Dental Braces Should NOT Be Removed During Pregnancy
Dental braces do not need to be removed during pregnancy and orthodontic treatment can safely continue throughout gestation in a healthy pregnant woman without complications. The physiologic changes of pregnancy do not contraindicate orthodontic appliances, and removing braces unnecessarily would interrupt treatment and potentially compromise the final outcome.
Safety of Dental Care During Pregnancy
- Dental treatment, including orthodontic care, is safe throughout pregnancy for both mother and fetus 1, 2, 3, 4.
- Pregnant patients are not medically compromised and should not be denied dental treatment simply because they are pregnant 2.
- Most dental work is safe during pregnancy, and dentists should provide care based on well-grounded data to avoid harm 4, 5.
Optimal Timing for Dental Procedures
- The second trimester (weeks 17-28) is the ideal time for elective dental procedures, though routine orthodontic adjustments can be performed throughout pregnancy 3.
- The first trimester involves organogenesis when the fetus is most susceptible to teratogenesis, making this period less ideal for elective interventions 3.
- Emergency dental treatment can and should be performed during any trimester when acute pain or infection is present 3.
Pregnancy-Related Oral Health Considerations
- Pregnancy increases the prevalence of periodontal diseases due to hormonal changes, and periodontal pathogens may migrate to the uterus potentially causing premature delivery 1.
- Pregnancy-related gingivitis is common due to altered physiology and increased inflammatory response 3, 5.
- Oral health assessment should be part of comprehensive prenatal care, and obstetricians should routinely refer pregnant women to dentists 4.
Specific Orthodontic Management
- Orthodontic treatment is not contraindicated during pregnancy 5.
- Routine orthodontic adjustments and maintenance can continue with standard precautions.
- Enhanced oral hygiene is particularly important during pregnancy due to increased risk of gingivitis with fixed appliances 3, 5.
Common Pitfalls to Avoid
- Do not delay necessary dental care due to unfounded concerns about pregnancy - this misconception among dentists, obstetricians, and patients can lead to worsening oral health 1, 4.
- Avoid unnecessary radiographs during the first trimester, but diagnostic radiographs may be performed after the first trimester if absolutely necessary with appropriate shielding 3.
- Do not assume all medications are contraindicated - lidocaine anesthesia and paracetamol are safe, and certain antibiotics (amoxicillin, ampicillin, some cephalosporins and macrolides) can be prescribed if needed 3.
Patient Positioning During Appointments
- Position the patient on her left side or semi-erect to minimize aortic compression and optimize uteroplacental blood flow, particularly in the third trimester 5.