Зубы при pregnancy: лечение, удаление, чтоto do if a tooth aches during pregnancy

Update: October 2018

ATо время вынашивания плода практически каждая женщина
faces the problem of “bad” teeth. Haveхудшается состояние зубов
even those women who have not had dental trouble
до of pregnancy. What is the reason whether it is possible to engage in treatment
teeth during pregnancy? How to protect your teeth when carrying a child and
Does dental health affect the course and development of pregnancy?

How does pregnancy affect teeth?

It is during the gestation period that the condition of the teeth deteriorates dramatically. AND
this is not connected with the well-known postulate: “the child takes
calcium from the teeth to build your skeleton “, which is fundamentally
wrong, but with a powerful hormonal adjustment that starts with
moment of conception.

Increased progesterone production leads to an increase in
blood supply not only the uterus, but also other organs, as well as the gums.
ATследствие этого ткани десны размягчаются и становятся рыхлыми, что
facilitates the penetration of germs in the gums and teeth and promotes
the development of gingivitis, stomatitis and exacerbation of caries.

Gingivitis without timely treatment easily goes into
periodontitis, which is dangerous not only the loss of a tooth or teeth, but also
потерей of pregnancy. In addition, hormonal changes affect
the amount of saliva and its acidity. AT период беременности отмечается
increased salivation and a shift in the pH of the saliva towards acidity,
which contributes to the thinning of tooth enamel and the multiplication of microbes. AT
As a result, caries develops and progresses rapidly.

It also affects the condition of the mouth and teeth in particular.
toxicosis. Nausea and vomiting also play a role in the pH shift of saliva,
lead to the loss of minerals (fluorine, calcium, phosphorus,
magnesium), which causes the demineralization of teeth (thinning of enamel)
and the progression of caries.

The importance of playing and changes in taste during
pregnancy, consumption of a large number of simple carbohydrates,
which quickly split in the oral cavity, serves as a catalyst
for the reproduction of bacteria and the spread of caries (as deep into
tooth and on adjacent teeth).

ANDзменение состава и рН слюны, а также ослабление иммунитета в
the period of gestation affects the formation of plaque. If a
Do not prevent oral diseases during
gestation, disregard plaque, then he
quickly transformed into tartar, which is also fraught with loss
tooth. In addition, plaque is one of the predisposing
factors of gingivitis.

What affects the health of teeth?

However, not all pregnant teeth deteriorate health dramatically.
Someone loses a few teeth in 9 months, and someone saves
healthy and snow-white smile before and after childbirth. What is the reason?
Dentists in addition to the mandatory hormonal adjustment, which
occurs in the period of gestation
predisposing factors that provoke oral diseases
cavities and teeth:

Genetic predisposition

Heredity is not the last place in the state of the teeth.
If a у родителей будущей матери проблемы с зубами начались еще в
at a young age, she most likely cannot avoid dental
патологии во время of pregnancy.

Non-compliance with the rules of oral hygiene

AT период вынашивания плода женщина должна особенно тщательно
follow and care for the oral cavity. It is not only double
brushing your teeth, but also regular (at least 3 times during pregnancy)
посещение dentist, выявление первых признаков кариеса и
his active treatment, taking vitamin and mineral complexes,
shown pregnant and compliance with the rules of healthy nutrition.

The presence of chronic somatic pathology

ANDмеющиеся хронические заболевания пищеварительного тракта
(enteritis, gastritis, colitis), endocrine pathology (sugar
diabetes, thyroid disease), bone and joint pathology
(arthritis and arthrosis, osteoporosis) lead to a violation of calcium
exchange, it is not absorbed by the body in the required dosage that
aggravates the condition of the teeth, promotes their demineralization and
the development of dental diseases.

ATредные привычки

Sadly to talk about it, but not all pregnant
способны отказаться от вредных привычек ради будущего baby
Smoking affects the acidity and composition of saliva, which is already in
the gestation period did not change for the better, but
alcohol intake disrupts the absorption of minerals necessary
for dental health. Also do not forget about the habit of cracking
nuts or strong caramel, which is traumatic not only for fragile
teeth of a pregnant woman, but also for an ordinary person.

