needs

Pregnancy brings a change in hormones, especially increased levels of estrogen and progesterone, which are linked to plaque buildup on teeth. Plaque that is not removed can cause gingivitis and swollen gums that are tender and prone to bleed. Most pregnant women experience gingivitis to some degree, but it doesn't usually surface until the second trimester. If you had gingivitis before becoming pregnant, your condition will likely be aggravated; untreated gingivitis can lead to a more serious problem -- periodontal disease. Swollen gums that become irritated can also lead to pregnancy tumors, benign growths that will usually shrink and disappear without treatment. However, if the tumor causes discomfort or interferes with chewing or brushing, the dentist may suggest removing it.

Special Preventive Tips

• Brush at least twice a day with fluoride toothpaste and after each meal, if possible.
• If brushing your teeth causes morning sickness, rinse with anti-plaque and fluoride mouthwashes or water.
• Pay close attention to your gum line and keep it clean.
• Floss daily.
• Focus on nutrition, including plenty of vitamins C and B12.
• Visit your dentist for a check-up and cleaning in both your first and second trimesters to control plaque and maintain good oral health.

Handling Dental Emergencies During Pregnancy

If you experience dental problems causing pain, you can be treated at any time; however, consult your doctor if anesthesia is required or a medication is prescribed to you. Avoid X-rays during pregnancy, unless they are critical to emergency treatment. It is recommended to schedule elective procedures after your baby's birth. While you're expecting, have great expectations for maintaining good oral health. By doing so, you'll keep your beautiful smile and share it with your baby!

By Brian J. Gray, DDS, MAGD, FICO

Will I Be Comfortable During My Root Canal Treatment?

The answer should be an emphatic "YES!" Fortunately, dentistry has developed new techniques for delivering local anesthetics painlessly. These techniques also assure that the anesthetics act more rapidly and produce a more "profound" level of anesthesia. Additionally, modern dental procedures utilize better technologies that are generally much less traumatic and invasive than those of the past. The result of these advancements is that patients should have minimal or no discomfort during the tooth numbing and/or treatment procedures. Root canal treatment should not cause pain, but rather relieve it when present and keep it from reoccurring. Unfortunately, dental pain may also have a psychological component, possibly stemming from a negative past experience, a story in the media, or even the fear of the unknown. Sometimes these situations can prove challenging for the patient and the dentist to control. Examples include:

• Some patients associate tooth pain with past root canal treatment when, in fact, the pain they remember was experienced prior to their emergency visit. Oftentimes, this pain develops over a period of several hours to a few days and is allowed to build and worsen before seeking treatment. Once the patient seeks emergency care, endodontic treatment should not be uncomfortable and should provide quick and certain relief from any painful symptoms stemming from root canal disease.
• Patients may become very anxious when being examined or treated dentally because the mouth is such an important part of the body and psyche. Some patients may feel anxious and vulnerable because of their positioning in the dental chair with members of the dental team working above them in such close and intimate proximity.

These and other distresses are real to the patient. Much of the time, however, the distress can be reduced or eliminated if the patient discusses it with the dentist and gets understanding and reassurance. The doctor and the patient must work together in these situations to make certain that the patient feels as comfortable, trusting, and informed as possible in the dental environment. Most individuals can do this satisfactorily. If patients continue to feel significant distress, even after having these discussions with the dentists, they should be aware that there are supplementary modalities for which they might be candidates. These modalities include:

• Oral sedation involves ingesting a sedative pill or liquid before the appointment. This can help anxious patients a great deal and make the treatment experience much less psychologically stressful.
• Nitrous oxide analgesia, known as "laughing gas," can be inhaled along with oxygen to make patients feel less anxious and more comfortable.
• Intravenous sedation can be administered in a dental facility by a specially trained and certified dental team or by a specially trained dental anesthesiologist. With intravenous sedation, patients are not asleep and they can still respond, but they will not feel or remember anything. This technique works very well in creating a pleasant experience for many anxious patients and is a good anesthetic modality for more lengthy dental procedures.
• Hospital dentistry is conducted in an environment where a variety of anesthetic modalities are available and can be used under the safest medical conditions. General anesthetic and intravenous sedation can both be utilized in the hospital setting.

These sedative techniques and medicines may also be helpful if particularly lengthy treatment procedures are necessary in specific situations.

With all of the advancements in pharmaceuticals and in their delivery, there should be no need for any patient to delay root canal treatment because of fear that the treatment will be painful.

By Clifford J. Ruddle, DDS, in collaboration with Philip M. Smith, DDS