Dental Health and Pregnancy

Dental health is the health of your gums and teeth. It’s an important part of your overall health. If possible visit your dentist for a regular dental checkup every 6 months.  Get regular dental checkups before and during pregnancy. If you haven’t been to the dentist recently, see your dentist soon after you find out your pregnant. At your checkup, tell your dentist that you’re pregnant.  If you’re not pregnant yet, let your dentist know that you’re planning to get pregnant.

Dental checkups during pregnancy are important so that your dentist can find and treat dental problems. Regular teeth cleanings also help prevent tooth decay. If you have any problems, your dentist can recommend treatment during pregnancy or after you give birth. Some studies show a link between gum disease and premature birth (birth before 37 weeks of pregnancy) and low birth weight (less than 5 pounds, 8 ounces). Taking good care of your gums and teeth during pregnancy can help you and your baby.

Changes your body goes through while pregnant can affect your gums and teeth. During pregnancy, you have more blood flowing through your body, more acid in your mouth and rising hormone levels. Hormones are chemicals made by the body.  These changes mean that you’re more likely to have some dental health problems during pregnancy than you did before you got pregnant. These problems include:

Gingivitis. This is when you have red, swollen or sore gums. Your gums may bleed when you brush your teeth. High levels of the hormone progesterone can lead to gingivitis during pregnancy. Without treatment, gingivitis can become a serious gum disease called periodontitis.

Loose teeth. High levels of the hormones progesterone and estrogen during pregnancy can affect the tissues and bones that keep your teeth in place. This can make your teeth loose.

Periodontitis. This is a serious gum disease. It happens when there’s swelling and infection in the gums and bones that keep your teeth in place. This can make your teeth loose.

Pregnancy tumors. These tumors are not cancer. They are lumps that form on swollen gums, usually in between teeth. This can cause bleeding. The tumors may be caused by having too much plaque (sticky bacteria that forms on teeth). Pregnancy tumors usually go away on their own. But you may need to have them removed by surgery sometime after you give birth.

Tooth decay. This is when acids in your mouth break down a tooth’s enamel. Enamel is the hard, outer layer of a tooth. Because you have more acid in your mouth than usual during pregnancy, you’re more likely to have tooth decay. If you have morning sickness   and throw up often, you are more likely to have even more acid in your mouth.  Brushing your teeth after you throw up will help.

Tooth loss. If you have serious tooth decay or gum disease, your teeth may fall out or your dentist may need to remove your teeth.

Signs and symptoms of dental health problems during pregnancy include: bad breath, gums that hurt when they’re touched, or gums that bleed when you brush your teeth, loose teeth, mouth sores, lumps or other growths, red or red-purple gums, shiny, sore or swollen gums, and toothache or other pain.  Call your dentist if you have any of these signs or symptoms.

If you have a dental problem, your dentist may take an X-ray. Dental X-rays can show problems, like cavities, signs of plaque under your gums or bone loss in your mouth. Dental X-rays use very small amounts of radiation. If x-rays are necessary due to dental emergency, make sure your dentist knows you’re pregnant and protects you with a lead apron and collar that wraps around your neck. If you think you could possibly be pregnant, tell your dentist as well.   This helps keep your body and your baby safe.  American College of Obstetricians and Gynecologists (ACOG) recommendations say dental x-rays are safe since most dentists now use digital x-rays, which have 10 to 20 percent of the previous amount of radiation. Plus, the abdominal shield and thyroid collar, blocks out almost—if not all—the radiation that would even get near the developing baby.

The kind of dental treatment you get depends on the problem and how far along you are in your pregnancy. You may need a good teeth cleaning or you may need some dental work in your mouth. Your dentist can safely treat many problems during pregnancy. Scientific studies have shown that there is no evidence relating early miscarriage to first trimester oral health care or dental procedures.  The best available evidence shows that dental care is safe for both mother and baby.  The risk of infection from an untreated dental problem, like an abscess, poses a greater risk to you and your baby than the dental procedure itself. In fact, a dental infection can cause pre-eclampsia, pre-term birth, developmental delays—even miscarriage.

You can help to prevent dental problems and help keep your teeth and gums healthy.  It is important to brush your teeth with fluoride toothpaste and floss every day. Brush using a toothbrush with soft bristles at least twice a day or more often if you are experiencing morning sickness.  Regular brushing and flossing around the gum line can remove plaque and prevent periodontitis and tooth decay. If morning sickness makes you feel too sick to brush your teeth, rinse your mouth with water or mouthwash. If you throw up, rinse your mouth with water to wash away the acid. Floss gently at least once a day to clean in between your teeth.

Saliva is the greatest natural defense mechanism so chewing a sugar free gum with xylitol can increase the salivary flow which washes away food debris, neutralizes plaque acids, and keeps bacteria at bay. After a meal, drinking a glass of water can help too.

Eat a healthy, balanced diet. Your baby’s first teeth begin to develop between three to six months into pregnancy. Healthy diets containing dairy products, cheese, and yogurt are a good source of these essential minerals and are good for baby’s developing teeth, gums, and bones. Nutrients, like calcium, protein and vitamins A, C and D, help your baby’s teeth grow healthy.  Limit sweets. Having too many sweet foods or drinks can lead to tooth decay. Instead of sweets, drink water and pick healthy foods like fruits, vegetables and dairy products. Eat fewer foods high in sugar, including candy, cookies, cake, and dried fruit; and drink fewer beverages high in sugar, including juice, fruit-flavored drinks, or soft drinks; drink water or milk instead.

Tell your dentist the names and dosages of all drugs you are taking – including medications and prenatal vitamins prescribed by your doctor – as well as any specific medical advice your doctor has given you. Your dentist may need to alter your dental treatment plan based on this information.   If you experienced any gum problems during your pregnancy, see your dentist soon after delivery to have your entire mouth examined and the condition of your gums evaluated.

Michalowicz, B., DiAngelis, A. J., Novak, M. J., Buchanan, W., Papapanou, P. N., Mitchell, D.,  Rogers, T. B. (2008). Examining the safety of dental treatment in pregnant women. The Journal of the Americal Dental Association, 685-695.

Michalowicz, B., Hodges, J., & DiAngelis, A. (2006). Treatment of periodontal disease and the risk of preterm birth. New England Journal of Medicine, 1885-1894.

Ressler-Maerlender, J., Krishna, R., & Robinson, V. (2005). Oral health during pregnancy: Current research. Journal of Women’s Health, 14(10), 880-882.

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