Pregnancy and Root Canal Therapy
When one thinks of having a baby it is indeed a joyous time. When one thinks about root canal therapy it immediately conjures up all sorts of negative thoughts. So how are these two diametrically different conditions related?
Well on occasion, a pregnant woman will have a toothache, an infection in the tooth, or break her tooth into the pulp chamber (nerve) and it will be in the best interests of that woman and her baby to be treated during her pregnancy.
In an ideal world, root canal specialists would rather not treat a pregnant woman during her gestation. The world is not perfect and emergencies arise. We want you to be absolutely assured that if you need to have this treatment we can carefully, gently, and expertly take care of you, your baby, and your aching tooth.
Why Do We Need Root Canal Therapy?
In the center of our teeth lies a chamber. It is called the pulp chamber. It is the living part of our tooth. The pulp (material in the chamber) is composed of connective tissue, nerves, and blood vessels. We commonly refer to this as “the nerve” of the tooth. If any outside force violates this space this tissue will die. These outside forces usually consist of advanced decay that has gone from the enamel, through the dentin, and into the pulp chamber. This is a bacterial invasion that can quickly lead to an infection that is manifested at the tip of the root. This presents as swelling, redness, and pain (especially upon tapping the tooth). If the infection is left untreated an abscess may form in the bone.
Many times at this stage antibiotics come into play as part of the treatment. In our pregnant patients, we want to guard against any chance of pain and or infection. Simultaneously we want to be as conservative as possible in terms of taking x rays or prescribing medications. Another way of violating the sanctity of the pulp chamber is by trauma.
Hard food, candies, grinding our teeth can all cause a fracture of the crown of the tooth that exposes the pulp. Once the pulp is exposed it is in the best interests of that patient to be treated as soon as possible.
How to Avoid Root Canal Therapy
The first and most important is home care. Brushing one’s teeth with a small soft brush or an electric brush for two minutes, twice a day is highly recommended. Using a toothpaste that is very low in abrasion level and has a long shelf life of fluoride is best (we recommend Sensodyne, Colgate, and Crest in that order). Flossing every night is a must! Reducing sugar in your diet, eliminating honey, dried fruit, and soda is also very helpful. If you grind your teeth a nite guard becomes essential in protecting against trauma while we are sleeping.
Visiting the dentist regularly (every six months). It may be prudent if you are planning to become pregnant to make sure that your last checkup and cleaning are up to date. If any dental work is diagnosed do not procrastinate. Do it right away before conception.
What is Root Canal Therapy and its relationship to Pregnancy?
Dr. Lipner will carefully examine you. He will take a detailed medical history. If needed he will liaison with your OBGYN. If x rays are needed, they will be at a distinct minimum. They will be digital in nature thus assuring low levels of radiation. You will be draped with TWO lead aprons to make doubly sure that your baby is absolutely, unequivocally safe.
The best time to have root canal therapy is in the SECOND trimester, weeks 14 through 20. Dr. Lipner will try to do your root canal therapy during this time. In the first trimester, there is a very rapid development of the fetus. So passing the milestone of the first trimester is in everyone’s best interest. During the third trimester, you may feel less comfortable lying back in a dental chair.
Be aware if you are suffering from pain and facial swelling, you may need immediate care regardless of the trimester. The risk of an untreated infection outweighs the minimal risks associated with root canal therapy. Both the AMA and ADA have deemed that root canal therapy is safe during pregnancy.
Once you are numb Dr. Lipner will place a rubber dam around your tooth. This isolates the tooth from the rest of your body. He will gently drill a small hole (access) onto the top of your tooth. From here he will place his root canal instruments, reamers, and files, into the pulp chamber and then into the canals. He will clean out the infected tissue (pulp), shape the canals, and then disinfect the chamber and the canal. Next, he will fill the canals (obliterate) with gutta-percha; and then the root canal process is over. Much much easier than giving birth. Now you are out of the woods, infection and pain have vanished. The final restoration (core and crown) will be done after the baby is born.
Anesthesia and Pain Medication During Pregnancy
Everyone who is concerned about the expectant mother and her baby is concerned about anesthesia and medications and how it affects the fetus. The American Dental Association states that local anesthesia such as lidocaine and mepivacaine (no adrenalin) is perfectly safe.
The American Pregnancy Association recommends using as little anesthesia as possible while providing the mother with total comfort during her procedure.
Sometimes with Root Canal Therapy antibiotics may be needed. We follow the current standard of care set forth by the American Medical Association. Most antibiotics like Amoxicillin are perfectly fine.
On rare occasions, patients may experience some discomfort. We offer deep breathing techniques to alleviate most problems. When needed we will prescribe Tylenol as an analgesic. Advil, Motrin, and Aleve are contraindicated during pregnancy.
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