Dental treatment first trimester

[rubyroot]

I was due to have root canal after getting an absess around the time I conceived. I took antibiotics and this stabilised infection. Root canal was booked and then I found out I was pregnant. I postponed root canal and went for early scan. All okay. Had discussion with dentist and she said if i wanted to put it off that's okay, but if I end up with anymore pain in tooth then i could book in and just get the root canal kick started. This would invokve digging out infection and dressing the tooth and then i could postpone the rest of the treatment.

Anyhow its two weeks after my booked appt that I postponed and my tooth is a bit sore and I'm worried it's getting worse.

I've had 4 pregnancy losses and so I'm very worried about the effects of the local anaesthetic. My dentist said it is very safe, some things online say to wait til second trimester, some things say its safe and the studies done on it are actuly conflicting.

I know I'm probably being over paranoid but I've googled far too much and there are some studies which suggest that local anesthetic can have an effect on tubal defects. Other studies conflict with this. They are all animal studies.

I just don't know what to do for the best. I'm on the verge of ringing dentist to get the root canal kickstarted, but then crapping it that it may have an effect on my developing pregnancy.

Any experience or knowledge, anyone?

I've worked in dentistry for 14 years. I totally understand why you feel so anxious about it. Local anaesthetic is safe, as are x-rays in the mouth. Dentists tend to caution x-rays in pregnancy, only as mums/to-be mums tend to worry about radiation, but there is no evidence that dental x-rays can cause any harm to you or your baby in pregnancy. A nasty infection/swelling and the stress of pain carries far more threat than a single x-ray. To make you comfortable and if you are worried about x-rays, you could have the first stage of the root canal done under local anaesthetic (no x-ray required), and then get it completed once the baby is here?

Hi, sorry to hear about your dental pain, how far along are you?

I found out a few weeks ago I have a cavity and need to have a wisdom tooth extracted but the dentist won't take it out til I'm past 12 weeks (I'm 10 weeks).luckily it's early days for me and have very little pain.

I have also had a wisdom tooth extraction at 37 weeks with a local anaesthetic due to an abscess in my last pregnancy with no issues.

If you can hold out til 12 weeks I would, but If it's causing you unmanageable pain then get it sorted asap x

The only dental local anaesthetic that is contraindicated is citanest as there is a small amount of evidence that it can induce labour. However, this is not a routine anaesthetic used anyway. All the routine ones e.g. lidocaine or articaine are totally safe

Thanks @LuckyA I've been googking too much and found a study on mice that led to tubal defects with lidocaine so it's this study that's worried me nd the fact that most sources I read say second trimester is better. I'm currently about 8 weeks, so waiting 4 weeks seems like a lot. I'm actually not concerned about x rays @LuckyA its the local I'm worried about. If I hadn't had so much pregnancy loss I guess I would be less paranoid. I thi k I'm going to have to take the plunge and get the root canal started. It does worry me though. Thank you so much for both of your replies

@Thistle86 this is what I don't understand and is why I'm so cautious. Why are there so many dentists who refuse to give locals in first trimester!

Its so hard when you've had losses. I'm also in the same boat and worry about every little thing now. If it helps, I've administered lidocaine in hundreds of pregnant women over the 14 years and not heard of any adverse outcomes from them. Nor have I heard of it from any of my colleagues or dentist online forums. I also wouldn't be worried if I had to have dental treatment myself under it whilst pregnant. If you're really worried, you could ask for a non-adrenaline anaesthetic eg septanest, or try to wait it out until 8 weeks? But you also need to be comfortable and get rid of any infection you have

@Thistle86 @rubyroot I'll tell you why- they are all worried that if something happened to the baby, that they would get pulled into a medico-legal case. So its not "worth the hassle" even though theres no evidence against anaesthetic or x-rays

@LuckyA I did think that may be the case.. Eg liability etc.
I'm not worried about local during pregnancy, more the first trimester. Have you treated a lot of women in first trimester? Thanks again for your responses, they're really useful. X I'm sorry you've been through loss and are so worrying. It's am anxious time isn't it?

Also not so

Yes lots in the 1st trimester. If somebody comes in in pain and they have an infection, I always think its better to get that sorted as that can affect them and the baby more than the materials used in the treatment itself.
A local anaesthetic is just that- local. It only stays close to the tooth and in the surrounding gums until it wears away after a few hours. So it cant travel to harm a baby in the uterus.
Its such a horrible time. I try to just keep as busy as I can and take one day at a time x

@LuckyA I thought it was just local initially, but I have read that they do actually go through placenta to the fetus on the vast majority of academic articles I have read. Apparently lidocaine does go througb in greater amounts than buoivicaine I read. But vasoconstricters are also normally in lidocaine which means it crosses placenta more slowly than lidocaine without vasoconstricters

www.openanesthesia.org/placental_transfer_local_anesthetics/