Dental implantation during pregnancy: is it worth the risk?

Why you should postpone implantation during pregnancy

Most experts rightly believe that during pregnancy, dental implantation should be delayed. Especially if there are no urgent medical indications for this. Here are several arguments in favor of this decision:

• Implantation is stressful
  . This is a surgical procedure that requires pain relief (anesthesia). At first glance, this may seem like a minor intervention, but it is not, especially for a pregnant woman. It is worth considering postoperative complications (for example, swelling) and limitations. Among the latter are some dietary restrictions, which are undesirable for pregnant women.
• The effect of x-rays
  . Before implantation, radiographic examinations (for example, panoramic X-ray) must be performed. These are additional doses of radiation that are undesirable during pregnancy.
• Medications
  . Dental implantation during pregnancy also means an additional drug load on the body. In particular, this is the administration of anesthetics, and after surgery - the use of antibiotics and painkillers. During pregnancy, such medications are prescribed only in extreme cases.
• Calcium and other elements
  . A pregnant woman spends significant resources of her body on the development of the fetus. In this sense, dental implantation in such a situation may turn out to be of poor quality, because calcium and other microelements are also necessary for successful implantation.

Considering the difficulties that sometimes arise, most doctors are inclined to believe that implantation and pregnancy are incompatible. Therefore, if you are in the process of installing dental implants (and this takes up to 6 months), then it is better to hold off on plans to conceive a child.

Is it possible to carry out implantation at the stage of pregnancy planning?

Dental implantation and conscious pregnancy planning are two mutually exclusive concepts. Especially if a woman is preparing for IVF. This procedure requires complete calm and maintaining the body’s immune forces at a high level.

It’s another matter if you are wondering when you can get pregnant after implantation. You can do this after a few months:

• If implantation was carried out with immediate loading, then it is advisable to wait six months until the implants are guaranteed to take root. After this time, it will be possible to carry out re-prosthetics, but pregnancy will not affect this process in any way - it is completely painless and non-traumatic,
• if implantation was carried out with delayed loading, then the minimum period is 2 months. But here you need to understand that after the implant takes root, you will need to install a permanent prosthesis, and to do this, cut the gum, remove the plug and fix the abutment. This should not be done during pregnancy. Therefore, if pregnancy has occurred, you will have to wait with prosthetics. Or immediately postpone the date until you receive a prosthesis.

How long can it be safe to place an implant?

If you have already decided to install implants, then you need to understand that dental implantation during pregnancy is optimal at 12-29 weeks of gestation. During this period, all organs and systems of the fetus are already formed, so the likelihood of complications is minimized.

Important!

It is strictly forbidden to place an implant in the early stages of pregnancy. During this period, all the tissues and organs of the baby are formed. It is important that this process proceeds correctly, without unnecessary stress on the mother’s body.

It should be taken into account that dental implantation for pregnant women is not carried out in all cases. In this situation, a woman must visit the dentist. The decision about implantation is made by doctors based on the current state of health. In most cases, they prefer to postpone implantation or replace it with other types of tooth restoration.

How long after giving birth can an implant be placed?

Turnkey implant installation includes preparatory work, system selection, surgery and rehabilitation period. Young mothers' bodies are weakened after childbirth. It will take at least 12 months for him to fully recover. Therefore, during this period there is no need to expose him to unnecessary stress.

1. An important contraindication to the installation of a pin is the lactation period, when the baby is fed with mother's milk.
2. When breastfeeding, medications are contraindicated for women.
3. Pain and stress are common reasons for stopping breast milk production.
4. The baby needs to be given close attention. Therefore, the parent will not be able to regularly visit the dentist.

When a baby is fed formula, implantation can begin earlier. In any case, you should consult with an orthopedist about starting to restore your dentition. He will suggest the best treatment option for the postpartum period.

What should pregnant women do if a tooth is missing?

If during pregnancy a problem arose in the dentition (or you did not have time to solve it after becoming pregnant), then the algorithm of actions is as follows:

• Do not panic.
  Remember that dental problems are temporary. After pregnancy, you will be able to eliminate all defects. And unnecessary worries in such a situation are completely undesirable. In addition, dentists can offer you dental prosthetics during pregnancy and a number of other alternative methods that have no absolute or temporary contraindications.
• Get tested
  . After conceiving a child, your obstetrician-gynecologist is responsible for your health. It is this doctor who decides on the advisability of certain medical interventions during pregnancy. Therefore, after visiting the dentist, you should consult your gynecologist, who will give his opinion regarding dental implantation.
• Choose a competent dentist
  . At the Center of Israeli Dentistry, doctors have extensive experience working with pregnant women. It is important to contact a specialist who understands all the nuances of women’s health in this situation.

