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Molly Maloof, MD

Director of Clinical Content

hi! So about 2 months ago I found out I had an abscessed tooth, but now I am 8 months pregnant and I am worried the infection will spread! What can a doctor do with a woman this far along in pregnancy with this problem??

8 months pregnant, no pain (anymore) the tooth is just tender
  • Ethnicity: African American/Black
  • Height: 5 foot 4
  • Weight: 168lbs
  • Conditions: had a root canal on this tooth before

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Featured Answer

2 UpVoted this answer
The third trimester is the safest because the baby is for the most part fully formed, just gaining wait and getting ready for the big day. Most gynecologist i have asked have no problem with local anesthetic (lidocaine) and amoxicillin, but always check.
1 UpVoted this answer David J. Darab, DDS, MS Oral and Maxillofacial Surgeon, Hickory
You should see your dentist as soon as possible for an evaluation. There could be a lingering dental infection present that can be easily and safely eradicated. Some simple tips to keep you at ease:

Lidocaine is the most commonly used anesthetic drug used for dental work. Lidocaine will cross the placenta after administration. If dental work is needed the amount of anesthesia given should be as little as needed, but still enough to make you comfortable during your dental work. Request additional anesthetic if you are still experiencing pain. When mom is comfortable, the amount of stress you and the baby will feel will be reduced.

Preventing or removing dental infection often involves the use of antibiotics. Antibiotics such as penicillin, amoxicillin, and clindamycin, which are labeled safe in pregnancy, may be prescribed after your procedure with no worries about the health of your baby.

-Dental x-rays should be avoided whenever possible during pregnancy. If X-rays are needed (such as during a dental emergency), your dentist will use extreme caution to protect you and your baby. Advances in technology have made X-rays much safer today than in the past. The American College of Radiology studies have shown no single diagnostic x-ray has a radiation dose significant enough to cause adverse effects in a developing embryo or fetus.

-Preventive dental cleanings and regular dental exams during pregnancy are not only completely safe, but are highly recommended by both dentists and physicians alike. Pregnancy causes hormonal changes to a woman’s body. This increase in hormones causes the gums to bleed easily, become inflamed, and trap food causing increased irritation to your gingival tissue.

It is believed that periodontal disease may lead to premature birth by the spread of oral bacteria to the placenta or amniotic fluid. Systemic inflammation caused by periodontitis may also lead to preterm labor and membrane rupture. The probable culprit is a chemical called prostaglandin, released into the bloodstream during inflammation, which can induce labor. Prostaglandin is released in very high levels in severe cases of periodontal disease.

Almost one half of women experience pregnancy gingivitis, starting in the 2nd or 3rd month of pregnancy. It generally increases in severity all the way through to the eighth month. Pregnancy gingivitisThis pregnancy gingivitis can be very uncomfortable and cause inflammation, bleeding, redness or tenderness in the gums. If you already have poor oral hygiene and gum disease before pregnancy begins, expect an extreme progression in your periodontal condition as you end your first trimester and onward.
1 UpVoted this answer
If its very swollen it can be, numbed with local anesthetic, lanced and drained, then placed on antibiotics to prevent the spread of infection, then treated with a root canal or extraction after childbirth.

If it's just tender...Antibiotics now, and treatment with root canal or extraction after childbirth. Dr. G
Kenneth Garner
1 UpVoted this answer
You should see an Endodontist to evaluate the tooth and determine if it is better to clean the root canal. Most likely the reason the tooth does not hurt any more is because the infection has been able to drain through a fistula. A fistula is a small opening on the gum area on the side of the (root area) tooth. Usually appears like a small papule that will burst once fluid accumulates which is pus from the site of the infection traveling from the root affected. If this pus couldn't drain you will be in a lot of pain.
Alejandro Peregrina
1 UpVoted this answer
You say that you "found out" that you have an abscessed tooth. Can I assume you had and examination and diagnosis by a qualified clinician? If so,the treatment will depend upon the severity of the abscess and the long term prognosis for the tooth if treated endodontically. Since you are not in acute pain, but still tender, I would still want to control the infection if not for you personally, the 8 month old fetus developing. You are likely exposing your unborn child to the same infection. Consult with your OB/GYN about appropriate antibiotic therapy. If the tooth is restorable and can be saved, temporary measures to remove the infected pulp can be accomplished with electronic apex location (without a radiograph if that concerns you) and appropriate medications to control the infection and discomfort can be safely administered until your child is born. When and if you life calms down after the baby is born you can pursue the final endodontic treatment and restoration of the tooth.

Don't suffer unnecessarily and don't expose your child to unnecessary stress and infection.

This is a manageable situation. Good luck.
John W. Vollenweider
1 UpVoted this answer
Great question! I wish there were a simple, straightforward answer. To treat your abscessed tooth you either have to extract the tooth (not a good option obviously) or do a root canal. To do a root canal (or extraction) requires anesthetic, pain medication and antibiotics. I would suggest you check with your OB to find out if it is preferred that these medications be taken while you are pregnant or while you are a new mother and probably breast feeding. You have to also consider time/hassle doing dental work that will require multiple visits to the dental office while you are eight months pregnant or while you are a new mother caring for an infant. X-ray exposure is another consideration. X-rays will have to be taken while doing a root canal. This is minimal risk to the baby as you are in your third trimester and radiation from modern dental radiographs is minimal but your doctor will not perform root canal therapy without written release from your OB. You must also consider the possibility of a "flare up" from the tooth. A tooth with an abscess can become uncontrollably painful at any time which would force you into treatment at what could be the most inopportune time.

I warned you that the answer is not a simple one as there are many factors that have to be considered. If you were my wife, I would recommend you have the root canal done ASAP as I'm far more concerned with the tooth flaring up and infection polluting your (and your baby's) blood stream 24/7.

Good luck...with the tooth AND the baby (and congratulations!)
Bradford J. Lockhart
1 UpVoted this answer
At 8 months the baby is mainly just adding weight and most Ob/Gyns say this is a safe time for dental treatment. Of course check with your physician. You can have a root canal to save the tooth and yes the infection can spread if you do not get treatment.
Garry Phillips
As I understand, you learned of the infection while 6 months pregnant. I would suggest you revisit the last dentist who saw you and has x-rays on file. If you have an active infection, it is best to treat is rather than let it linger. In short, treating and getting rid of the infection is the safest route. It is always best to inform your ob/gyn as well so that doctor can coordinate with your dentist as to the best precautions. Regardless, I suggest you get your teeth cleaned every 3 months while pregnant. Also, if you are worried about x-rays, simply ask your dentist to use 2 aprons and request digital x-rays. Digital x-rays can reduce your exposure to about 1/3 the radiation. Congrats on the newcomer and hope that helps.
The tooth should be examined and reevaluated with x-ray, probing. Perhaps, an opinion from an endodontist. Depending on its anatomical location with respect to the potential spread of the infection,the area and size of the abscess, the condition of the abscess and the patient's physical and mental health, allergy, a treatment plan can be decided with options as to whether leave as is for 4 more weeks or have a root canal retreatment or extract the tooth if absolutely necessary.
You have had a root canal in this tooth and it had abscessed again. However there is no pain. Have you noticed a bump and discharge from the gums? I would advise that you see your dentist and evaluate if the tooth has to be extracted or retreated. You may be able to be treated with antibiotics until after your delivery.
Brian Stoute