Among the many concerns pregnant women have, the question of whether it is safe to visit the dentist comes up on a regular basis, says Dr. David Weinstein, chief of obstetric/gynecology at Missouri Baptist Medical Center. “I’m glad you’re covering this, as it’s something that’s been misunderstood, and it’s good to set the record straight,” he says.
Women—and even some dentists—express concern about dental X-rays, anesthetics and even cleaning techniques. However, Weinstein points to a 2013 committee opinion issued by the American College of Obstetricians and Gynecologists (ACOG). The opinion states that to potentiate general health and wellbeing, women should routinely be counseled about the maintenance of good oral health habits throughout their lives, as well as the safety and importance of oral health care during pregnancy.
In other words, “the major concern is that the avoidance of dental care could turn small problems into very large problems that could impact a patient’s overall health,” says Dr. Gilad Gross, director of the division of maternal-fetal medicine at Saint Louis University School of Medicine and director of perinatal outreach for SSM Health Care.
“ACOG states that dental cleanings, X-rays and local anesthetics are safe in pregnancy,” Gross says. “The X-rays done in the dental office are not associated with the amounts of radiation to cause concern. However, it is still recommended that abdominal shielding is done to limit exposure.” Weinstein adds that women also should feel safe in getting dental fillings and root canal procedures as needed during pregnancy.
Good oral hygiene is important during pregnancy to help avoid periodontal disease, which may cause inflammatory responses that have been implicated in preterm births. The ACOG opinion states, “Although some studies have shown a possible association between periodontal infection and preterm birth, evidence has failed to show any improvement in outcomes after dental treatment during pregnancy. Nonetheless, these studies did not raise any concern about the safety of dental services during pregnancy.”
Weinstein notes that gums can become more tender and likely to bleed during pregnancy, yet pregnant women need to brush, floss and receive dental exams as usual. There is no conclusive evidence regarding dangers associated with dental bleaching, however professional opinions vary regarding whether or not pregnant women should avoid this procedure.
“Part of a general and thorough history is to ask patients if they have dental problems; and if they do, they need to not delay care,” Gross says. “Often, there is an assumption that they should table care until the pregnancy is over, and it is our job to make sure that they get the care they need in a timely fashion.”