Hello Dr. Hall,
I am 24 weeks pregnant and have been dealing with my upper right second molar for some time. I went to the dentist before I was pregnant to get a thorough cleaning and exam and found out there was small decay in that tooth. I had the cavity filled but the dentisit did not use novocaine and he said the very small filling went deeper than he thought.

Well, since that time back in September I have had periods of cold sensitivity and air sensitivity. I went back and he said it needs a root canal. My question for you is whether I can wait to have this procedure done until after delivery in 3 months? I am very cautious during pregnancy and would like to avoid procedures/xrays if at all possible. How do I know if my tooth is infected or just sensitive? It only hurts when provoked by air and cold fluids. Need your advice for helping me discern what is right for me and my child. Don’t want any unknown infection to spread to my unborn child. Thanks!
– Courtney from Maryland

Cortney,

Based on what you have told me, I am skeptical of this dentist for two main reasons:
1. The story of the decay on this tooth doesn’t make sense. First you say he said it was such a small cavity that it didn’t need novocain. Now that doesn’t make sense in itself. If it is truly a cavity, it goes into the dentin of the tooth, and cleaning it out will hurt. And then you never know exactly how much it will spread out once it’s in the dentin. I never suggested to a patient that a cavity was so small that it didn’t need novocain – I just gave the injection unless they objected.
2. Anyway, he admits he misjudged it, and then it starts being sensitive to cold and air. If it truly does need a root canal now, that means that the cavity was huge. Doesn’t make sense. And if it’s only sensitive to air and cold, and only sometimes, well there are several possible causes for that besides having a huge cavity in the tooth, so I question whether or not you need a root canal. Or was something done wrong during the process of putting in the filling, and that’s why it’s sensitive?

Anyway, all of this just doesn’t add up. Now I can’t examine your tooth to tell you for sure, but just trying to go from what you’re telling me you don’t need a root canal at all, much less right away.

I would get a second opinion. A quality second opinion from a really good dentist.

Yes, you want to avoid any major dental work in the last trimester of pregnancy, so that’s a factor, too. But then if the tooth is indeed infected, that will not be good for your baby and you’ll want to get that taken care of, which means you should get the root canal treatment. If you do need an x-ray to properly diagnose this, and you have a lead apron on, I’ve tested that and if the lead apron covers your tummy, the baby gets no radiation exposure. That has to be your call. But my advice would be to get a second opinion, put on the lead apron and have them take an x-ray if they need to, and test the tooth, and see.

Good luck,
Dr. Hall

Follow-up comments and question from Cortney – How can I tell if a tooth is infected?

Other links:
Ask the dentist a question.
Read another post where we discuss getting a root canal treatment while pregnant.
Read more about teeth that are sensitive after a filling.