pregnant and tooth abcess - Mothering Forums
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#1 of 9 Old 09-06-2006, 09:44 PM - Thread Starter
 
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WELL, just came back from my dentist and he confirmed that I have a tooth abcess and need a root canal - which TOTALLY freaks me out

I am about 5 months pregnant. Has anyone been through this before? Did it go well?? (Don't tell me your horror stories, please - I am freaked out enough!) What kind of meds did you take?

Thanks!
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#2 of 9 Old 09-07-2006, 12:37 PM
 
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During my last pregnancy, I had a horrible toothache... it wasn't abscessed but did need to be drilled out and filled... I was told by my OB that once I made it past 4 1/2 mos. I could have any dental work necessary. I wouldn't go overboard though... if your tooth is hurting really bad go get it taken care of, but I would hold off on any additional work if possible. How did the Dentist determine you needed a root canal? Did he do x-rays? That's the only way to tell for sure. Besides, they aren't supposed to work on a tooth until the infection is gone. Unfortunately, if you're going to have problems with teeth, pregnancy is the prime time it pops up. If you have any x-rays done, make sure the dentist covers your abdomen!!
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#3 of 9 Old 09-07-2006, 04:11 PM
 
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Hi,

Sorry about your tooth. I know first hand how miserable this can be. I had a partial root canal when I was nine months pregnant with my daughter in 2001. I was given an anesthetic and an xray, and everything came out fine. I was so relieved I wanted to kiss the dentist. I had the job finished after I delivered.

Chances are, at 5 months pg, you are out of the period were it would be dangerous for your baby.

Good luck!!

Lisa
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#4 of 9 Old 09-07-2006, 06:19 PM
 
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I just had one done last week at 13 wks and did tons of research. Everything went fine. Will be back to post more details later.
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#5 of 9 Old 09-09-2006, 03:33 AM
 
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Ack! I forgot to come back and post! So sorry! :

So did you have xrays? They are pretty important in determining the extent of your problem - you don't want to get 1/2 the problem fixed now and have to go back and get it all done again next year. If you haven't had them done yet, try to find someone who can do digital xrays and double or even triple up on the lead bibs. You want them covering your belly and your neck (to protect your thyroid). Also check out www.iaomt.org to see if there is a holistic dentist in your area. DO NOT, I repeat DO NOT get your tooth filled with the silver-colored amalgam filling. It contains over 50% mercury in a form that is especially harmful to developing fetuses. See below for alternate recommendations.

Since it's late, I'm going to c&p what I sent to another Mama in the same situation. Sorry for the funky formatting, it was from an email. I hope this helps and feel free to PM me for more info.


When I went it, my X-rays revealed that yes I needed a RC but that
it hadn't abscessed yet. That's when the infection goes down the
little tunnel in your tooth root (aka the root canal itself) and the
pus/funk leaks out the bottom and goes into your jaw. That's bad in
pregnancy because that means the infection in entering your bloodstream
and going to the babe. If you do have an abscess you will need antibiotics,
and I'm sorry but I don't know too much about that, but do do some
research because I think I read somewhere that certain ones can mess
with baby's teeth in utero.

I did a ton of research on the Dental forum, PubMed and the internet in
general. Here's the protocol I came up with for myself:

- Local anesthesia was a 4mg dose of Citanest Plain (generic: prilocaine)
placed with no topical. I chose Citanest Plain because it contains no
epinephrine (adrenaline - can make baby's heart race) and no methylparaben
(because I am a freak about chemicals, feel free to ask me more about it).
Citanest Forte does have epi so make sure you specify which type. Instead
of using a topical anesthetic (which contains epi/adrenaline) for inserting
the needle, they had this vibrating thing - almost like a tattoo gun - and
he wiggled my cheek around a lot. It hardly hurt. They say that without
the epi, the numbness doesn't last as long, but for me it was full 2 hours
before I got feeling back. Make sure that they aspirate the needle first
(pull back on the plunger to see if they draw blood - means it is in a vein)
because you don't that in your veins and traveling to baby. [Citanest Plain
is FDA Class B for pregnancy - same as Tylenol. Next best choice would be
something like carbocaine w/out epi but that is Class C.]

- For the crown build-up (what they fill the hole with before capping the
tooth), I requested a composite called Diamond Lite because it has no
bisphenol-A which is a hormone disrupter. Here's a good thread with other
brands and more info:
http://www.mothering.com/discussions...d.php?t=498160. I originally
asked if they could special order it for me, but this dentist happened to
have it on hand. I guess he doesn't usually the DL for this procedure but
he said he liked the results. Whatever you do, do not under any
circumstances get your tooth filled with the silver colored amalgam filling.
It contains over 50% mercury and there have been several studies done that
show the type of mercury in amalgam fillings is especially harmful to the
fetus. If you already have amalgams in your mouth (I have 5 big ones), make
sure that they don't mess with them at all - don't even get them polished or
scraped at a cleaning while pregnant. If the tooth in question already has
an amalgam filling in it, write me back and we can go from there.

