The answer to whether you can get cavities filled while pregnant is yes; restorative dental care is considered an integral part of comprehensive prenatal health. Delaying necessary treatment for tooth decay can lead to more serious infections that pose a greater risk to both the pregnant person and the developing baby than the dental procedure itself. Routine dental check-ups and treatments, including cavity fillings, are strongly encouraged throughout pregnancy.
Understanding the Safety of Dental Procedures During Pregnancy
Safety protocols in modern dentistry are adapted for pregnant patients. One primary concern is the use of local anesthesia, which is necessary for a comfortable filling procedure. Lidocaine is the preferred drug because it is classified as Pregnancy Category B, meaning studies have not shown harm to the fetus.
Lidocaine is often administered with a very small amount of epinephrine, a vasoconstrictor that prolongs the numbing effect and minimizes the amount of anesthetic that enters the maternal bloodstream. While epinephrine can cause a transient increase in the pregnant person’s heart rate, this low dose is considered safe and is preferable to the stress response an individual would experience from pain. Dentists are trained to use the minimal effective dose necessary to achieve complete numbness, which is crucial since pain and stress can lead to the release of natural chemicals that are best avoided during pregnancy.
Dental X-Rays
Dental X-rays are sometimes required to accurately diagnose the extent of a cavity. The radiation dose from a dental radiograph is extremely low, comparable to the amount of natural background radiation absorbed daily. To further minimize any perceived risk, the standard protocol involves covering the patient with a lead apron and thyroid collar, ensuring the abdomen and thyroid gland are shielded. Although some professional bodies now state that fetal dose from dental X-rays is negligible, the use of protective shielding remains a common practice for patient comfort and adherence to the principle of using radiation “as low as reasonably achievable.”
Filling Materials
Regarding the filling material itself, most dentists avoid placing new amalgam (silver) fillings during pregnancy. Amalgam contains mercury, and while the amount released is very low, many choose to use composite resin (white) fillings as a precaution to eliminate any potential mercury exposure entirely. Composite fillings are metal-free and are a safe, durable alternative for restoring a decayed tooth.
Optimal Timing for Cavity Treatment
The timing of restorative dental care is primarily determined by the stages of fetal development and the physical comfort of the pregnant person.
First Trimester
The first trimester is the period of organogenesis, when the fetus’s major organs are forming. For this reason, many dentists prefer to postpone elective procedures like fillings until after this initial stage. Treatment focuses instead on emergency treatment for acute pain or infection.
Second Trimester
The second trimester, from weeks 13 to 27, is widely considered the ideal time for routine dental procedures, including cavity fillings. Fetal development is stable during this time, and the pregnant person is typically past the severe nausea and fatigue associated with the first trimester. The patient can usually lie comfortably in the dental chair, allowing the dentist to work efficiently.
Third Trimester
Dental treatment in the third trimester can become physically challenging due to the increased size of the abdomen. Lying flat on the back can become difficult and may risk a condition called supine hypotensive syndrome, where the uterus compresses a major vein. If a filling is necessary in this late stage, the dental chair will be adjusted to keep the patient in a semi-reclined position with the right hip slightly elevated to maintain proper circulation.
Consequences of Untreated Dental Decay During Pregnancy
Untreated dental decay is a progressive bacterial infection that can quickly advance into the pulp of the tooth, leading to a painful abscess. This localized infection can then spread to other parts of the body, creating a systemic infection that requires antibiotics and more complex procedures, posing a direct threat to the pregnancy.
The inflammation caused by oral infections, particularly severe periodontal disease, has been linked to adverse pregnancy outcomes. Studies suggest a correlation between maternal periodontal disease and an increased risk of preterm birth and low birth weight babies. While the association between simple caries and these outcomes is less definitive, decay that progresses to an abscess contributes to the overall inflammatory load that can trigger a preterm labor response.
Another significant consequence of untreated decay is the risk of transmitting cavity-causing bacteria to the newborn. High levels of Streptococcus mutans in the pregnant person’s mouth can be passed to the infant after birth through shared utensils or kissing, increasing the child’s risk for early childhood caries. By filling cavities and reducing the bacterial load, the pregnant person protects their own health and reduces the likelihood of passing this infectious disease to their baby.