Can I have a scale and polish procedure done during pregnancy?

November 09, 2022

A scaling and polishing procedure is targeted towards removal of debris, plaque, calculus and tartar from the surface of teeth. Scaling can be done manually through hand instruments or with more efficient methods like ultrasonic scaling which uses specialised scaler tips that perform the cleansing action by sonic waves.

The removal of plaque and calculus is necessary in order to prevent the harbouring of microbes that can cause cavitations or lead to inflammatory conditions of the tissues surrounding the tooth. Polishing involves smoothening of the tooth surface with an abrasive agent and a rubber cup which also brightens the tooth surface.

Is it normal for my dentist to recommend scale and polish if I'm pregnant?

Scaling and polishing are the most basic clinical procedures in dentistry. During pregnancy, pregnancy gingivitis and periodontal diseases are commonly seen. Pregnancy gingivitis leads to inflammation of underlying bony structure that can lead to the formation of pyogenic granulomas or pregnancy tumours. In order to prevent this from happening, pregnant patients need to maintain a strict oral hygiene.

If scaling and polishing is not done at the time the mother has pregnancy gingivitis, and if oral hygiene is not maintained, then it can lead to inflammation of the structures surrounding the tooth. This is called periodontitis. It affects the tissues that help in keeping the tooth firm in its bony socket. Periodontitis during pregnancy can be harmful to the patient. Certain pathogens involved in the inflammatory process release chemicals that hinder the development of the foetus. This has been linked to pre-term and low birth weight delivery of the infant.

What should I do if I've got gingivitis while pregnant?

It is advisable for pregnant patients with gingivitis to take Vitamin C supplements. In the second trimester, scaling and polishing procedures can be carried out. However, there are certain rules that a dental surgeon must follow during the procedure.

At what stage during pregnancy is safe to have the teeth scale and polish procedure?

If a scaling and polishing procedure is opted for during the first or second trimester, then the patient should be positioned upright and not in a reclined position. A reclined position will lead to the weight of the foetus get shifted to the major blood vessels of the heart, leading to hypotension. The patient is asked to have a healthy snack and is required to empty their bladder before the procedure.

If a scaling and polishing procedure is opted for in the third trimester, then the patient is positioned in a left lateral position. This is done by placing a pillow under the patient's right side.

Before beginning the scaling and poliahing procedure, patients should be relieved of any anxiety before starting with the procedure as it may also be detrimental for the developing foetus.

A scaling procedure can be carried out in a routine manner even in pregnant patients. The ultrasonic tips are moved in a gentle stroking motion to remove the plaque. A polishing procedure is followed which involves the use of a rubber cup in order to brighten the tooth surface. It can be used in conjunction with a non-abrasive paste. Airflow (air and polishing powder under pressure) can also be used on pregnant women.

The environment should be kept as sterile as possible as scaling is a procedure that generates a lot of aerosols. If there is episode of nausea or syncope during the scaling procedure, then it should be managed accordingly and the treatment should be rescheduled.

During pregnancy, the foetus's growth can cause a rise in diaphragm and stomach, and also leads to decrease in intestinal mobility. All this can contribute towards the development of an increased gag reflex. While performing the scaling and polishing procedure it is advisable to not flood the mouth with water or put the ultrasonic scalers in increased depths or else the patient might have frequent episodes of gag.

Is there any post-operative care I should carry out after dental scaling and polishing?

After the procedure, the patient is advised chlorhexidine mouthwash. Swishing the oral cavity with this mouthwash can result in elimination of harmful pathogens responsible for periodontal conditions. The patient should be warned not to swallow the mouthwash. Even though no research has been identified in humans regarding the risk of chlorhexidine on foetus, it is always advisable to ask the patient to expectorate it completely.

Scaling and polishing is the safest dental treatment during pregnancy. It is advisable to opt for this procedure in the second and third trimester. Special emphasis should be given on the systemic condition of the patient and the treatment should be planned accordingly.

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