- Per my midwife, I took 3000mg of vitamin C the day of and will continue to
take 1000mg a day for the week after. Some say that vit C helps your body
process the chemicals and the mw said it wouldn't hurt. She did say not to
take all 3k mg at once because it is hard on your stomach and to remember
that it is completely water soluble, so you pee it right out. I took 500mg
about and hour before the appt, 1000mg right after, another 500mg when the
anesthesia wore off and the final 1000mg at bedtime (because I knew I
wouldn't be up to pee for several hours. I did throw up the morning after, maybe
from the vit C, so I might have to reconsider the 1000mg bedtime dose. I'll
keep you posted. [I continued taking it at bedtime and didn't puke again, must have been my body processing the anesthetic or something.]



Let us know how everything goes!
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#6 of 9 Old 09-09-2006, 03:39 AM
 
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Oh, forgot to mention that everything went fine. It hardly hurt and the dentist even told me that I "wasn't being a pain in the ass" with all my questions. It was a little sore for 2 or 3 days after but I just made sure not to chew on that side of my mouth, and now a week later I am pretty much back to normal (but still being gentle because I have a temporary crown until next week). Never needed Tylenol or anything.

However, if you do want some Tylenol, my mw recommended to either make the decision to take it or not and then do it. Aka, don't wait until the pain is unbearable b/c then the Tylenol won't be enough. If the anesthesia starts to wear off and the pain is escalating, go for the Tylenol and keep on it every 4-6 hours - whatever the label says. Not a doctor here of course, just repeating what I was told. With the Citanest, there is a small chance of some weird heart thing happening when you mix it with acetaminophen, but that is usually only with pre-existing conditions and higher doses of Citanest. Do a google search for the Citanest patient info insert for the actual details.
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#7 of 9 Old 09-09-2006, 12:12 PM - Thread Starter
 
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Thanks to all for replying! I am glad to hear some good outcomes

And paisley - thanks for all the great info!

Here is the history - I have had alot of problems with this tooth (years of problems!) and have been too chicken to get all the work done on it - mostly because I was scared, but also because I was always either pregnant or breastfeeding and didn't want the work done without meds! The tooth had cracked long ago, at the time I got a temp white filling to replace the broken part - but the dentist who did it did a crappy job, it hurt like crazy, so I got a new dentist and he eventually put a crown on it last year. The tooth was still really sensitive to hot/cold, but I kept saying no to a RC..... Then in the middle of Monday night, I woke up to intense pain in this tooth - never before have I had this much pain with a tooth. The pain will subside with tylenol, but it *always* comes back, and got so bad I could not bite down at all - so I went back to my dentist. He did not take an x-ray because he is certain it is abcessed (considering how much pain I was in, the fact it has not ever hurt like this before, it is very sensitive to pressure meaning that inside the tooth is inflamed/swollen and likely infected or in the process of getting infected). So he is sending me to a specialist who will want to take their own x-rays. Since the tooth already has a crown on it, they just need to drill through the crown to do the RC - which to me, sounds pretty nasty! (But according to my dentist, is simpler than having to do the crown as well.) I am on antibiotics right now - penicillin which is safe for the baby - there is NO WAY I am going to say no to modern medicine right now and risk a worse infection or an infection in my baby.... Tylenol is helping me deal with the pain. AND now I am just waiting to hear from the specialist who will try to get me in ASAP.... My doctor (specializes in maternity cases) also said I could take an anti-anxiety med (Atavan) for the procedure!!!!! (I am very scared of these procedures....)

What I can't believe is how much energy this is taking from me. I am so tired all of the time - way more tired than from the pregnancy - I literally have to sit/lie down multiple times a day. It must be the infection zapping me - I wasn't like this before Monday.....

Anyways, thanks for all the info. Hopefully the penicillin will make the tooth less achy and I will get in sooner than later to get the procedure done. I am not good at waiting....
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#8 of 9 Old 09-09-2006, 05:16 PM
 
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I have to ask.

At 4.5 months I had a very old filling partially fall out. The dentist drilled out the rest of the almalgam filling and replaced it with the same. The anesthetic did not contain epinephrine but I did get a topical first.

So, now I want to know the problems associated with the almalgam filling.
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#9 of 9 Old 09-09-2006, 10:00 PM
 
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I have never done a root canal, as research I did indicated they harbour bacteria which can be bloodborne in low levels anyhow.
I always opted to have the toothe entirely removed.
Infection source totally gone with no chance of future infection.

YMMV
Goodluck!

I have had dental work done many times pregnant with no trouble.
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