Your dentist has just told you that you have an impacted wisdom tooth that needs to be extracted. However, you also just found out that you are pregnant. Although most dentists prefer to postpone major dental work until after the baby's birth, sometimes the pain and chance of infection makes postponement difficult. The pain, stress and risk of infection are not good for you or your baby's health. Although tooth extraction is relatively safe, be sure to inform your dentist or dental surgeon of your pregnancy so he or she can take certain precautions.
What Is an Impacted Wisdom Tooth?
Your wisdom teeth, also called third molars, are the final set of molars to appear. They typically erupt during early adulthood, although in some people they never appear at all. They serve no real purpose, but they can cause problems when they don't grow in correctly.
An impacted wisdom tooth is one that doesn't erupt through the gum tissue or only partially breaks through. This causes pain and swelling of the gums and jaw and can also put you at risk for infection. The only effective treatment for impacted wisdom teeth is surgical removal. According to the website Impacted Wisdom Teeth, many dentists recommend removing wisdom teeth as soon as they appear, even if there are no problems because removal later in life is more prone to complications.
Wisdom Tooth Extraction During Pregnancy
Although not ideal, having one or more wisdom teeth extracted while you are pregnant is usually safe and a better alternative than living with the pain and chance of infection. Timing of the procedure is one of the most important considerations. If at all possible, the dental work should be performed during the second trimester.
During the first trimester or first 3 months, the growing baby is the most susceptible to birth defects. During the last trimester, sitting in a dental chair for hours can be uncomfortable, and you are more likely to have high blood pressure and increased chance of excessive bleeding. There is also a chance of premature labor during this final stage of pregnancy.
The Procedure and Precautions
Before the extraction takes place your dental surgeon will need to take x-rays of the impacted teeth and surrounding teeth and bone. Although the dose of x-rays should not be strong enough to affect the unborn baby, it's still important to wear a lead apron to protect it.
The extraction procedure, done by a doctor like Dr. Michael G. Allard, is typically done in the dental office under a local anesthetic. Novacaine and lidocaine are the anesthetics of choice as they don't cross through the placenta. Your dentist may also inject the area with epinephrine as that will constrict the blood vessels in the surrounding tissues and keep the anesthetic in the immediate area. When all 4 wisdom are extracted at once or in cases where the teeth are severely impacted, a general anesthetic may be necessary. In such cases, the dentist will use the lowest effective dose for the shortest amount of time.
Your dentist will likely use an antibiotic before and after the surgery. Penicillin and amoxicillin are considered safe for you and your baby. Tetracycline may cause yellowing of the baby's teeth and should be avoided.
For pain, rinse your mouth 2-3 times daily with a saline solution. If further pain relief is necessary, talk to your obstetrician for recommendations. Avoid aspirin as it can cause blood thinning and increases the chance of bleeding and late stage abortions.
Keep a close watch for signs of infection. Putting a moist cloth or gauze over the area can help with pain and healing. Keep a firm bite over the incision to help keep bleeding to a minimum and may help ease pain. It's important to return to your dentist for a follow-up visit a few days after the surgery to make sure the area is healing satisfactorily.