Routine dental care, including restorative procedures like fillings, is generally considered safe and is recommended throughout pregnancy. Maintaining good oral health is part of overall prenatal health, and delaying necessary treatment can introduce greater risks than the procedure itself. The American Dental Association and the American College of Obstetricians and Gynecologists both affirm that restorative treatments can be safely performed. However, the timing of the procedure and the specific materials used warrant careful consideration and discussion with your dentist.
When Dental Work is Safest
For non-emergency dental work, the second trimester is widely regarded as the optimal time for treatments such as cavity fillings. This period, typically weeks 13 through 27, is preferred because the fetus has moved past the most critical stage of organ development, which occurs in the first trimester. Although urgent dental care is necessary at any stage, elective procedures are often postponed until this middle window to minimize potential stress or concerns.
The later stages of pregnancy, the third trimester, present challenges that make dental visits less comfortable for the mother. Lying flat on the back in a dental chair can become physically difficult and may cause a drop in blood pressure. This is due to the weight of the uterus potentially compressing the vena cava, which can lead to lightheadedness or postural hypotension. To maintain proper circulation, the dental professional will often adjust the chair by tilting the patient slightly to the left side.
Medications and Materials Used in Fillings
Anesthesia
Local anesthetics, which are used to numb the area for a filling, are considered safe for use during all stages of pregnancy when administered in appropriate doses. Lidocaine, the most common dental anesthetic, is classified as a Category B drug by the FDA, indicating a low likelihood of negative effects on the fetus. The dentist will use the minimum effective dose to ensure comfort and minimize any potential transfer across the placenta. General anesthesia and oral sedatives are typically avoided during pregnancy due to their higher risk profile and potential for fetal harm.
X-Rays
Dental X-rays, which may be needed for diagnosis or treatment planning, utilize extremely low levels of radiation. To ensure maximum safety, dentists must always employ an abdominal shield, such as a lead apron, to cover the mother’s torso. The American College of Obstetricians and Gynecologists agrees that X-rays performed with appropriate shielding are safe. If the need for a diagnostic X-ray is not immediate, some procedures may be deferred until the second trimester or after delivery, but they should not be avoided if necessary for proper treatment.
Filling Materials
When it comes to the material for the filling, the choice is often between dental amalgam and composite resin. Traditional amalgam fillings contain a small amount of elemental mercury, which has raised concerns among some patients. While research suggests the mercury levels released from amalgam are very low, many dentists and patients prefer to use composite resin fillings during pregnancy. Composite resins are tooth-colored, metal-free materials made from a blend of plastic and glass particles, and are generally regarded as a safe alternative for expectant mothers.
Why Untreated Cavities Pose a Risk
Delaying the treatment of a cavity allows decay to progress, significantly increasing the risk of a severe oral infection, such as an abscess. An abscess is a pocket of pus that forms when the bacterial infection reaches the pulp and spreads to the bone supporting the tooth. This type of infection causes pain and leads to systemic inflammation, which poses a risk to the pregnancy.
Poor maternal oral health, including untreated cavities and gum disease, has been associated with adverse pregnancy outcomes. Research indicates a link between inflammation caused by severe infections and a higher incidence of preterm birth and low birth weight. Furthermore, high levels of cavity-causing bacteria can be transmitted to the baby, increasing the child’s risk for early childhood cavities. Addressing decay promptly through a filling helps eliminate the source of infection and supports the health of both the mother and the developing baby.