Pregnancy became known when the abutment or prosthesis remained to be installed

In the case of fixing the prosthesis, you should not have any worries. This is the final and most enjoyable stage of implantation. This means that the fusion of the implant with the bone tissue was successful. Prosthetics do not require medications or anesthesia, because It is completely painless and does not require surgical intervention. But the abutment and gum former require a tissue incision, so you still have to wait either until the end of pregnancy, or at least until the second trimester, which is considered safer in terms of external interventions.

Author: Dzhutova A. V. (Thank you for your help in writing the article and the information provided)

Alternative to implantation during pregnancy

If the issue of restoring a lost tooth (or teeth) is urgent, then dentists can offer pregnant women a number of alternatives. In particular, these are:

• removable dentures;
• fixed dentures.

This can be either a temporary or permanent solution to an existing problem. In this case, everything depends on the defect itself, medical indications and patient preferences. It is noteworthy that if the tooth root is preserved, then crowns can be placed on special (stump) inlays.

How to plan pregnancy and combine it with implantological treatment?

This question is often heard from patients during consultations.

Typically, implant treatment is very extended and consists of several stages.

The first stage is the implantation operation. We dealt with it above and determined that during pregnancy it is undesirable (with rare, rare exceptions) due to the necessary drug therapy in the postoperative period.

The second stage is the formation of gums. It is often combined with the first stage, implantation surgery (as in the case described at the beginning of the article). This is a simple procedure within the mucous membrane; it does not require subsequent antibiotic therapy.

The third stage is prosthetics. The orthopedic doctor removes the former, fixes the transfer instead, takes impressions, selects and tries on the abutment, fixes and adjusts the crown. These stages are more like assembling a construction set than a treatment, and therefore do not even require anesthesia.

Therefore, the only obstacle to pregnancy is implantation surgery. Because of the drugs. All other stages of drug therapy do not require, so they can be carried out during pregnancy.

Therefore, when it comes to planning a pregnancy, I recommend that my patients go through implantation before it, and all other stages during or after. Well... what else to do on maternity leave, if not teeth?)))

When can you get pregnant after implantation surgery?

Yes, they ask that too. Let me remind you that there is an obstacle – drug therapy. We proceed from this.

Why do you think antibiotics are prescribed, for example, twice a day? Because their concentration in the blood drops below a certain level after 12 hours and must be maintained. Consequently, after 24-36 hours only traces of medications remain in the body, and after 2-3 days there are none left at all.

Antibiotics are not salts of heavy metals; they do not accumulate in the body; they disintegrate and are eliminated quite quickly. Therefore, as soon as they hatch, you can safely engage in sex..., ahem, get pregnant, in general))).

As I already wrote, the remaining stages of treatment no longer require drug therapy.

Summary: it is better to undergo implantation surgery before pregnancy (a few days in advance), the remaining stages - during or after, since they do not require drug therapy.

Dental implantation during breastfeeding

The issue of dental implantation during breastfeeding is more complex and complex. The fact is that if a woman has lost a tooth during pregnancy, then postponing implantation for several months is not a problem. But if you delay this issue (for a year or more), then the risk of atrophic changes in the jaw bone increases. This is due to the lack of proper load on the area where the tooth previously was.

In this regard, the decision about implantation during breastfeeding is decided together with doctors. If anesthesia drugs are eliminated from the body quickly (which will not have a significant impact on the quality of feeding), then with antibiotics things are more complicated.

In most cases, as in the situation with pregnancy, during breastfeeding doctors also prefer alternative options - crowns, bridges, etc.

What to do if pregnancy occurs before the surgical stage

Is it possible to have dental implants during an unplanned pregnancy? When pregnancy has become a pleasant surprise for you, and you have already set a date with your doctor and have gone through the preparatory period, you need to postpone the process of installing the implant until you give birth and stop breastfeeding your baby.

