Pregnancy and Orthodontic Treatment

Last updated on December 2, 2021

As adults, many people want to have beautifully aligned teeth. In particular, women in their 20s to 40s have a high demand for beauty, and many of them want orthodontic treatment. One of the concerns is the relationship between pregnancy and orthodontic treatment.

Flow of orthodontic treatment

First, orthodontic treatment basically follows these steps

Excludes cases requiring osteotomy.

(1) Orthodontic consultation on what kind of orthodontic appliances to use and how long the treatment will take

(2) Detailed examination (radiographs, mold taking, etc.)

(3) Pre-treatment before orthodontic treatment

(Tooth extractions for convenience to create space, placement of anchor screws to create a fixation source, and treatment of tooth decay and periodontal disease. Tooth extractions and anchors may be performed during orthodontic treatment.)

4) Orthodontic treatment

(5) Transition to retainer

Problems with orthodontic treatment during pregnancy.

X-ray (photography)

Cephalographs (standardized head X-ray photographs) are often taken for diagnosis prior to orthodontic treatment. Radiation exposure is about 0.03 mSv (millisievert) per exposure. Since the world average for Japanese people is 2.4 mSv per year of natural radiation exposure from cosmic rays and other sources, it is easy to see how low the radiation exposure from X-rays is. In addition, the amount of actual radiation exposure is even lower because the abdomen is covered with a protective apron that contains lead to protect against radiation. Therefore, it is generally safe to take x-rays before orthodontic treatment even if you are pregnant. If you are concerned, it is safer to avoid the morphogenetic period from 9 to 15 weeks, when the baby's organs are being formed.

Convenience extractions and anchor screw placement

Convenience extractions and anchor screw placements are surgical procedures (i.e., they are considered to be open procedures). Therefore, anesthesia is used at the beginning of the procedure. Anesthetics such as those used during childbirth (Xylocaine) are used. Anesthetics are metabolized in the liver and do not cross the placenta, but the stress of pain during anesthesia is still present, so it is advisable to consider your physical condition and consult with your dentist before undergoing anesthesia procedures during pregnancy.

Whenever a surgical procedure is performed, painkillers and antibiotics are prescribed after the procedure. Acetaminophen is often prescribed for pain relief because it is considered relatively safe. A well-known brand name is Koronal. Nonsteroidal anti-inflammatory drugs (NSAIDs), which are often prescribed in dentistry, should not be used in large doses in late pregnancy, as they can cause heart failure and swelling of the fetus. Well-known trade names for NSAIDs are Loxonin and Voltaren.

When undergoing surgical procedures during pregnancy, it is recommended that, if possible, first aid procedures be limited to the early stages of pregnancy, and that procedures be performed only after the pregnancy is stabilized.

Treatment of cavities and periodontal disease prior to orthodontic treatment

Treatment of cavities and periodontal disease prior to orthodontic treatment is essential. If not treated, orthodontic appliances will not fit properly and teeth will not move into their proper positions. In particular, when periodontal disease develops, inflammatory substances can be transmitted to the uterus via the bloodstream, causing uterine contractions. This can cause premature labor and low birth weight. In addition, bacteria associated with periodontal disease can adhere to the placenta, which can lead to infection of the baby with periodontal disease.

Procedures requiring general anesthesia, such as osteotomies

Large surgical procedures such as osteotomies should be avoided during pregnancy.

Concentrate on taking care of cavities and periodontal disease during pregnancy so that you can proceed smoothly to treatment after delivery.

Orthodontic treatment can be continued during pregnancy.

Once orthodontic treatment has begun, orthodontic treatment can be performed as usual, with the exception of the period around childbirth. Orthodontic treatment generally requires visits to the dentist's office about once a month to ensure that the teeth are moving properly, to check for any damage to the appliances, and to receive additional appliances and supportive devices. However, as the last month of pregnancy approaches, visits to the clinic become more difficult. Some clinics may instruct patients to refrain from visiting the clinic for about a month before and after the birth because of the heavy burden on the body. Also, depending on the patient's physical condition, or due to homebirth, there may be a gap of 3 months or more between visits. In such cases, the dentist may decide not to apply force to the teeth during the period when the patient cannot come to the clinic and maintain the teeth in their current state, since there is a possibility that the teeth will not move as planned.

During delivery, patients are asked to remove any prosthetic devices such as mouthpiece orthodontics, while fixed devices such as wire orthodontics can be left in place.

Some people may be concerned about whether it is safe to come to the clinic with a baby after giving birth. Recently, there are dental clinics that state on their websites that it is possible to come to the clinic with a baby, or that have childcare staff on site.

During pregnancy, the amount of estrogen, one of the female hormones, increases. The higher estrogen levels increase the number of periodontal bacteria in the oral cavity, which can lead to swollen, reddish-red gums. Therefore, daily self-care is more necessary than ever. Self-care is easier with prosthetic appliances (removable appliances), but very difficult with fixed orthodontic appliances. If possible, it is a good idea to clean the mouth during visits to the clinic.

summary

Various physical changes occur during pregnancy. If you are planning to have orthodontic treatment during pregnancy, please consult with your dentist carefully before proceeding with the treatment.

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