Constant stress

ATо время стресса в кровь в большом количестве выбрасывается
hormone – cortisol, which reduces the already weakened immunity
have a future mom. Reduced immunity “plays into the hands”
pathogenic bacteria, including those living in the oral cavity,
which contributes to the flourishing of dental diseases. And pregnant women,
as known, emotionally labile, any seemingly trivial for
them turns into a serious stressful situation, resulting in
both the state of health in general and the state of the teeth in
particular.

Are pregnancy and dental treatment compatible?

Many women still do not know whether teeth are being treated during
pregnancy or not. Yes, teeth during gestation are not only possible,
but it also needs to be treated, especially if the woman did not bother to advance them
health Carious teeth, gum disease and oral cavity are
sources of chronic infection, in particular staphylococcus, which
very dangerous for the unborn child.

Almost every third woman who has a chronic focus
infections in the body during pregnancy, the fetus is infected, and patients
teeth in this situation play an important role.
Pathological bacteria from carious or decayed teeth along with
food enter the gastrointestinal tract, from where they penetrate
blood flow and spread throughout the body.

Not only is the pathology of the oral cavity can lead to
development of sepsis, but it will definitely affect the course
pregnancy, growth and development of the fetus. Caries and other diseases
teeth predispose the occurrence of preeclampsia, cause
infection of the fetal membranes, water and fetus, which is especially dangerous in
the first trimester when the placenta is not yet formed and pathogenic
microorganisms easily penetrate to the fetus. It may provoke
the threat of interruption, and even spontaneous abortion.

In later periods, sore teeth can cause
premature birth, the birth of a weakened low-weight child with
diseases of the digestive and respiratory systems, skin
and reduced immunity.

In addition, a woman’s carious teeth are a danger to
baby after pregnancy (childbirth), as close
contact between mother and child cannot be avoided (breastfeeding,
kisses and other things).

Optimal terms for dental treatment

Ideally, reorganize the teeth, as well as chronic
gynecological and somatic diseases, should be still at the stage
pregnancy planning. A woman should relate to the upcoming
pregnancy is serious because any hotbed of chronic infection in
The body represents a potential threat to the fetus. But,
as a rule, either the pregnancy happens unexpectedly or the future
mother neglects examination during her planning.

It doesn’t matter what state the woman’s teeth are in
in addition to taking various tests, they will be appointed
consulting a dentist already when registering for
of pregnancy. Repeated Dental Examination
appointed before maternity leave, that is, at 30 weeks, and
The last time you should see a doctor in 36 weeks. But if u
women have problems with their teeth and mouth, then more frequent
A visit to the dentist can not be avoided.

Dental treatment during pregnancy

First trimester

First trimester длится с момента оплодотворения и имплантации
eggs up to 14 weeks. This is the most crucial stage of pregnancy
because it is at this time that all organs and systems are laid
baby The placenta is known to finish its formation 16
weeks, so dental treatment within the specified time is not desirable, so
as the protective function of the placenta is not yet fully expressed and the embryo
vulnerable to drugs.

In addition, the first trimester accounts for the maximum
the number of critical periods for threatened abortion
(visiting the dentist is always stressful not only for the pregnant woman, but also
for the average person). But the exception is when
teeth hurt in the early stages. In this case, emergency
procedures (removal of the “nerve” or the tooth itself) after consultation with
with your obstetrician and given the risk of exposure
drugs on the germ.

Second trimester

Second trimester (14 – 26 неделя) считается самым благоприятным
period for dental therapy. The laying of organs has already happened,
placenta has been formed and is actively functioning, psycho-emotional
the condition of the pregnant is quite stable. At that time
It is recommended to carry out all necessary preventive procedures and
if necessary, medical (tooth extraction, filling).

Third trimester

Dentists do not advise to undergo dental treatment in the third
trimester. Firstly, the uterus is already so enlarged that
horizontally on the dental chair squeezes
inferior vena cava and aorta, which impairs uteroplacental
blood flow, and, moreover, dramatically reduces blood pressure and
provokes the development of acute vascular insufficiency (syncope).
In addition, the uterus in the last stages of gestation is very sensitive
reacts to external stimuli that may end
premature birth, and physical strength and psycho-emotional
the condition of the pregnant woman is significantly depleted.

