It's not forbidden to have a wisdom tooth extraction while you're pregnant BUT you should calculate the risks and benefits for doing so. There are two main questions which you should ask yourself before undergoing the extraction.
Questions to ask yourself before undergoing the extraction:
Is it beneficial for me to have the wisdom teeth taken out?
Will it cause me more harm if I don't remove them?
As a general guideline if you have answered yes to both of the questions above then you should consider having them removed despite your pregnant status.
In case you wanted to think about it in a slightly different way, you can distill those two questions down to one. Are your wisdom teeth causing you excruciatingly unbearable pain right now? At the end of the day that is the only question which you need to ask and answer.
Symptomatic wisdom teeth while pregnant
If your wisdom teeth become symptomatic while you're pregnant, it becomes a legitimate reason for having them removed.
The American College of Obstetricians and Gynecologists (ACOG) has a guideline for oral care during pregnancy, which explicitly recommends treating any condition that requires immediate attention without delay. Delaying would only result in more complicated problems later on.
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.
Perhaps that may be surprising because you were expecting all dental procedures to be postponed to after delivery of the baby. However, that is NOT the case because most obstetricians are actually quite comfortable with their patients undergoing dental procedures which includes extractions, root canals, and dental fillings.
A study by the Journal of Maternal Fetal Neonatal Medicine has shown that both obstetricians and dentists both agreed that pregnant women should receive dental care. Although dentists appeared to be more concerned about the safety of the procedures and medications provided than the obstetricians did.
The obstetricians on the other hand were more comfortable with the treatments but seemed to be less likely than dentists to recommend it. Perhaps more training and raising of awareness is required for this interdisciplinary field so that a unified goal is achieved.
With that being said, we would like to add one additional condition for you to consider if you should have the third molars taken out during pregnancy. What you should consider is the severity of the symptoms because pain can fall within a spectrum.
Some of them can be mildly painful or annoying while others command your full attention by preventing you from doing simple daily tasks. Obviously the former is not as urgent while the latter is emergent.
So how bad is it hurting you right now?
Common symptoms
Localized pain around the area
Localized swelling
Gums may appear red and poofy
Diffuse pain affecting the entire side it is on
Pain may be triggered by certain actions such as eating/drinking
Pain may be spontaneous
These symptoms range in severity because some of them can be mild while others can hurt a lot. Depending on how bad it is, you may be forced to have them treated whether you want to or not.
Symptomatic conditions
There are various conditions which may cause the wisdom to suddenly become symptomatic. Unfortunately some of them are completely out of your control.
Symptomatic third molar conditions:
Partially impacted. Only partially stuck in the bone.
Fully impacted. Completely submerged in the bone.
Gum flap over wisdom tooth. The gums cover over a portion of it.
Fully erupted but difficult to keep clean. Due to being the last tooth in the mouth it makes hygiene difficult.
These are all conditions which your third molar can present itself in. Typically whenever it starts to bother you or cause you pain, we refer to the condition as pericoronitis. The literal definition of that is inflammation around the crown of the tooth.
Most commonly if the tooth is partially erupted or fully erupted, the most common cause for them to become inflamed is if you get food or plaque lodged around the gums. Basically if you're unable to clean it or forget to, it will eventually swell up and that is basically the source for your wisdom tooth pain.
What you should do
The best thing that you can do if you have wisdom teeth that are prone to becoming inflamed is to actually pay more attention to them. When you brush and floss, you should spend more time around that area.
If you really have trouble reaching them because they're literally the last tooth in your mouth you can try using a water flosser. This is a device which shoots high pressure water to flush out food debris and plaque.
The waterpik is one of the most widely available brands of water flossers. It works well but don't be shy in trying out other brands as well!
What to expect for the procedure
It is in our opinion that you should ONLY remove the wisdom tooth which is bothering you and leave the other ones alone. Most people have four in total. You only need to address the one which is symptomatic.
You should also try to go through the procedure without any IV sedation if possible. Getting sedated adds an additional layer of risk that you need to take. We do however understand that many people may be nervous going into it.
What to expect:
Administer local anesthetic.
Release the periodontal ligament fibers (PDL).
Possibly section the tooth if it is impacted.
Elevate the tooth with an elevator.
Deliver the tooth with forceps.
Now wasn't that easy because it was explained with only five steps! Perhaps it may be just our opinion but the wisdom tooth extraction is really not as bad as you think. All of our patients who've had their tonsils removed all said that it was "way worse" than having the wisdom teeth taken out.
Also just in case you were wondering, you don't technically have a waiting period to have your tooth extraction after giving birth. You may do it at any point but it may be more comfortable to recover a little bit before proceeding if it is not an emergency.
Asymptomatic wisdom tooth while pregnant
If your wisdom teeth are asymptomatic during pregnancy meaning that they don't hurt, it may not be enough of a reason to have them removed. The benefits will not outweigh the risks from getting the procedure.
Basically if they're not bothering you, you may be taking on more risk than necessary by having them taken. Perhaps it may be better to simply leaving them be.
Since they are not hurting you, having the wisdom teeth extracted would be considered an elective procedure. It is considered so because there is no urgency or an emergency to have the procedure done immediately or promptly.
The ACOG's guideline for non-obstetric surgery during pregnancy explicitly recommends that all elective surgery should be postponed until after delivery. Yes, you read that correctly. All elective surgery should be delayed until after giving birth and wisdom teeth extractions fall under the category of oral surgery so it would apply.
Therefore, asymptomatic wisdom teeth removal should be postponed until after delivering the baby.
Verdict
You can certainly get your wisdom teeth removed while you're pregnant but only if they are bothering you. The ACOG states that all dental treatments which are pressing can be performed at any stage of the pregnancy because delaying it will only complicate the problem.
However, they've also stated that as a part of their surgical guidelines, all elective surgeries should be postponed until after delivering. This means that if your wisdom teeth are asymptomatic you should hold off on them until after giving birth.
As a summary, you should get them taken care of if they are bothering you but if they aren't then you can just leave them alone! There is no rush in getting them out, you can always wait until after the baby arrives.
