A deep cleaning, formally known as Scaling and Root Planing (SRP), is a non-surgical dental procedure necessary to treat chronic gum disease. This treatment removes hardened plaque and tartar from below the gum line, down to the root surfaces of the teeth. For most expectant mothers, necessary dental care, including SRP, is considered safe and is often strongly encouraged. The decision to proceed depends on the infection’s severity and requires special considerations for the safety of the mother and fetus. Addressing active gum infection should not be postponed until after delivery.
Hormonal Changes and Gum Health
Pregnancy involves a significant rise in circulating hormones, specifically estrogen and progesterone, which directly impact the health of the gum tissues. These hormonal changes increase blood flow to the gums, causing them to become more sensitive and leading to an exaggerated inflammatory response to plaque. This heightened sensitivity is why approximately 40% of pregnant individuals develop a condition known as “pregnancy gingivitis,” characterized by red, swollen, and bleeding gums.
If gingivitis is left untreated, the inflammation can progress to periodontitis. The presence of increased progesterone can also make it easier for certain oral bacteria to grow, further exacerbating the infection. Treating this active bacterial infection stabilizes the gum tissues and prevents the disease from advancing to cause bone loss.
Safety Protocols for the Procedure
When a deep cleaning is necessary during pregnancy, dental professionals implement specific safety modifications. Local anesthetics, such as lidocaine, are required to numb the gums and ensure comfort during the procedure. Studies show that lidocaine is safe for use during pregnancy and does not increase the risk of adverse outcomes like miscarriage or low birth weight.
While routine dental X-rays are generally avoided, necessary diagnostic X-rays are safe when proper shielding is used. The patient is protected with a lead apron placed over the abdomen, which minimizes radiation exposure. The dentist or hygienist will also adjust the patient’s position in the dental chair, especially during the second and third trimesters.
Lying flat on the back can compress the vena cava, a major blood vessel, leading to lightheadedness and a drop in blood pressure. To prevent this, the patient is typically seated in a semi-reclined position or tilted slightly to the left side. These procedural adjustments prioritize maternal comfort and safety throughout the treatment.
Optimal Timing During Pregnancy
While dental care is safe at any point, the timing of a deep cleaning is optimized based on fetal development and maternal comfort. The first trimester is often reserved for emergency procedures only, as it is the period of organ formation, and many women experience significant nausea. Elective or non-urgent treatments are typically postponed during this initial stage.
The second trimester, spanning from roughly week 13 to week 27, is widely considered the ideal window for non-emergency procedures like SRP. The fetus is more developed and stable, and the pregnant person is generally more comfortable and past the intense morning sickness phase. Treatment resolves the infection efficiently before delivery.
Procedures in the third trimester are safe but can be physically challenging due to the size of the abdomen and difficulty remaining seated. If the infection is not urgent, the procedure may be delayed until after birth. If the gum disease is active and severe, treatment should proceed without delay.
The Connection Between Gum Disease and Pregnancy Outcomes
The decision to undergo a deep cleaning is often justified by the potential risks of leaving the infection untreated. Active periodontal disease is a chronic infection that causes systemic inflammation. This inflammation is a concern because it is thought to contribute to adverse pregnancy outcomes.
Studies show a correlation between untreated periodontitis and an increased risk of preterm birth, which is delivery before 37 weeks of gestation, and low birth weight. The pathogenic bacteria from the infected gums can potentially enter the bloodstream and spread to the feto-placental unit, leading to inflammation and injury.
Treating the gum infection helps reduce systemic inflammation, benefiting the mother’s health. Although anti-infective therapy has not been definitively proven to alter pregnancy outcomes, eliminating active infection is a widely accepted goal of prenatal care. Consultation between the dentist and the obstetrician is important to ensure a coordinated and safe approach to treatment.