Dental Care Throughout Pregnancy
Preventive, diagnostic, restorative, and periodontal dental procedures are safe throughout pregnancy and should be provided routinely to maintain maternal and fetal health. 1
Routine Dental Care Recommendations
Preventive Care
- Dental examinations and prophylaxis should be performed every 6 months throughout pregnancy to maintain optimal oral health 1
- Routine dental cleanings and preventive treatments are safe during all trimesters 2, 3
- Oral health assessment should be part of comprehensive prenatal care, with obstetricians routinely referring newly pregnant women to dentists 2
Timing of Dental Procedures
- The second trimester (weeks 17-28) is the ideal time for elective dental treatment, though this should not delay necessary care 3
- Emergency dental treatment can and should be performed at any time during pregnancy when acute pain or infection is present 3, 1
- The misconception that dental services should only be provided during the second trimester is incorrect—most dental work is safe throughout pregnancy 2, 4
Safe Dental Treatments During Pregnancy
Procedures Confirmed Safe
- Prophylaxis (dental cleanings) can be performed throughout pregnancy 4
- Periodontal treatment is safe and effective during pregnancy 1, 4
- Restorative dental care (fillings, crowns) is safe throughout pregnancy 3, 1
- Tooth extractions are safe when clinically indicated 1
- Emergency dental procedures should not be delayed regardless of trimester 3, 1
Diagnostic Imaging
- Diagnostic radiographs may be performed after the first trimester if absolutely necessary, using appropriate shielding 3
- Radiographs should not be avoided when clinically necessary, as untreated dental disease poses greater risk 2
Safe Medications During Pregnancy
Anesthetics
- Lidocaine is considered safe for local anesthesia during pregnancy 3
Analgesics
- Paracetamol (acetaminophen) is the safe analgesic of choice for dental pain during pregnancy 3
Antibiotics (When Infection Present)
- Amoxicillin is the first-line antibiotic for dental infections during pregnancy 3
- Ampicillin, certain cephalosporins, and some macrolides are also considered safe alternatives 3
Critical Timing Considerations
First Trimester (Weeks 1-16)
- Organogenesis occurs during this period, making the fetus most susceptible to teratogenic effects 3
- Elective procedures are ideally postponed, but emergency treatment should never be delayed 3
- Diagnostic radiographs should be avoided unless absolutely necessary 3
Second Trimester (Weeks 17-28)
- This is the optimal window for elective dental procedures 3
- Patient comfort is maximized and fetal risk is minimized during this period 3
Third Trimester (Weeks 29-40)
- Dental treatment remains safe but patient positioning may become uncomfortable 5
- Emergency and necessary treatments should still be provided 1
Common Oral Health Changes in Pregnancy
Periodontal Considerations
- Pregnancy increases inflammatory and immune responses, often aggravating periodontal conditions 3
- Periodontal disease is encountered frequently in pregnant patients due to hormonal changes 3
- While some studies suggest associations between periodontitis and adverse pregnancy outcomes, periodontal treatment is safe and should be provided 3
Preventive Counseling
- Pregnant women should be educated about maintaining oral hygiene throughout pregnancy 2
- Information about the safety of dental treatment should be provided to overcome misconceptions 2
Critical Practice Points
What NOT to Do
- Do not delay treatment of dental disease simply because a patient is pregnant—pregnant patients are not medically compromised and should not be denied dental care 5
- Do not postpone emergency treatment regardless of trimester 3, 1
- Do not avoid necessary radiographs when clinically indicated, as untreated disease poses greater risk 3
Overcoming Barriers to Care
- Many dentists are reluctant to treat pregnant women due to lack of information, but this reluctance is not evidence-based 3
- Prejudices about the safety of dental treatment during pregnancy can result in harmful delays in care 2
- Dental practitioners should actively accept and treat pregnant patients throughout all trimesters 4
Integration with Prenatal Care
- Dental screening should be incorporated into routine prenatal care protocols 6
- Screening for periodontal and urogenital infections should be performed as indicated during preconception and prenatal visits 6
- Obstetricians and general medical practitioners should routinely refer pregnant women for dental evaluation 2