Root canals are safe to get while you're pregnant but you should only do it if it is urgent or it is an emergency where you are in severe pain.
As a general guideline, if you've answered yes to either of the above you should probably consider getting the root canal done. It means that the benefits of getting it most likely outweigh the risks of not getting it.
We'll explain why it is safe and recommended to do so by providing you studies to back it up. We'll also describe when it is not recommended to get the root canal if you're pregnant.
Root canal for a symptomatic tooth while pregnant
If your dentist tells you that you need a root canal because the tooth is hurting, you should definitely proceed with treatment. It is safe to have it done and it is even recommended to do so by OBGYNs.
According to The American College of Obstetricians and Gynecologists (ACOG) guideline for oral care during pregnancy, you should not delay treatment for teeth that require prompt attention.
What that means is if that toothache is causing you distress, you can and should have it addressed. If you leave it untreated, it will only complicate the matter further.
Inform women that conditions that require immediate treatment, such as extractions, root canals, and restoration (amalgam or composite) of untreated caries, may be managed at any time during pregnancy. Delaying treatment may result in more complex problems.
To reiterate, you are safe to get the root canal done regardless of your pregnant status. You can stop worrying and proceed with getting the pain relief that you deserve.
Conditions which may require a root canal
There are many dental conditions, which may cause the tooth nerve to die or become unhealthy. Once that happens, it becomes symptomatic and that is usually when the avalanche of pain ensues thus necessitating endodontic treatment.
Oral conditions requiring root canal therapy:
Irreversible pulpitis. Tooth dies and causes spontaneous pain without triggers.
Large filling close to the nerve. Restorations that are too close may irritate the pulp.
Tooth abscess. A dental abscess can kill the tooth nerve.
Decay into the nerve. Untreated small cavities will eventually grow to reach the nerve.
All of these conditions result will injure the tooth nerve to the point of no repair. They typically cannot recover from such a situation and the only treatment available for an unhealthy nerve is to remove it from the tooth.
The removal process is a physical one and only your dentist can perform it. There is no home remedy which can calm down a dying nerve. Although if you wanted to be more extreme, you can take out the entire tooth in lieu of doing the root canal. Just know that once you remove the tooth it won't grow back so it is an irreversible procedure.
In case you were wondering, yes it is also safe to not only extract your tooth but also remove your wisdom teeth while you're pregnant.
Consequences for delaying treatment
If you continue to put it off, it'll only cause you more pain and put you in more distress. A pregnant mother who is in distress is NOT a healthy environment for the baby to grow and develop in.
A study by the Journal of Psychoneuroendocrinology found that expecting mothers who had at least one stressful event had a 27% increase in cortisol levels. In essence, being in pain will increase stress which consequently increases the stress hormone, cortisol.
Subjecting pregnant women to altered hormone levels may potentially have side effects for the development of the child. Studies have shown that elevated cortisol levels may lead to low birth weight. So yes, a tooth abscess can potentially cause harm to your unborn baby.
What to expect during the procedure
Now that you know it is safe to have the root canal done while you're carrying a baby, the next biggest obstacle to care, would be the patient's perception that it'll be a scary and painful procedure.
We're here to tell you that it shouldn't be that way. You will be thoroughly numb for it so you really shouldn't feel any pain at all.
Here is what to expect:
Administer local anesthetic to numb the tooth.
Remove all of the decay.
Extirpate the unhealthy nerve.
Sterilize and disinfect the entire canal.
Place a root canal filling material.
That is basically it for the entire procedure. It's not that scary when it can be explained in five steps right? Although you should be aware that the entire procedure will probably take about an hour in total. That'll give you a sense for how much time you should allocate to for this day.
After the root canal is completed, you may not be able to even tell that the tooth had it done because it should look the same. However, you can definitely tell that it did get the treatment if you simply looked at the x-ray. These teeth usually have a white line going through the entire length of the tooth, which represents the root canal filling material.
Root canal for an asymptomatic tooth during pregnancy
Believe it or not but there are teeth that do need root canals but are asymptomatic, meaning they don't hurt at all. The classic case condition which necessitates this is a dead tooth that has started to turn grey.
Dead teeth typically have sustained trauma or an injury many years ago. Over time they start becoming discolored. These teeth should be root canal treated and then bleached internally from the inside out to improve the cosmetic appearance. After that they can have either a veneer or crown to cover up the grey color.
The reason why it needs to be whitened internally first is because the dark discoloration underneath makes it very difficult to mask. The veneer is practically a very thin piece of porcelain and the grey color underneath may show through it!
Nonetheless, since these teeth are not symptomatic nor are they even painful, it would be in your best interest to hold off on their treatment. The reason being that it is not urgent or emergent. It is technically classified as an elective procedure at this point.
Guideline concerning elective procedures
According to the American Dental Association (ADA), all cosmetic and elective procedures should be postponed until after giving birth. A root canal on an asymptomatic tooth that does not seem likely to cause you harm any time soon would fall under this category.
In fact, the ADA piggybacked their recommendation based on the ACOG's guideline for non-obstetric surgery during pregnancy. There they explicitly stated that all elective surgeries should be postponed until after delivering the baby!
The Verdict - Can you get a root canal while pregnant?
It is safe to get a root canal while you're pregnant and you should do it especially if it is hurting you or if it is infected. It is recommended by both the ACOG and the ADA to do so.
However, if you're getting the treatment done on a tooth that is not hurting nor is it infected, you may want to rethink it. Guidelines say that you should hold off on non-urgent procedures until after the baby is born. This is all to minimize the risks that the expecting mother has to undertake.
So, what are you waiting for? If its hurting, go ahead and get it treated because it is considered a dental emergency.
Does the trimester matter?
Just so that we're clear, when we say that a root canal is safe to get during pregnancy we mean that it can be done at any trimester. It doesn't matter if you're 4 weeks pregnant or 30 weeks. You can have it done at the first, second, and even third trimester.
However, studies do say that the second trimester is the safest but if you NEED it done because the toothache is killing you in the first trimester, you should not delay it. Just get it done.