I’m in my second trimester of pregnancy at 22 weeks. I experienced sensitivity in an upper left molar tooth that my dentist did a root canal on about six years ago. The sensitivity got worse and became painful, so I went to the dentists. My dentist did an x-ray and found an infection. My options are to do another root canal, try an apicoectomy, or get the tooth extracted and replace it with a dental implant. My dentist said that there is more than a 50% -60% chance that my root canal treatment will be successful.

Since I’m pregnant, I have several concerns: the anesthetic and how it might affect my baby, a second root canal failure, and needing an apicoectomy or extraction anyway, discomfort, and a long process with a dental implant. And if something goes wrong with the treatment, I might need a pain killer or antibiotics, so I’m concerned about how that will affect the baby, too. Will you please tell me whether a root canal or an apicoectomy requires more anesthetic? How long does it take to determine if a root canal is successful? I’ve been with this dentist for about three years, so another opinion will increase my comfort and help me decide on a treatment option. – Thanks. Miriam from Tulsa, OK

Miriam,

We recommend that you repeat the root canal treatment because it’s the least invasive treatment. If you can avoid an apicoectomy or dental implants while you’re pregnant, try to do so. But only have the treatment completed by a root canal specialist (endodontist). Endodontists have advanced training and specialized tools that will produce predictable results. An endodontist will reduce the risk of root canal failure.

1. Reasons to Get Root Canal Treatment During Pregnancy

• The tooth is infected, and removing the infection protects you and your unborn child.
• An untreated infection will spread.
• Allowing the infection to linger might create a dental emergency at the most inconvenient time.

2. Local Dental Anesthetic During Pregnancy

Repeating root canal treatment requires a minimal amount of anesthetic because the tissue and nerves inside your tooth are dead. Root canal surgery, or apicoectomy, requires ore anesthetic because the tooth is accessed through your gums. Although dental anesthetic is generally safe during pregnancy, it’s best to limit it with a procedure that requires less of it.

3. Evaluating the Success of Treatment

An endodontist can quickly tell if treatment is successful. A canal often leads to unsuccessful therapy if ledges, curves, or blockages are challenging to navigate. Your endodontist will know if there were difficulties or not. If the endodontist’s instruments can get to the root tips and successfully seal them, the treatment will likely heal well. Otherwise, the endodontist will recommend root canal surgery.

We hope you have a smooth root canal treatment, recovery, and delivery of your new baby. Congratulations!

Steven Brooksher, DDS of Baton Rouge, LA, sponsors this post.