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Dentistry/Root canal in the first trimester?

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Question
Hello,

About 4 weeks ago I started having some sensitivity to cold in a back molar that had been previously filled.  I went to the dentist 2.5 weeks ago and he removed and replaced the old filling.  I don't think it was a particularly big filling.  It didn't seem like much drilling.  It was a little sore but generally better for 3-4 days, and then all of a sudden the sensitivity was back, this time with pain radiating to my ear like an earache any time I ate anything crunchy, cold, or hot.  

The dentist prescribed an antibiotic and I'm halfway through the course of it.  The sensitivity is better in that I don't have the pain radiating to my ear, but it is definitely still noticeable.  

Does this sound like I'm going to need a root canal?  I just found out yesterday that I'm pregnant (only 4 weeks) and I am very paranoid about this type of thing during pregnancy.  Last time I didn't take so much as a single Tylenol.  If I do need a root canal, how long can I put it off for?  I honestly don't even want xrays done as the radiation makes me nervous!

Answer
Hi Melissa,

Congratulations on your pregnancy....what an excited time for you. I can certainly understand your concerns for your child.

It's hard to give you good advice without being able to exam you, but I can help with some of your concerns. First, I don't believe you have an abscessed tooth which is why the antibiotics don't seem to be really fixing the problem. When a tooth feels hot & cold and sensitive to biting, that tells me that the tooth is still alive and the pulp of the tooth is irritated, making it more sensitive. We most often see this in teeth that have a crack or in patients that grind or clench their teeth. Whether you need a root canal or not really depends on which of these things is going on and whether there are things that can be done to reduce to irritation to the pulp. If there is a crack, sometimes a crown will solve the problem. If it's grinding or clenching, maybe a nightguard. If none of this works, then a root canal would be the last choice.

Anytime we treat a patient who is pregnant, we try to postpone any elective treatment until the 3rd trimester. However, if it is an emergency, we need to do what we need to do and then finish things in the 3rd trimester. If you are in pain, that can be as hard on your baby as getting medications and treatment. I would not put off doing what is necessary to get pain free. As for X-rays, with the lead apron and the low dose Xray technology available today, there is little, if any, risk to the fetus.

I hope this helps. Write back if you have more questions.

Gary Backlund DMD, MSD

Dentistry

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Gary Backlund, DMD, MSD

Expertise

I am an Endodontist ( root canal specialist ) and can answer questions about root canals and their treatment. I cannot diagnose or treat online, but can answer general questions. I have been a specialist for 25 years and am Past President of the Washington State Association of Endodontists.

Experience

25 years practicing as a specialist

Organizations
American Association of Endodonists, Past President Washington State Association of Endodontists.

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