Dental Implants?

AGK2015 · October 2015

So I just broke off quite a large chunk of one of my molars. It just so happens to be a retained baby tooth. Every time I visit the dentist, there's talk of extracting it and replacing it with an implant (there's no adult tooth under there, and the thing has no roots), but every time, we decide to hold off so long as the tooth isn't causing any problems.

Welp. I think I've got a problem.

There's no pain at the moment, so I'm good there, but I've already flown into full-fledged panic mode over the potential for dental procedures. I have a rather extreme and completely irrational fear of needles, to the point where I have a history of avoiding medical care because the possibility of needles are more frightening than potential health deterioration or death.** I've been able to decline lidocaine for things like fillings and crowns, since the drilling doesn't bother me, and nitrous oxide has helped immensely for those procedures where the anesthetic is unavoidable. I suspect that an extraction/implant will absolutely require some sort of numbing agent, but Dr. Google is telling me that the nitrous may not be safe or permissible during pregnancy, though different sites seem to have different ideas about whether or not it can be used after the first trimester.

I do much better at dealing with my dentist when I go in with a sense of what could/might/probably will happen--from the best to the worst case scenario--instead of panicking in the chair when my dentist tells me how we're going to have to handle things. I guess I'm looking for some input from folks who have needed major dentistry done during pregnancy before. Did your dentist put the procedure off until you'd delivered? For my fellow phobics, was laughing gas offered as an option? If not, what other techniques did you use to cope with the anxiety? For those who've had implants (whether pregnant at the time or not), what was the process like? Did you need stitches in your mouth? Could you tell they were in there? Dental Fear Central, my usual go-to, doesn't have a handy description available, so I'm having a tough time piecing together a good sense of what happens, or exactly how many needles are involved.

Appreciate the input; I'm still waiting for my dentist to call me back, but in the meanwhile, knowledge is power!

** I know. It's horrifying. Don't worry, I didn't start trying to conceive until I managed to get back on track with the medical establishment--all my shots, regular bloodwork, and ten years worth of make-up dentistry. And as terrifying as it has been, I've been following each of my doctor's recommendations to a tee during my pregnancy, and will continue to do so. I'll even be getting my very first flu shot!

NachosAndPeaches · October 2015

I have no answers but can you ask for some Valium before any numbing? Also usually they can give a numbing cream before the shot so you barely feel the shot.

cmjenkies · October 2015

Not necessarily dental related, although I also recently discovered I will be needing some dental work done soon too and am not too keen on it..

Many Western countries use nitrous oxide as a pain management option during labor. I had a conversation about this with a friend of mine who is studying to become a doula recently when we were talking about alternative pain management strategies. Very popular in the UK and used in Canada as well from what I've read.

https://americanpregnancy.org/labor-and-birth/nitrous-oxide-labor/

As far as use during pregnancy for dental work, that I'm not sure about one way or another.

AGK2015 · October 2015

NachosAndPeaches said:
I have no answers but can you ask for some Valium before any numbing? Also usually they can give a numbing cream before the shot so you barely feel the shot.

Numbing cream definitely helps with the feel of the needle, but it's not so much the pain that freaks me out as the concept that there is (or will be) a needle in my face. It's a lot like blood work: I know I won't feel it (or at least, not much), but the physical panic response happens anyway.

Valium, though.... if that's safe for baby, I'd definitely go for it. Thank you for the suggestion, I'll definitely be talking to my dentist about it.

JadaBlue · October 2015

I needed emergency dental work last week and was told no pain meds other than Tylenol.

They ended up doing a temporary fix. I've also read about laughing gas being used for labor quite safely and successfully, but I would be surprised if you could find a dentist in the U.S. who would comfortable giving it to a pregnant woman because of liability concerns. Of course I have no basis for that belief!

Monicagail1 · October 2015

I had an implant on one of my top front teeth. It was knocked out when I was 10, and have had a series of root canals and crowns before finally needing the implant about a year ago.