Acute Toothache

It’s hard to find someone who has never experienced
acute toothache. Especially not the situation when a tooth aches
during pregnancy – what to do in this case? First turn
You must contact your dentist (to appear at the reception or at
extreme case to call). Soothe a toothache if not
opportunities to visit a doctor immediately; some folk
means, after eliminating irritating factors (stop
food intake, carefully brush your teeth):

Rinsing

Rinse your mouth should be warm (not hot) water with the addition of
soda or sea salt, or a decoction of medicinal plants (sage,
Mint, Calendula, Chamomile, Oak bark, Hypericum flowers – what is under
by hand). Rinsing тем эффективнее, чем чаще и дольше оно
held (every 30 – 60 minutes).

Tampons

Attach to the gum cotton swab soaked with sea buckthorn oil,
fir, clove or “mask” of propolis on the painful
gum area.

Applications with onions and garlic, with bacon

Attach a gruel of finely chopped to the aching tooth and gum.
onion and garlic (antiseptic), mixed with salt.
Applications of fat – attach to the gums on the side of the cheek a small
slice of unsalted pork lard.

If popular methods have not brought relief
use (preferably after consulting a doctor) some
drugs:

  • paracetamol (safe during pregnancy) – take no
    more than 4 tables / day;
  • no-shpa – antispasmodic, effectively relieves toothache, 2 each
    pills no more than 3 p / day;
  • spazmalgon – eliminates only mild pain, taking 1
    Tablyu no more than 3 times a day;
  • Nurofen (active ingredient ibuprofen) – has
    anti-inflammatory and analgesic effect, take 0.2 –
    0.6 gr. three times a day.

Future mothers should remember that no matter how strong the tooth
pain, warming of the painful area is not allowed (fraught
periostitis – flux), alcohol and aspirin, and, moreover,
applying acetylsalicylic acid tablet to the gum (there will be
�”Aspirin” burn).

Tooth filling in pregnant women

Moms-to-be are very worried about the question: “Is it possible to seal
teeth in the waiting period of the child? “. The answer is simple – if
there is such a need, it means you need to put a seal
necessarily, since a tooth with a hollow during pregnancy can
completely collapse and after giving birth it will turn out that you will also fill
there is nothing. If caries is superficial or medium teeth, then its treatment
will fit into one visit to the dentist that does not even require
pain relief.

In the presence of deep caries a doctor with a drill
mechanically eliminates (reverses) dead and destroyed areas
and install first an arthritic paste that will “kill the nerve”,
that is, it will cause necrosis and dissolution of the pulp, then put
temporary seal.

A few days later, a temporary seal is opened and produced.
depulpation followed by the installation of permanent fillings. With
pregnancy is allowed to use all kinds of fillings, including
light-cured. Treatment of deep caries is very painful and
is performed under anesthesia.

Anesthesia of teeth in pregnant women

Fear of visiting a dentist is often associated with the fear of pain
time of medical procedures. Anesthesia of the teeth
pregnancy is well tolerated and even recommended. Fear and pain
not only deliver a lot of unpleasant minutes, but can also cause
hypertonia of the uterus. Anesthesia is performed before drilling the tooth,
pulp removal or other manipulations on the pulp and in front of
extraction of the tooth.

With лечении беременных женщин используется только местная
anesthesia (even for ordinary patients, general anesthesia is not
preferably due to the high risk of complications). Currently
dentists use local anesthetics that do not penetrate
through the placental barrier and have a reduced concentration
vasoconstrictor substances (and in some they do not exist at all). For
anesthesia in pregnant women use Ultracain and Ubistezin. Before
anesthetic injection of the gum is treated with novocaine spray
(saliva should spit).

It is important to remember that women preparing to become mothers should
warn the dentist about your pregnancy and term.

Tooth extraction in pregnant women

If the tooth can not be saved, then the question arises about its removal.
Tooth extraction during pregnancy is delayed for 2 trimester, but if
an emergency situation arose, the extraction of the tooth is carried out in any
term. Removal is carried out under local anesthesia and after
conducting radiography. To avoid possible complications,
It is important to follow the doctor’s recommendations after the extraction of the tooth and
in no case warm the wound surface.

Particularly noteworthy is the removal of a wisdom tooth. Have
pregnant women, this operation is undesirable because
technically more complex and often accompanied by complications
(fever, inflammation that requires prescription
antibiotics). Therefore, if possible, the removal of wisdom teeth
lay off for the postpartum period.

