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The Pregnant Patient

I had a patient come in, 14 weeks pregnant, and was due for check-up xrays (4 bwx’s – once a year). My patient disclosed that she was concerned about her dental visit prior to coming in so she called her OBGYN the day before. Her doctor said it would be okay to have xrays taken, just to double up on the lead aprons. I made the decision to take the xrays on my pregnant patient.
My boss stopped me at the end of the day and wanted to inform me that she doesnt feel comfortable having any xrays taken on a pregnant woman no matter what point they are at in their pregnancy and if there is an emergency tooth issue, then we can address it accordingly.
I am just curious as to what other hygienists and doctors use as their pregnant patient protocol.



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I would also consider clinical findings, is the patient caries active, perio charting numbers, how is homecare? If there is nothing found that is concerning, it doesn’t hurt to wait.

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In my office we get a release from the patient’s OB/GYN. The release normally says that it is safe for radiographs and to double shield if it makes the patient more comfortable. If the patient is uncomfortable with radiographs we won’t take them or push the issue, unless the patient is having symptoms/pain. I feel like your boss should have let you know what she “felt comfortable with” before the patient came in!

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In my office we only take x-rays on pregnant patients if they are in pain. And if we have to take X-rays, we double shield and turn the exposure down lower and then adjust and darken the computer image.
My boss feels it is safe, however we typically avoid routine X-rays just to make the patient feel more comfortable if their isn’t anything standing out.
I had a FMX taken when I was 5 weeks pregnant (didn’t know I was pregnant) plus had a crown prep done. My son turns 7 in a couple days and is completely healthy and at the top of his class. I’m confident having 22 dental X-rays, plus lidocaine, did not hurt him at all.
However, I still feel that it’s better to be safe then sorry and I don’t take X-rays on pregnant patients unless necessary.

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In my office we double wrap the pt in a lead blanket for radiographs on pregnant women. I have read that it is completely safe to take radiographs on pregnant women. It takes much less radiation to take an X-ray these days and the digital sensors are much more sensitive than standard film. My Dr also agrees with this. If a patient asks to not have radiographs taken we will explain our reasons for taken them but will not take them if she choses not to have them done.

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We only take radiographs on pregnant patients if we see clinically that there is a reason to or the patient is in pain. We also double shield. Probably totally unnecessary, but it seems to make people more comfortable.

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