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How is a toothache treated during pregnancy?

Dental Women's Health Gynaecology

I’m 21 years old and pregnant. I've suffered from a toothache for almost 3 weeks. Are there any considerations to take note of for treatment of my toothache?

DOCTOR’S ANSWER (1)

All acute infections should be treated early whether or not there is a pregnancy. Infections can affect the health of both the mother and the developing baby. There is evidence that maternal infections during pregnancy can result in low birth weight or even premature delivery.

A toothache occurs when the pulp (the nerve of the tooth) is infected by bacteria that cause decay by burrowing deep into the tooth. The pulp becomes severely inflamed as it is overcome by the infection. Chemical changes from the inflammation along the nerve pathway trigger nerve endings to go into overdrive. This is the mechanism behind the classic toothache presentation of constant pain that throbs and aches and which also can disturb sleep.

All toothaches are treated in one ot two ways:

1) Root canal treatment followed by a crown

This allows you to preserve the tooth for chewing on and appearance. Since only the infected nerve tissue within the tooth is removed, this is the most natural way to have the tooth continue in service. 

A crown is important to prevent the tooth from breaking apart after the root canal has been completed.

2) Extraction of the tooth

This is more appropriate when the tooth has been severely broken down by the decay process that it is too fragile to be repaired reliably, when there is a root fracture or if there is resorption (destruction of the root by the body). These conditions make long-term reliable reconstruction of the tooth impossible.

After pregnancy, a more long-term artificial tooth (such as an implant or a bridge) can be planned for.

Both root canal treatment and extractions need pre-operative xrays for a thorough survey of the tooth and the surrounding area. Proceeding with treatment WITHOUT XRAYS is not advisable due to the increased risk of complications occurring.

Digital dental xrays need only half of the radiation dose required to make the xray image, as compared to traditional xray film. To put things into perspective, the radiation dose from a typical intraoral dental xray is much LESS than the background radiation dose humans receive just by living on Earth (or from eating 12-20 Brazil nuts). Most dental practices in Singapore use digital xray systems instead of film. 

Lead shielding is also used to protect sensitive organs (the thyroid and pelvic area) from the xray beam. Since dental xrays are rarely aimed in the direction of the pelvis and since the radiation doses used are extremely low, it is extremely unlikely that the developing foetus will be harmed. In fact, the European Union DOES NOT make it mandatory for lead aprons be used for routine dental xray-taking for pregnant women. The EU guidelines also DO NOT restrict the use of dental xrays during pregnancy.

It is a good idea to call ahead to your chosen practice to confirm that these facilities are available. Furthermore, a toothache is classified as a dental emergency and xrays are essential to diagnosis and treatment.

190 views 20 Feb 2019
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