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Root Canal Treatment is not something women want to worry about when they are pregnant but they may not have a choice. Can an RCT be performed safely in pregnant women? Are there any risks or precautions to be aware of? We have the answers.

Tooth pain somehow seems to arise at the moments when it is least opportune like just before traveling or an important meeting. It can require an emergency visit to the dentist to get relief or the use of a few painkillers until such a visit can be scheduled.

However, what about having severe tooth pain during pregnancy? This is the time when all elective treatment is avoided, no painkillers are advised, and most antibiotics are contraindicated. Can root canal treatment be performed during pregnancy?

RCT during pregnancy

The short answer to the question posed above is yes. Root canal treatment can be performed in pregnant women safely and without jeopardizing any other aspect of the patient’s health [1]. A pregnant woman is not ill or medically compromised, even though she may require some special considerations [2]. To refuse dental treatment to a woman just because she is pregnant is not necessary.

The ideal time to provide root canal treatment in pregnant women is the second trimester [3]. The first trimester is when the developing baby’s organs are being formed and the third trimester carries a risk of pre-term birth. The uterine cavity has also not enlarged enough to make lying down on a dental chair uncomfortable.

This is why any dental treatment which can be postponed until the second trimester is to avoid any unknown complication arising from dental treatment. This is of course only possible if the tooth requiring the root canal is not painful.

A tooth requiring an RCT can be acutely painful and should be treated as a dental emergency. In such a situation, asking a pregnant woman to bear the pain for a prolonged period of time or to make use of painkillers is counter-productive.

There is also mounting evidence to show that the flow of bacteria from an infected tooth into the body should be of more concern than any bacteria that is spread inside the body during the treatment [4].

The stress from severe pain can also cause the release of certain harmful chemicals in the body that can do more harm to pregnancy than any dental treatment could [5].

Can an RCT cause harm during pregnancy?

A lot of women are afraid that getting root canal treatment during their pregnancy could cause the developing fetus harm. Let us look at all aspects of an RCT individually.

X-rays can be vital to the diagnosis and treatment in dentistry. X-rays are avoided in general but sometimes may be necessary. Enough evidence has been collected to prove that necessary dental x-rays, preferably taken with a digital sensor requiring 100th of the exposure of a regular sensor, do not cause any harm to the fetus [6].

A lead apron for coverage should be used as an added precaution.  

Local anesthesia administered during the procedure can also be similarly used without any risk to the fetus [7]. As mentioned before, getting the treatment done without pain and stress is more important to the health of the pregnancy.

The irrigants used to disinfect and clean the tooth or the filling material used afterward have all been definitely shown to be harmless to the pregnancy and can be used without hesitation [8]. Since a root canal treatment is geared towards providing relief from pain and to reduce the spread of bacteria inside the body, root canal treatment is undoubtedly beneficial to the pregnancy rather than suffering pain and letting the infection fester.

Precautions to be taken during root canal treatment for a pregnant woman

The most important consideration to be taken during root canal treatment of a pregnant woman is the position on the dental chair [9]. A laying down position for a long time could cut off the blood supply to the fetus and this is why treatment should be administered to the patient in a sitting position.

The appointments should be kept short and preferably in the morning. Only necessary X-rays should be taken with all the proper shields in place. Any treatment which is not considered essential or is unlikely to become a problem during the term of the pregnancy should be deferred till after the baby has been delivered.

The use of painkillers and antibiotics should be kept to a minimum and only be prescribed after proper consultation with the attending physician of the patient [10].

Conclusion

Dental treatment is quite poorly understood when it is seen in relation to dentistry. Patients and even a lot of doctors are unaware of the harm that a dental infection can do to a developing fetus. Dental treatment performed with proper care and precautions will lead to resolution of the infection inside the body and help improve the pregnancy outcomes.

Root canal treatment is one of the most frequently performed procedures in dentistry and thus also one of the most common treatments needed by pregnant women. It can be performed safely without any risk to the fetus and should not be delayed.  

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