Why is it important? In the first trimester of pregnancy, the vital organs of the baby are formed, and the woman has a very high risk of miscarriage. These two factors should be decisive for you if you do not want problems and complications.

What to do if pregnancy becomes known during the implantation process?

It also happens that pregnancy occurs during the implantation procedure (which often takes several months). Let us immediately note that there is nothing catastrophic in this. In this case, it is important to adhere to the following recommendations:

• Keep calm.
  There is absolutely no need for unnecessary worries. If conception occurred after the installation of implants, then this indicates that the processes of osseointegration (engraftment of the implant into bone tissue) are already in full swing.
• Notify doctors.
  Tell your dentist about your pregnancy, and tell your gynecologist about implants. Doctors will take current circumstances into account.
• Take vitamins and minerals
  . Most likely, the doctor will prescribe vitamin and mineral complexes. In particular, these are preparations with calcium, fluorine, phosphorus and other elements. This is necessary for the harmonious development of the fetus during implantation.
• Practice good oral hygiene
  . Maintain good oral hygiene. During this period, infectious and inflammatory diseases (for example, gingivitis, periodontitis and others) are especially dangerous, because they will require taking antibiotics and other drugs that are undesirable during pregnancy.

What risk factors prevent implantation during pregnancy?

Pregnancy is a period of hormonal changes, when the mineralization and strength of enamel is disrupted and immunity decreases. The mother’s body practically gives everything to the future baby, who “takes” useful elements from the woman’s teeth, bone and muscle tissue. Due to hormonal imbalance in a pregnant woman, the structure of the gums changes, the mucous membrane becomes loose, the risk of getting gingivitis and any infectious disease increases, the protective functions of saliva worsen and its pH changes. Any wounds in a woman’s body during this period heal very poorly, which can ultimately lead to peri-implantitis, rejection of the structure, and difficulties and risks during the rehabilitation period.

Why else do specialists refuse implantation for pregnant women:

• it is necessary to undergo an x-ray: the radiation dose of modern tomographs and radiovisiographs is minimal, and there is also no information that x-rays have a negative effect on the fetus. However, experts insist that taking pictures of pregnant women is only possible when the potential benefit is many times greater than the possible risk. In addition, you will have to undergo radiography not once, but at least three times,
• the need to undergo additional manipulations: for example, implantation cannot be carried out without prior sanitation of the oral cavity. Those. it is necessary to cure all dental problems, remove decayed teeth, if any. Perhaps the patient has bone tissue atrophy and cannot do without its augmentation. And if it is not advisable to carry out dental treatment during pregnancy, it is allowed in the second trimester, then surgery to build bone, removal is contraindicated due to the traumatic nature, difficult rehabilitation,
• getting into a stressful situation: any person is worried, even if he understands that the procedure will be completely painless and successful. But dental implantation during pregnancy is double stress for a woman, there is no doubt about it,

When there is excitement in the body, cortisol is produced in increased quantities, and scientists have proven that the hormone also negatively affects the fetus. Babies whose mothers were nervous had an increased risk of developing diabetes and cardiovascular pathologies. Women themselves, due to the production of the hormone, risk increasing toxicosis, uterine tone, and increase the risk of miscarriage in the early stages and premature birth in the later stages.

• pain reactions: firstly, during pregnancy the pain threshold decreases, i.e. even the slightest intervention causes very severe pain, plus the woman may not be affected by anesthesia, which in itself is harmful, penetrates the placental barrier and leads to the development of abnormalities in the fetus. Secondly, without anesthetics it is impossible to carry out dental implantation and calmly go through the rehabilitation period. Thirdly, the feeling of pain again causes increased activation of adrenaline in the blood, which leads to uterine tone,
• lack of calcium in the body: it would seem that this factor only harms the baby. But in fact, it also affects the quality of implant healing and its fusion with the jaw bone tissue. If there is a lack of an element, and successful osseointegration requires a lot of it, the implant may simply not take root and will be rejected,
• risk of infection: implantation involves inserting an implant either through a puncture, through surgical guides, or through incisions. Even with the most minimally invasive intervention, a wound is formed that requires time to heal. And given that in pregnant women it will take a long time to heal, it cannot be ruled out that bacteria will penetrate there, especially against the background of weakened immunity,
• taking antibiotics and medications: often during the rehabilitation period, doctors prescribe various drugs to patients to maintain immunity for rapid recovery, healing of wounds and relieving the inflammatory process. Antibiotic therapy is contraindicated for pregnant women.

