Dental Surgery During Pregnancy

Timing of Dental Procedures

Surgery should ideally be avoided between weeks 3-5 post-conception due to possible association with neural tube defects, though anesthesia and surgery are safe if medically indicated during the first trimester, according to the American College of Obstetricians and Gynecologists 1, 2
Surgical operations can be safely performed during the first two trimesters; in the third trimester, either proceed with surgery or defer until after delivery based on clinical urgency, as recommended by the American College of Surgeons 3, 4

Maintain adequate maternal oxygenation and optimize uteroplacental perfusion throughout the procedure, as advised by the American Society of Anesthesiologists 1, 2, 6
Multimodal analgesia including regional analgesia techniques, infiltration with local anesthetics, and opioid use on an as-needed basis are all safe in pregnancy, according to the American Pain Society 1, 2, 6

Paracetamol is the first-line analgesic for mild to moderate pain during any stage of pregnancy, as recommended by the American Academy of Pediatrics 1, 2, 6, 7, 5
First-line pain management is Paracetamol 975 mg every 8 hours or 650 mg every 6 hours, according to the American College of Obstetricians and Gynecologists 7
Avoid NSAIDs after 28 weeks gestation because they may cause premature closure of the fetal ductus arteriosus and oligohydramnios, especially if administered for >48 hours, as warned by the American College of Rheumatology 1, 2, 6

Diagnostic radiographs may be performed after the first trimester if absolutely necessary, using abdominal shielding, as recommended by the American College of Radiology 3
Chest X-ray and imaging with abdominal shielding are safe, according to the American College of Radiology 3

Pregnant patients undergoing surgery should undergo risk assessment for thromboembolism, as they are at very high risk for venous thromboembolism, as advised by the American College of Chest Physicians 1, 2, 6
Consider low-molecular-weight heparin and pneumatic compression of lower legs when appropriate, according to the American College of Chest Physicians 1, 2, 6