Attention to a woman's dental health can and should continue throughout pregnancy. The treating dentist must be diligent to the special situations surrounding treating the pregnant patient and the risks involved for both fetus and mother. Undertaking the proper precautions with these patients not only provides the best dental care, but also helps avoid potential complications. Any complication or question that arises with a complicated pregnancy should prompt referral to the patient's obstetrician for further evaluation.

Access to dental care during pregnancy is impeded, in part, by a limited window of opportunity for treatment. The ADA (American Dental Association) suggests that elective dental care should be avoided, if possible, during the first trimester and the last one-half of the third trimester. This time frame apparently is widely recommended because it includes the periods of greater risk of harm to the developing embryo or fetus, as well as the least comfort for the mother.

During the first trimester, risks of birth defects associated with the use of teratogens are higher than in the other two trimesters. In addition, a large number of pregnancies undergo spontaneous abortion during the first trimester, and any dental procedures performed around the time of the spontaneous abortion could be perceived as causal. During the last one-half of the third trimester, the increased sensitivity of the uterus to external stimuli increases the risks associated with premature delivery. Other factors that can limit access to dental care during pregnancy include lack of insurance coverage, women’s beliefs about dental treatment during pregnancy, and providers’ (both obstetricians’ and dentists’) attitudes and beliefs.

Findings have shown that most mothers did not make a dental visit during pregnancy, and of those who reported having oral problems, one-half did not seek care. Preliminary analysis of qualitative results shows that some women may believe that poor oral health status during pregnancy is normal; also, they may fear certain aspects of dental care during pregnancy. For example, some women may believe that they or their fetus could be harmed by treatment. If pregnancy modifies perceptions of oral health and dental care in women, it may contribute to women's avoidance of dental treatment while pregnant. Therefore, researchers and health program planners should give increased attention to the oral health needs and behaviors of pregnant women.

It is important to understand that establishing a healthy oral environment is the most important objective in planning the dental care for the pregnant patient. This objective is achieved by adequate plaque control (brushing and flossing) and professional prophylaxis including coronal scaling, root planing, and polishing.

Patients should be encouraged to schedule elective dental treatment during the second trimester but seek prompt care for acute dental problems.

Back            Next           Home