FAQ

How long after giving birth can an implant be placed?

It is important to take into account several factors here: normalization of hormonal levels, normalization of the cycle, as well as breastfeeding. In most cases, implantation is carried out 1.5-2 years after birth.

Is it possible to get crowns while breastfeeding?

It is possible, but only after consultation with doctors. In this case, the effect of drugs (in particular, antibiotics) that can be used in dental practice is taken into account.

How does pregnancy affect installed implants?

Just as implantation negatively affects pregnancy, and vice versa. During gestation, the main part of nutrients and minerals goes to maintaining the woman’s vital organs and systems, as well as the formation of the fetus. In this case, osseointegration of the artificial root (implant) is considered by the body as a secondary phenomenon. Therefore, the quality of implantation may be low.

Is it possible to get pregnant after dental implantation?

Yes. In most cases, women of childbearing age who are planning a child are advised by doctors to postpone conception after having implants installed. You can plan for a child 4-6 months after implantation.

ATTENTION!

This material is not a substitute for medical advice and should not be used for diagnosis or treatment.

Sources:

1. Vt H, TM, TS, Nisha VA, A A. Dental considerations in pregnancy—a critical review on the oral care. J Clin Diagn Res
   . 2013;7(5):948-953. doi:10.7860/JCDR/2013/5405.2986
2. Favero V, Bacci C, Volpato A, Bandiera M, Favero L, Zanette G. Pregnancy and Dentistry: A Literature Review on Risk Management during Dental Surgical Procedures. Dent J (Basel). 2022 Apr 19;9(4):46. doi: 10.3390/dj9040046. PMID: 33921608; PMCID: PMC8072957.
3. Bajkin BV, Wahl MJ, Miller CS. Dental implant surgery and risk of bleeding in patients on antithrombotic medications: A review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol. 2020 Nov;130(5):522-532. doi: 10.1016/j.oooo.2020.07.012. Epub 2022 Jul 25. PMID: 32811791.

Why don't pregnant women get implants?

Despite the relative safety of the procedure, implantation can be dangerous for the unborn baby and mother:

• it is necessary to undergo an orthopantomogram or computed tomography, which means the patient will be exposed to x-rays;
• anesthetics that are not included in the list of approved drugs are used for pain relief;
• the development of inflammatory and allergic reactions is possible;
• the process of osseointegration requires calcium, which the fetus urgently needs;
• low level of immunity, high risk of developing infectious diseases;
• psychological aspect: pain, anxiety, stress.

The greatest sensitivity to pain appears in the first trimester. The pain threshold decreases and the patient may experience shock during the procedure. Also, postoperative pain is difficult to relieve with medication. Due to high levels of stress, miscarriage is possible, and at a later stage, premature birth.

The most common complication during implantation is inflammation of soft and bone tissues. To stop the infection, it is necessary to take antibiotics, which can negatively affect the formation of the fetus.

Since at this time the body experiences a calcium deficiency, the implant healing process may be delayed. In addition, this element is very necessary for the proper formation and growth of the child.

During pregnancy, gums become loose and often inflamed. Gingivitis is also included in the list of contraindications for surgery.

How does the implantation process work?

Dental implant surgery is a surgical procedure. It allows you to replace bone tissue with artificial one and restore the function of the tooth. All questions about treatment, time intervals between operations and other important nuances are decided only by the attending physician. This is especially important during pregnancy.

Let's figure out how implantation occurs and what effect it has on the body of a pregnant woman and the fetus. The operation can be divided into 4 stages:

1. Preparation;
2. Surgical intervention;
3. Microoperation;
4. The final (orthopedic) stage.

Preparatory stage

At this stage, the woman is examined by a therapist and referred for tests. A general visual examination is also carried out, indications and contraindications for the operation are determined.

At the preparatory stage, it is necessary to understand whether the body is ready to install an implant and whether there is bone tissue atrophy. If atrophy is confirmed, then bone tissue is augmented before surgery. It is also necessary to perform sanitation and computed tomography, and conduct preparatory treatment of the oral cavity before surgery.

When restoring the upper row of teeth, a preliminary visit to an otolaryngologist is also mandatory.