X-ray of teeth

Probably, not only future and real moms know about the dangers
X-ray for the fetus, therefore X-rays
opportunities during pregnancy try to exclude (except
emergency situations). But while undergoing treatment, dentist
it may be necessary to conduct a x-ray of a tooth, including
the number and during pregnancy (before extraction of the tooth or filling
dental canals). If it is possible to postpone tooth treatment for a second
trimester, it is advisable not to carry out X-rays in the early stages
of pregnancy.

But, по сути, рентген зуба не на столько опасен, чем возможные
последствия не вылеченного зуба для будущего baby Especially since
spot irradiation directed only to the maxillofacial
the surface, and the neck, chest and belly of the woman are protected
from exposure to a lead apron. Today, many
dental clinics are equipped with special devices –
radioviziografami, with the help of which the exposure time, and,
accordingly, the radiation dose is reduced tenfold.
(radiovisiography is optimal for examining pregnant women and
children).

Prosthetic teeth

In the waiting period for the birth of the baby, many women appear
free time, and, accordingly, the question arises: “Is it possible
�”Do” teeth during pregnancy?

Prosthetic teeth на данном жизненном этапе не имеет
contraindications performed by an orthopedic dentist
troublesome and absolutely safe for the fetus.
The only thing that should be refrained from during the gestation period is
from dental implants. Withживление зуба требует от организма затрат
large amount of energy that is necessary for growth and
child development. In addition, for better implant healing
medications that suppress immunity are often prescribed, which is absolutely
contraindicated in pregnant women.

Haveход за полостью рта

It is important to take proper care of the oral cavity during
pregnancy:

  • It is necessary to brush your teeth at least 2 times a day, and preferably
    after every meal.
  • For удаления налета и кусочков пищи из труднодоступных мест
    flossing should be used.
  • Toothbrush to choose with soft or medium hard bristles
    different lengths.
  • Brushing your teeth should last at least 3 – 5 minutes, and
    capture all surfaces (anterior and palatal, chewing), and
    Brush movement in the horizontal and vertical sides.
  • Do not forget about the surface of the tongue.
  • It is better to choose a toothbrush with an elastic moving head, and
    change it every 2 months, a maximum of 3 months.

For беременных выпускаются и специальные зубные пасты, которые
sold in pharmacies. Suitable pastes for future mothers:

  • Presidential 9 months;
  • Bionics green;
  • Splat organic;
  • Splat biocalcium.

With покупке другой пасты следует внимательно изучить ее состав.
Toothpaste for future mothers should not contain:

  • sodium lauryl sulfate and sodium loreth sulfate (causes
    irritation of the mucous membrane and accumulates in the body)
  • triclosan (antibacterial action, destructive not only for
    dangerous, but also beneficial bacteria)
  • fluoride and fluoride are by and large useful, but high
    concentrations are toxic, so their content should not be
    more than 0.1 – 0.6% to other substances
  • abrasives such as silica and carbonate
    calcium in high concentrations other than plaque scrape and
    enamel, so the degree of abrasiveness should not exceed 25
    units.
  • do not use whitening toothpaste (for
    smokers), and should also give preference to pasta with
    marked “hypoallergenic”.

Mouthwash – as an addition to brushing your teeth apply
rinsing with dental elixirs or home remedies (infusion
oregano, Hypericum and mint).

Chewing gum – if at the beginning of pregnancy is concerned
nausea and vomiting, it is recommended to neutralize the acidity of saliva
use xylitol or sugarless gum. After
rinse each mouth with warm soda
Brush your teeth if possible.

Proper nutrition – it is desirable to exclude from the diet sweet and
confectionery, sweet carbonated drinks and store
fruit juices, replacing them with fresh fruit and mineral water. AT
diet should prevail foods high in calcium
(milk, cottage cheese, kefir, eggs, cheese, nuts), vitamin D and phosphorus
(cod liver, sea fish, seafood).

Do not neglect the intake of vitamin-mineral complexes,
which include calcium (Pregnavit, Elevit). But from
additional calcium supplements should be avoided (his
excess causes premature aging of the placenta and early
ossification of the seams of the fetal head).

With the preventive purpose of developing gum disease
carry out massage (with a finger with a small amount of toothpaste
gums are massaged every day for 5-7 minutes).

The future dad should also treat all teeth before birth.
baby since then there will be close contact with the newborn
(hug, kiss, swaddle, play).

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