Routine dental care, including necessary restorative procedures like fillings, is considered safe and is highly recommended throughout pregnancy. Delaying treatment for a cavity or infection can pose a greater risk to both the mother and the developing baby than the dental procedure itself. Untreated dental infections can progress and potentially lead to more serious health issues. Always inform your dentist and obstetrician about your pregnancy status and any medications so they can coordinate your care.
Why Dental Care is Crucial While Expecting
Physiological changes during pregnancy increase the risk for several oral health problems, making regular dental visits especially important. Elevated hormone levels can cause an exaggerated inflammatory response to dental plaque, often leading to “pregnancy gingivitis,” characterized by swollen, red, and bleeding gums. If gingivitis is left untreated, it can progress to periodontitis, a severe gum infection that damages the soft tissue and bone supporting the teeth.
Some studies suggest a link between severe maternal infection, such as periodontitis, and adverse pregnancy outcomes, including preterm birth and low birth weight. Treating periodontal disease during pregnancy is associated with improved maternal oral health. Oral health concerns are also exacerbated by increased acidity from morning sickness, which erodes tooth enamel and increases the risk of new cavities. Timely fillings are necessary to stop the decay process and prevent the infection from spreading.
Scheduling Dental Procedures During Pregnancy
While dental treatment is safe at any point during gestation, the timing of non-emergency procedures like routine fillings often follows specific recommendations for patient comfort and practicality. The second trimester (weeks 13 through 27) is considered the ideal time for restorative dental work. By this time, the risk of morning sickness has usually decreased, and the patient can typically lie comfortably in the dental chair for the necessary duration of the procedure. The first trimester is often avoided for non-urgent care, and the third trimester is sometimes avoided because lying on the back for an extended period can be uncomfortable due to the pressure of the growing uterus. Elective cosmetic dental procedures, such as teeth whitening, should always be postponed until after delivery.
Addressing Safety Concerns for Fillings
Local Anesthetics and X-Rays
The specific materials and techniques used during a filling procedure are carefully considered to ensure safety. The use of local anesthetics, such as lidocaine, is safe for pregnant individuals. The minimal effective dose is used, and the amount that crosses the placenta is very low, making the procedure much safer than allowing pain and infection to continue. Dental X-rays, if required for diagnosis, are also considered safe throughout pregnancy. Modern digital dental X-rays use extremely low doses of radiation, and a lead apron is used to shield the abdomen, minimizing any exposure to the developing fetus.
Filling Materials
Regarding filling materials, there are specific recommendations concerning dental amalgam, which contains elemental mercury. The U.S. Food and Drug Administration (FDA) has advised pregnant women to avoid getting new amalgam fillings whenever possible. This recommendation stems from concerns about the potential for mercury vapor exposure. For this reason, composite resin, often called white fillings, is the preferred material for new restorative work during pregnancy. Removing existing amalgam fillings that are in good condition is not recommended, as the process of drilling can temporarily increase mercury vapor release. Unless the removal is medically necessary due to decay, it is best to postpone any work on existing amalgam until after delivery.