Additionally, a pregnant woman needs to visit highly specialized specialists to analyze the condition of the body and fetus, and also if she has specific diseases. But it is best to postpone the procedure until the postpartum period.

Surgical intervention

At this stage, implants are introduced. The operation can last from half an hour to an hour. Its duration depends on the severity of the process and the number of teeth.

Before starting the operation, the doctor must disinfect the oral cavity and administer an anesthetic. At the request of the patient, both local and general anesthesia can be used. Sometimes a combination of the two types is used. Before prosthetics, you must make sure that anesthesia is safe for the fetus!

When using local anesthesia, the operation time is significantly reduced. In addition, it will be easier for the surgeon to do it. The use of drugs for local pain suppression allows the patient to avoid discomfort during surgery.

If a woman is afraid of dental procedures, she is additionally prescribed sedatives to help her calm down and get ready for implantation. The severity of sedation can be mild, moderate or severe.

Full anesthesia “in position” is extremely risky and is used in cases of major operations or the installation of two or more implants. It can be carried out by intravenous administration of the drug or by inhalation.

After all preparatory steps are completed, the surgeon prepares the bone tissue for implantation. He first cuts the gum and separates it from the periosteum, then, using special instruments (dental cutters), widens the incision for further insertion of an artificial root into it. The latter is screwed into the hole.

Before tightly suturing the wound, the doctor installs a temporary crown that will prevent tissue from growing into the inside of the implant.

10 days after the sutures are removed, microsurgery is performed. In its process, the plug is removed and an abutment is installed, the function of which is to connect two parts of the structure: a metal rod and the outer part of the implant - the tooth.

Orthopedic work

At this stage, impressions are taken of the female jaw, after which they are transferred to a specialist in creating prosthetics. The production time for dentures can vary and range from several days to weeks. It depends on the complexity of the work, the number of implants and adjustments to the individual characteristics of the patient’s jaw.

We must not forget that after the operation there is a rehabilitation period, which is about 5 months. It is at this time that the implant will fuse with the bone tissue.

During the rehabilitation period, it is necessary to adhere to a number of rules, carry out regular hygienic cleaning of the oral cavity, use antiseptic rinses and visit the dentist monthly. Solid food should not be consumed. The main task at this time is to monitor the condition of the oral cavity.

It is important to know

It’s good when everything in life is planned and goes according to the approved schedule. However, reality can bring surprises. What to do if pregnancy becomes known during dental implantation?

It all depends on what stage the implantation is at. The easiest option is when pregnancy is discovered during the preparatory stages. In this case, you just need to postpone the operation until after birth.

It is much more difficult if pregnancy becomes known during osseointegration. Is it possible to reduce the negative consequences of implantation for the health of the mother and fetus in this case, and how to do this? Actually, this is a task for doctors (gynecologist and dentist) who treat and observe their patient. However, it is also useful for the expectant mother to know what she should do to reduce the risk.

To combat pain, drugs compatible with pregnancy should be used as analgesics. These are Paracetamol, No-Shpa, Nurofen, Riabal, Ibuprofen, Papaverine.

If engraftment is accompanied by inflammation, and there is a need to take antibiotics, you need to take drugs that have the least negative effect on the body of the mother and fetus.

Tetracycline and Doxycycline are absolutely contraindicated during pregnancy. They easily cross the placenta, accumulate in the teeth and bones of the fetus, and are toxic to the liver . But cephalosporins can be used during pregnancy without significant risks. They penetrate the placenta with difficulty and in low concentrations, and have virtually no negative effect on the fetus.

Stress during pregnancy can be reduced by premedication - measures aimed at reducing anxiety and the secretory function of the glands. The doctor will tell you how to do this, but basically premedication consists of taking tranquilizers and antihistamines.

During pregnancy combined with implantation, increased care for the oral cavity is necessary.

• Brushing your teeth after every meal.
• Rinsing your mouth with special rinses.
• Frequently change toothbrushes.
• Use of pastes rich in fluoride.
• Using flossers.

It is necessary to consume foods rich in calcium, which is required for the implantation of implants and the formation of the fetal skeletal system.

Although discovering a pregnancy during implantation is most often an unpleasant “surprise,” there is also a positive side to it. Pregnancy that occurs during osseointegration indicates that the process of implant healing is successful.