Dental, Abcess, 5 weeks Pregnant

Hoping some of the girls here can help me help a friend. A friend came and asked me some questions thinking I'd know the answer since I'm a nurse. But all things dental I tune out. I am a major dental phobe and could never even do dental lists :redface:.

So, my friend's dilema is this (she is also a dental phobe).

She is 5 weeks pregnant and has had a hell of a time getting pregnant. A few weeks ago she had a toothache around a tooth she broke a few years ago but had rebuilt. She went to the dentist today and they said the tooth is dead. Non responsive to percussion and CO2. They offered a root canal but she tried one once before and couldn't go through with it. The other option is to have the tooth removed (it's a back molar on the bottom). The dentist won't do it in the chair because of roots or something and the tooth is brittle. And my friend is a complete phobe. They want her to go to a dental surgeon who can do it in the chair (she's been to him before).

BUT (and here's where all you lovelies come in!) the dentist said there are risks associated with having the tooth out. Pregnancy related risks but didn't go into it further (other than hinting miscarriage or affecting development). But leaving the tooth and risking infection could be just as bad for the baby. The referal indicates she *may* have the beginnings of an abcess or something else that started with a p (can't remember now). The dentist also refused to do a filling she needed until she hits second trimester.

So. What are the risks? Why can't you have a filling in first trimester? What are the risks of having the tooth pulled under local in a chair?

My friend was given a script for AB's incase her tooth gets worse. She hasn't filled it because it's ok at the moment. But she is petrified of seeing the surgeon tomorrow (just to look) and wants to be a little prepared. What can I tell her? I don't understand the risks.

TIA

MG

I don't know the risks, but I had a tooth pulled in the chair under a local while pregnant (29 weeks I think) - a bit different, but it was a really positive experience.

I am a reformed dental phobe. I now love going to the dentist, because I found a good one.

Sorry no advice but I wanted to give your friend :hug:
I'd be a mess if I was in her position because I'm a stress head as it is. Hopefully somebody has answers for her.

I can only think that he won't do a filling because he may need to do an x-ray.

I was in a similar situation - I was pregnant and they couldn't do work (filling or root canal) because I would need an x-ray which I THINK is deemed safe at some point in pregnancy but my dentist refused to do one. She had a stillbirth herself so was ultra-cautious. I think she even said that another dentist would be happy to give me an x-ray but she wouldn't.

I had a wisdom tooth out when I was pregnant and ended up having to have the other tooth out too once I'd had DD2 because by that stage a filling or root canal wasn't going to save it.

I can't remember her mentioning any risks associated with having the wisdom tooth out while pregnant but I guess every situation is different.

A xray is the only reason I can think of too. I used tobe a dental nurse and we quite often treated women for severe problems like extractions and root canals. If she does have an infection she will need abx, so that may be the other problem.

If she chooses to go ahead with root canal, they can start the process WITHOUT doing an X-ray, it's not ideal but is possible.
I have no idea why he wont even do a filling as its perfectly safe.
I also dont see why the tooth cannot be removed, they will use LA that is safe. If its that bad she can't go through a pregnancy with a rotton tooth.

My midwife encouraged me to gargle salt water during pregnancy as a preventative measure because there is an infection that you can get in your mouth that also affects the placenta (or uterus lining? sorry i can't remember the specifics). Perhaps having oral surgery in the early days would increase your chance of the mouth infection at a time when then pregnancy is particularly fragile. Hope your mate can find a solution.

that's what I thought too Olive. And a local is LOCAL. I just drew stumps when she told me. I'll let her know and hopefully she will feel a little better. Poor thing doesn't have an appointment until 4pm and is going to end up spending the whole day freaking out.

She does have a script for AB's but was told to only fill it if the pain got worse.

I had to have a tooth fixed that broke when I was about 16 weeks PG. I swear the dentist said that they could only use a certain type of anesthetic because the other could cause abortion.

Does she want to save the tooth?

Sam you are right they tend to use one over anther fr pregnant women

If she is NSW she could call Mothersafe (or interstate equivalents). I had fairly significant amounts of dental work done with DS2, and he is a perfectly well little baby asleep behind me right now. I had the second stage of an implant (cutting the gum back open to reveal the post, doing impressions for the tooth to be made, then having it fitted), as well as filling work on several teeth. I also needed a few xrays. Mothersafe assured me that it was all ok, as did my dentist, and they used to put 2 lead aprons on me just in case.

I remember reading somewhere that you get exposed to more radiation flying in a plane (because you are closer to the sun) than having a dental xray.

Might be worth double-checking that she's been given appropriate abx for a pregnant woman. I also had abx while pregnant. And lots of drugs for morning sickness. As much as I wanted everything to be natural etc etc sometimes your health requires other things.

Hugs to your friend.

Olive - no, she doesn't want to save the tooth.

My friend went to the surgeon today who is going to wait 7 weeks to take the tooth out. If she gets pain or signs of infection she has to start ABs and go straight back to the surgeon. The surgeon was happy to take the tooth out in 5 weeks but friend feels more confident waiting for 7 weeks.

The reason they don't want to do it yet is because the organs are still forming and they worry about the local going into the blood stream and affecting organ development.

So there ya go!

Actually Wilbur, my friend brushes three times a day. Not all infections are due to poor hygiene.