In addition, because Bilan contains 1/100,000 of epinephrine, it is “used with caution for patients with hypertension, cardiovascular disease and diabetes”; because articaine is mainly metabolized by the liver, “for patients with severe liver insufficiency” Use with caution”; at the same time, it should be used with caution in patients who are highly suspected of being allergic to articaine or other ingredients in Bilan.
The above-mentioned “use with caution” includes in clinical operation:
(1) Do a blood check during injection to prevent the drug from being injected directly into the blood vessel;
(2) Use low-dose drugs to test allergy;
(3) Control the speed of drug delivery;
(4) Control the dosage.
If the pregnant woman is also a hypertensive patient or a highly sensitive group, be more cautious, including the use of supplementary or alternative methods in the clinic:
(1) Apply topical anesthetic first and then inject;
(2) When necessary, use the technique of root membrane injection to reduce the dosage;
(3) In the endodontic treatment, assisted intramedullary injection technology to reduce the circulation of anesthetics and so on.
In addition, many dental treatments do not require the use of local anesthetics, such as shallow caries, middle caries, occlusal trauma, most chronic apical periodontitis and chronic periodontitis, treatment of periapical abscesses, etc.
I don’t know if I say this will eliminate the fear of pregnant mothers about treating teeth during pregnancy and using a small amount of local anesthetics when necessary.
So, what is “when necessary”? The aesthetic restoration of teeth is certainly not called “when necessary.”
“When necessary” usually refers to tooth pain, including cold and heat stimulation pain, spontaneous dull pain, bite pain, swelling and pain around the tooth, these symptoms usually represent the presence of chronic inflammation of the dental pulp, periodontal and periapical period.
Once these symptoms appear, they usually last for a long time. Such long-term chronic adverse stimuli may harm the body and mind of the fetus and pregnant women. If a localized pulpitis is not treated in time and spreads to apical periodontitis, or even causes interstitial infection, it will become a longer and stronger adverse stimulus. At this time, it will be more difficult to control the infection through treatment and the medication will be more complicated.
It is common sense to prevent diseases and treat diseases early, and everyone is no exception. Pregnant women have toothaches, doctors declined and pregnant women delay is not a good way, the best way is to understand the disease, understand the pharmacology, and ensure safety, use skilled techniques to relieve the pain of the pregnant woman as soon as possible, and stop the unhealthy irritation that is occurring.
Stomatology is divided into multiple specialties, and there is a big difference between different specialties. If a dentist does not have the ability to quickly solve the pain of pregnant women and refuses it tactfully, it is also a responsible attitude to transfer it to other doctors. It is unnecessary if you have the ability to solve the problem and reject it. If doctors can provide treatment and pregnant women have a lot of worries, it is even more undesirable to drag small problems into big problems. I hope you don’t worry too much when you encounter this kind of problems, and look for doctors with professional matching skills, especially doctors who are experienced in endodontic treatment, to solve these problems with a shorter treatment course and a more reliable effect. Look at the picture below, our strict equipment management, standardized operation and one-time root canal treatment under the microscope.
Let’s talk about the risks of filming. The radiation dose of dental film is very low. The cumulative amount of radiation from filming 10,000 dental films is equivalent to the background radiation that people receive in nature in one year (2-4 millisieverts per capita in China). Many countries do not protect against dental filming. Their dental film machine is hung on the wall of the consulting room and is ready for use. Doctors and patients do not avoid it, including pregnant patients.
The relevant guidelines issued by the American Association of Obstetricians and Gynecologists (ACOG) in 2017 pointed out that the impact and risk of X-ray radiation on the fetus mainly depend on two factors: gestational age and radiation dose. That is, different gestational ages will correspond to different radiation safety doses. So, what is this safe dose? The data is clear:
(1) 0-2 weeks of pregnancy, the teratogenic dose threshold is: 50-100mSV (millisieverts), the main impact is fetal death;
(2) 2-8 weeks of pregnancy, the teratogenic dose threshold is: 200mSV (millisievert), the main effect is congenital malformations;
(3) 8-15 weeks of gestation, the teratogenic dose threshold is: 60-310mSV (millisievert), the main impact is intelligence and deformity;
(4) 16-25 weeks of gestation, the teratogenic dose threshold is 250-280mSV (millisievert), the main impact is intelligence.
So, as you can see, in all gestational ages, the minimum injury dose threshold is: 50mSV (millisievert).
The radiation dose of a dental film is 0.1-0.3uSV (microsieverts), and the conversion method of millisievert and microsieverts is 1mSV=1000uSV, that is to say, it is possible to take a total of about 200,000 dental films. Harm to the fetus
If the pregnant mother is still not at ease, there is no problem, most experienced doctors will relieve the pain without the help of dental films. If necessary, the baby will be rechecked and treated again if necessary.
For women during this pregnancy, they are very sensitive to various external conditions and the surrounding environment. Therefore, Director Bai Lian of our hospital created a music consultation room based on the characteristics of pregnant women, so that pregnant mothers can receive treatment while relaxing in the consultation room. Minimize the tension of expectant mothers.
Toothache during pregnancy and lactation