I'm not gonna lie, it was a long, uncomfortable process despite a long history of dental procedures and not being especially squeamish. Maybe made slightly more so because it was a front tooth. It's likely that you will be required to do some initial education as part of the prep process, but I'll share my experience.

I had an initial consult with the oral surgeon to ensure I was a good candidate and to learn about the process. They also gave me a cost estimate which ended up being wrong, super frustrating.

I could have opted to be sedated for the procedure. I thought I would be brave and tough and go with regular lidocaine. Also I wanted to drive myself home. I regret this. In retrospect I wished I had been sedated. I wasnt in a lot of pain per se, but it was uncomfortable and kinda scary. After the procedure I was in a lot more pain than I thought I would be. It lasted for a couple days, even with the pain meds. I had to wear a plastic retainer with a fake tooth so I wasn't walking around with a big hole in my smile.

After the implant healed they were able to put the regular crown on. That process wasn't bad.

Talk to your dr, but it's not something I'd want to do during pregnancy.

mojomama6 · October 2015

I was also going to vote for, not during pregnancy. I haven't had an implant, although I need several, but I have had major dental work during pregnancy, and it was pretty horrid. No dentist will sedate a pregnant woman (I called four surgeons when I needed three extractions while seven months pregnant- terrible mess), or administer nitrous, even when they're aware that it's considered safe enough even for home births in Britain. I had less-than-effective novocaine anesthetic.
If the tooth has no roots, you should be able to have it extracted with a relatively minor amount of pain, and get in for the implant later, when you're not knocked up. My oldest missing tooth has been gone for a decade, and my dentist says that I could probably still do an implant without bone grafts, so it's not like you're in a huge rush, yk?

Julesby · October 2015

So sorry you're going through this! I have two baby teeth that are bonded and my dentist and I have the same approach you have - do nothing until something happens. Because I was fearful something would happen during pregnancy, I asked about your scenario and was essentially told no dice. No procedures during pregnancy.

Not sure if it applies with a broken tooth, as opposed to a lost tooth, but can you get the retainer with the fake tooth until you can get an implant. (Prego brain means I can't remember the actual term for this.)

katierpowell · October 2015

Lurker (and dental assistant here) a baby tooth extraction, especially one without roots, is super easy. They can give you a topical anesthetic that can help with the pinch, and a good hygienist or dentist will make sure you never see the needle (even though you still know it's coming. I watch it every day and still panic a little when it's me). you can get a flipper to cover the space until next year after you deliver. Then you can get an implant and be sedated for that procedure. Definitely talk to your dentist though, if the piece is small enough that you broke and there isn't any pain, you may be able to just leave it for now, rounding off any sharp edges, and wait until after you deliver to do anything at all. Good luck, you'll do fine!

AGK2015 · October 2015

Thank you all! I'm still paying phone tag with the dentist, but I'm feeling much less terrified at this point. Knowing that I might have options beyond an immediate dental surgery helps a lot! I'll definitely go in with some actual questions and some confidence, which is a huge step up from the tearful acquiescence to whatever she suggests that I was anticipating!

HorrorDoll · October 2015

katierpowell said:
Lurker (and dental assistant here) a baby tooth extraction, especially one without roots, is super easy. They can give you a topical anesthetic that can help with the pinch, and a good hygienist or dentist will make sure you never see the needle (even though you still know it's coming. I watch it every day and still panic a little when it's me). you can get a flipper to cover the space until next year after you deliver. Then you can get an implant and be sedated for that procedure. Definitely talk to your dentist though, if the piece is small enough that you broke and there isn't any pain, you may be able to just leave it for now, rounding off any sharp edges, and wait until after you deliver to do anything at all. Good luck, you'll do fine!

Another dental assistant here, and I completely agree. I doubt any periodontist will want to do implant surgery on an expectant mother anyway

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