Preventive dental cleanings and annual exams during pregnancy are not only safe, but are recommended. However, not all types of dental work are approved and some should wait for after the birth.  You may find that you are in pain or have your health threatened by some dental problems.  All issues should be consulted with your dentist and obstetrician to make sure that the baby is not harmed or put at risk.

The rise in hormone levels during pregnancy causes the gums to swell, bleed, and trap food causing increased irritation to your gums.  Preventive dental work is essential to avoid oral infections such as gum disease, which has been linked to preterm birth.

Cavity fillings and crowns are considered dental work that should be treated to reduce the chance of infection.  The second trimester is considered ideal for this work to be done if done during a pregnancy.  Once you reach the third trimester, it may be very difficult to lie on your back for an extended period of time.

If possible, your safest course of action is to postpone all unnecessary dental work until after the birth.  However, emergency dental work such as a root canal or tooth extraction is may be necessary.  In these cases you should make sure your dentist knows that you are pregnant before you schedule the appointment.

Optional or elective treatments, such as teeth whitening and other cosmetic procedures, should be postponed until after the birth.  It is best to avoid exposing the developing baby to any risks, even if they are minimal.  Some of the newer procedures have not been around long enough for all of the implications to be understood.  It is best to not take chances and wait until after the birth of your baby.

You will find that medications are one of the higher risks of dental work during a pregnancy.  Currently, there are conflicting studies about possible adverse effects on the developing baby from medications used during dental work.  Lidocaine is the most commonly used drug for dental work.  Lidocaine does cross the placenta after administration.

If you find that dental work is necessary, the amount of anesthesia administered should be kept to a minimum, but still you need to make sure that you are comfortable.  If you experience pain, then you need to request additional numbing.  The amount of stress on you and the baby needs to be kept at a minimum and this is accomplished by keeping you comfortable.  You don't want to try and do the procedure without anesthesia because it could cause the baby a lot of stress.

Dental work often requires antibiotics to prevent or treat infections. Antibiotics such as penicillin, amoxicillin, and clindamycin, which are labeled category B for safety in pregnancy, may be prescribed after your procedure.

You will want to avoid taking routine x-rays that can be postponed until after the birth. However, X-rays are necessary to perform many dental procedures, especially emergencies.  According to the American College of Radiology, no single diagnostic x-ray has a radiation dose significant enough to cause adverse effects in a developing embryo or fetus.

Additionally, fetal organ development occurs during the first trimester.  You will want to avoid all potential risks at this time if possible.  Also, if you can postpone any non-emergency dental work during the third trimester, it is usually recommended.  This is to avoid the risk of premature labor and prolonged time lying on your back.

In summary, during a pregnancy you will need to continue to work on your oral hygiene and perform most routine maintenance of your teeth.  However, you will want to avoid any cosmetic or unnecessary dental work to avoid risks to the baby.  However, if emergency work is required, then it should be done while keeping stress to a minimum and in consultation with your obstetrician.