Treatment of caries during pregnancy


The treatment of caries during pregnancy is a problem that interests many expectant mothers for understandable reasons. They are concerned about the question of whether it is possible to treat teeth during this period without disturbing the normal development of the fetus.

The problem of caries during pregnancy

During this period, all the thoughts of pregnant women are occupied by the unborn baby, less attention is paid to themselves. This approach is completely untrue for one simple reason: the health of a pregnant woman is the health of the child.

Nature of the problem

Caries is a dental disease in which tooth enamel and dentin are destroyed with the formation of an open channel on its surface. There are 2 stages of pathology: early (formation of a carious spot) and late (damage to hard tissues). The late stage is divided into superficial, medium and deep caries. The development of the process is associated with the vital activity of pathogenic bacteria of various types, the bulk of which is the cariogenic bacterium Actinomyces naeslundii. When favorable conditions arise, the bacteria begin to multiply actively, turning carbohydrates into acid, which helps to eliminate fluoride and calcium from the tooth structure and the destruction of tooth tissues. If the process is not stopped in a timely manner, then the bacteria penetrate deeper and deeper.

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Causes of pathology

Caries patternThe initial stage of caries is based on the formation of plaque, which is a breeding ground for bacteria. The main reason for this phenomenon is a violation of basic hygiene rules. The development of microorganisms is facilitated by food debris not removed from the tooth surface and the fascination with sweets. Helps bacteria in their activities deficit in the nutrition of proteins, vitamins, mineral salts, fluoride and beneficial trace elements. An important factor is the composition of saliva, which can contribute to the development of infection.

During pregnancy, the likelihood of carious processes increases significantly for the following reasons:

  1. A change in the composition of saliva and blood in the direction of decreasing calcium and fluorine, which are consumed for the development of the fetus. The changed composition of saliva slows down the processes of remineralization of tooth enamel, weakening its structure.
  2. Hormonal disorders reduce the bactericidal properties of saliva, increasing the survivability of pathogenic bacteria.
  3. Violation of the usual diet and diet, the emergence of the need for salty, sweet, night snacks.
  4. Toxicosis leads to an increase in the concentration of hydrochloric acid in the oral cavity, which is present in the vomit.
  5. The neglect of monitoring the condition of the teeth due to the lack of preventive examinations.

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Symptoms of Caries

The appearance of carious lesions of the teeth is easily recognized by characteristic signs. The main symptoms of the disease: the appearance of a dark spot on the chewing area of ​​the tooth, the roughness of tooth enamel, the reaction of the tooth to food temperature (hot or cold) and its composition (sweet, salty), the appearance of halitosis, the feeling of a cavity on the tooth when conducting it tongue. With the deep development of pathology, toothache occurs, the nature and intensity of which depends on the prevalence of the process.

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Danger of pathology

Fever as a symptom of intoxication in cariesCaries is a focus of accumulation of infection, which can significantly affect a woman’s health and fetal development. The deepening of the pathology leads to the first complications – damage to the vascular and nervous dental zone with the development of pulpitis and periodontitis.

The appearance of deep purulent inflammatory sources contributes to the hematogenous spread of infection throughout the body. General intoxication of the body leads to fever, weakened immunity, exacerbation of toxicosis, disorders in the digestive system. Pain and other symptoms affect the psychological state of a woman. All this indirectly affects the development of the fetus.

The rapid activity of cariogenic bacteria provokes the production of cytokines. In turn, cytokines cause uterine contraction and expansion of the cervical canal, which leads to damage to the fetal membrane. As a result of these processes, the risk of the onset of intrauterine infection, an abnormal slowdown in the development of the embryo, expressed in the underestimated mass of the child at birth, miscarriage and premature birth, is increased.

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Features of the treatment of pregnant women

The dangerous effect of caries on the development of pregnancy indicates the need for treatment of the disease. It should also be borne in mind that the carious process tends to progress rapidly, and it should be treated when the first signs appear in the form of dark spots. At the same time, different periods of pregnancy have their own physiological characteristics, which must be taken into account when prescribing treatment, and its scheme should be decided by agreement of the dentist and gynecologist.

Dental treatment during pregnancyIn the first trimester of pregnancy, the embryo is very sensitive to the effects of any drugs, and the risk of miscarriage is quite high. By about 6 weeks after conception, the embryo begins to form in the fetus, and treatment of tooth decay can disrupt this process. Based on the characteristics of this period, we can conclude that it is impossible to treat caries in the first trimester of pregnancy. The exceptions are only particularly difficult cases associated with pulpitis and periodontitis.

The most favorable period for dental procedures is the second trimester of pregnancy. During this period, rapid fetal growth occurs, and the risk of negative effects as a result of therapeutic measures is small. It is especially important at this stage to carry out the necessary prevention of diseases associated with teeth.

In the third trimester, the load on the woman’s body increases dramatically, leading to a decrease in pressure and a rapid heartbeat. Uterine sensitivity to external influences increases. Dental treatment during this period is undesirable. In special cases, when the procedure is nevertheless carried out, it is necessary to place the woman in the dental chair taking into account the peculiarities of her condition (with an inclination on the left side with an angle of about 12-16 degrees).

During pregnancy, x-ray radiation is contraindicated, radiography should not be used in treatment. X-ray in the first trimester is completely excluded. In special cases, radiography is carried out in the 2nd trimester, but with the use of sensitive sensors and films, allowing to reduce the radiation intensity. Special protective lead aprons are also used.

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Pregnancy treatment

Ubistesin for anesthesia in the treatment of caries during pregnancyThe first step in the treatment of caries is to resolve the issue with local anesthesia. First of all, it should be borne in mind that general anesthesia during pregnancy is unacceptable. Local anesthesia should be carried out with great care and taking into account the individual characteristics of the body. Starting from 13-14 weeks of pregnancy, the following anesthetics can be used: Septanest, Scandonest, Ubistesin, Ultracain. Recently, the use of articain-based products has been spreading, which does not penetrate the blood, does not cross the placenta and cannot harm the fetus.

At a time when dental treatment is contraindicated, and toothache does not rest, it is necessary to remove the pain syndrome. For this, the following medicines can be used: No-shpa, Drotaverin, Grippostad, Tempalgin, Pentalgin, Ketanov, Nurofen. Ibuprofen can be used in the 2nd trimester, but is prohibited for use in the 3rd trimester.

At home, the treatment of toothache is usually done by rinsing with herbal decoctions and tinctures or soda (saline) solution.

Traditional medicine recommends such methods: a solution for rinsing the oral cavity from a herbal decoction (sage, plantain, St. John's wort, pharmacy chamomile), clove powder (seasoning), rubbing the gums with plantain juice, a compress on the gum from aloe leaves, Kalanchoe, pelargonium, applying pork fat on a bad tooth.

Caries during pregnancy is a source of increased danger. It is necessary to treat it, but taking into account the features of different periods of bearing a child. Treatment should be entrusted to a specialist, and the use of drugs should be carried out only after consulting a doctor.

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