Dental Care in Pregnancy

It is not absolutely clear whether gum and tooth disease in pregnancy can be linked to pre-term labor and low birth weight babies.  Some studies are very clear that it does relate. Other studies indicate a population at risk for dental disease is also at risk for other factors relating to preterm labor. Whatever the case, any infection during pregnancy, especially dental infection (cavities), puts stress on the body and perhaps on the developing baby.

There is also debate over the safety of dental procedures such as x-ray and anesthesia.  Most health organizations indicate such treatments are safe if limited during pregnancy.  If they are needed, a few things can be done to reduce the risks.

As with all medical treatments during pregnancy, the potential risks of dental care must be weighed against the benefits.  In the case of dental infections, I think benefits outweigh the risks, especially given recent advancements in the dental field.  As with all advice do your own research.  Draw your own conclusions and make your own plan of care.

Advice for General Dental Care During Pregnancy

• Avoid toothpaste containing sodium laurel sulfate as SLS or Triclosan.  Better yet, make your own powder with baking soda and essential oil, or use tooth soap instead of standard toothpaste. The chemicals in toothpaste can disturb your hormonal system and therefore your pregnancy and your birth.
• Brush with soft bristles as the abrasions caused by hard bristles can introduce bacteria into the blood stream.
• Use “oil pulling” as a part of your normal dental care
• Replace your toothbrush every few weeks unless you use a brush sanitizer such as Purebrush or you boil your toothbrush.
• Continue regular visits for cleanings and check-ups.  Pregnant women need more cleanings than normal due to pH and hormonal changes.
• Share with your dentist that you are pregnant.
• Make sure your dentist knows if you have heart conditions or if you ever had rheumatic fever.        
• Elective or cosmetic dental procedures, including whitening, should be postponed until after pregnancy.
• Dental repairs and disease should be treated during pregnancy rather than postponed.
• The 2nd trimester is the safest time for dental work.
• Select a dentist who uses digital radiography, which reduces radiation by at least 80%.  Request that 2 aprons be placed over you and additionally, request that a thyroid guard be used.
• If you need sutures, ask your dentist if she could use untreated thread such as non-absorbable silk. If that is not available, sterilized cotton thread could be used– if she agrees, of course.  If using non-absorbable sutures, you may want to consider using a strong myrrh mouthwash to prevent infection.
• If anesthesia is needed, request (in advance) that carbocain be used, as it does not contain epinephrine which can put your baby at risk. (Other epinephrine-free numbing agents may be used as well).

MIND

• Lower the amount of anesthesia that is needed by using relaxation techniques such as meditation, silent poem recitation, EFT, and of course, hypnosis. 
• If your dentist provides headsets, bring your own music/hypnosis.  If not, bring your own headset and music/hypnosis.

Body

• Acupuncture: Consider a visit to an acupuncturist prior to your appointment to have needles in place for pain reduction.  (Be sure to let your provider know you are pregnant).
• Acupressure:  If you place your thumbs on the corner of your jaw bone, back towards the ear, and slowly move them forward along bone (heading towards your chin) you will find an indentation just about one inch in from the corner.  Applying pressure (30 seconds on, 30 seconds off) to these spots can stop dental pain and lessen the need for anesthetic.  I have also heard of pinning old fashioned clothespins to the earlobes can reduce pain.  I know some dental practices even offer it as an option.

Supplements

• Do not take vitamin C for 2 days prior to treatment, as it can lower the effectiveness of anesthesia. (Vitamin C may improve the function of ketamine/xylazine but they are not advised for use here).
• Consider taking Bromelain (pineapple enzyme) the day prior and the day of your appointment to reduce pain. (one capsule between meals). Bromelain can thin the blood so it may not be appropriate in other situations requiring anesthesia.  Also do not take if you are allergic to pineapple or bee stings.

Homeopathic support:

• Rescue Remedy.  1 drop just prior to appointment.
• Aconite 30c to relieve anxiety the day of appointment.  Can be taken every 15 minutes.
• Arnica 30c for muscle pain.  Take for 3 days, starting the day before appointment.
• Hypericum 30c for pain.  Take after appointment, but not more than 1 dose per hour