In the first trimester, when should treatment for extensive active disease or caries begin?

• A. Immediately
• B. Wait until 2nd trimester if not extensive
• C. Wait until postpartum
• D. Never treat

Answer: (B)

In pregnancy care, protecting the fetus while addressing the mother's health is the priority, and the first trimester is a particularly sensitive window for fetal development. Because organ formation occurs early and many medications or anesthetic choices carry some risk to the fetus, elective dental procedures are typically postponed. If there is extensive active disease or caries, the goal is to minimize fetal exposure while preventing infection, which is best achieved by planning definitive treatment for the second trimester, when organogenesis is mostly complete and the pregnancy is more stable for dental procedures. If the disease is not extensive, delaying treatment until the second trimester is appropriate, rather than taking action in the first trimester or waiting until postpartum. Immediate treatment in the first trimester is reserved only for urgent situations where the mother's health is at risk.