Clinical Characteristics and Management of Oral Emergencies During Pregnancy: An Eight-Year Retrospective Study
This eight-year retrospective study of 2,190 pregnant women at Peking University School and Hospital of Stomatology reveals that acute dental pain is the most common oral emergency, with treatment rates significantly influenced by disease type and declining across trimesters due to shifts in case composition and clinical decision-making factors.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
Pregnancy is a time of profound physical change, a period where the body's hormones, diet, and behaviors shift in ways that can unexpectedly affect oral health. It is a well-established fact that these changes can make pregnant women more susceptible to dental problems, such as cavities, gum disease, and infections around the wisdom teeth. While medical guidelines clearly state that necessary dental care is safe during pregnancy, many women still hesitate to seek help. Fears about the safety of X-rays, the effects of local anesthesia, or the timing of treatment relative to the stages of pregnancy often lead to delays. Consequently, when pain or infection becomes unbearable, these women arrive at emergency rooms, creating a unique clinical challenge where doctors must balance immediate relief with the safety of the developing fetus.
To understand the reality of these emergency visits, researchers at Peking University School and Hospital of Stomatology looked back at eight years of patient records, from 2017 to 2024. They examined the files of 2,190 pregnant women who had come to their emergency department, carefully reviewing their ages, how far along they were in their pregnancies, what their specific diagnoses were, and what kind of immediate care they received. The goal was to move beyond general assumptions and see exactly what was happening in the clinic: what were the most common problems, how did the type of problem change as the pregnancy progressed, and how often were these women actually treated on the day they arrived?
The study revealed that the most frequent reason for an emergency visit was acute dental pain, which accounted for nearly two-thirds of all cases. This pain was most often caused by severe inflammation of the tooth nerve or infection at the tip of the tooth root. The second most common category was infection, such as swelling around the wisdom teeth or abscesses. When the researchers looked at the timing of these visits, they found that the second trimester, the middle period of pregnancy, saw the highest number of patients. This aligns with the common belief that the middle of pregnancy is the safest and most comfortable time for dental work, as the risks associated with the very early and very late stages are lower. However, the data showed that the types of problems women faced were not the same at every stage; as pregnancy advanced, the proportion of women arriving with severe pain increased, while the proportion arriving with infections decreased.
Perhaps the most significant finding concerned who actually received treatment on the day of their visit. Overall, slightly more than half of the women received some form of effective emergency management, such as a procedure to relieve pain or drain an infection. The researchers discovered that the type of disease was the single most important factor in deciding whether a patient was treated. Women with infections were almost always treated, with a success rate of 94 percent, because the standard care for these conditions, like cleaning around a wisdom tooth or draining a pocket of pus, is relatively simple and non-invasive. In contrast, only about 36 percent of women arriving with severe tooth pain received immediate treatment. This gap suggests that clinicians and patients alike are more hesitant to perform procedures for pain relief, possibly due to concerns about the tools or medications required, even though the study found that the decision to treat was driven far more by the nature of the disease than by the stage of the pregnancy itself.
When the researchers analyzed the data to see if the timing of the pregnancy changed the likelihood of treatment, they found a subtle but important pattern. The overall rate of treatment did drop as the pregnancy progressed, from the first to the third trimester. However, this decline was not because doctors became more reluctant to treat pregnant women as time went on. Instead, it happened because the mix of patients changed. Since the third trimester had a much higher proportion of women suffering from severe tooth pain—a condition that is treated less frequently than infections—the overall treatment rate for that group naturally fell. When the researchers accounted for the type of disease, the stage of pregnancy itself was not a strong predictor of whether a woman would receive care. The study concludes that while the need for emergency dental care is high, the decision to treat is heavily influenced by the specific condition rather than the gestational age, highlighting a need for better education to ensure that necessary pain relief is not withheld due to unfounded fears.
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