When you are pregnant, you become very aware of how important it is to take extra-special care of your body. You should also know that pregnancy is a time to take extra-special care of your teeth and gums. That’s because hormonal changes in your body during pregnancy can increase your chances of developing cavities, gingivitis and advancement of periodontal disease (gum disease).Women with periodontal disease are seven times more likely to have preterm births and low birth-weight babies in certain studies.
Preventive dental cleanings and regular dental exams during pregnancy are not only completely safe, but are highly recommended by both dentists and physicians alike. Pregnancy causes hormonal changes to a woman’s body. This increase in hormones causes the gums to bleed easily, become inflamed and trap food, causing increased irritation to your gingival tissue.
It is believed that periodontal disease may lead to premature birth by the spread of oral bacteria to the placenta or amniotic fluid. Systemic inflammation caused by periodontitis may also lead to preterm labor and membrane rupture. The probable culprit is a chemical called prostaglandin, released into the bloodstream during inflammation, which can induce labor. Prostaglandin is released in very high levels in severe cases of periodontal disease.
Almost one half of women experience pregnancy gingivitis, starting in the second or third month of pregnancy. It generally increases in severity all the way through to the eighth month. This pregnancy gingivitis can be very uncomfortable and cause inflammation, bleeding, redness or tenderness in the gums. If you already have poor oral hygiene and gum disease before pregnancy begins, expect an extreme progression in your periodontal condition as you end your first trimester and onward. In some women, gums swollen by pregnancy gingivitis can react strongly to irritants and form large growths. These are called pregnancy tumors. These are not cancerous and are usually painless in nature. This tumor may require removal by a dentist if it persists.
If you are planning to get pregnant, it is a good idea to see your dentist prior to trying to conceive to ensure your oral health is fine. You should have a thorough exam at this time along with a cleaning and complete treatment on any other issues you might have to stave off complications during pregnancy.
Once pregnant, there are a few tips to follow:
-Dental treatment such as cavity fillings and crowns should be treated to reduce the chance of infection. If dental work is to be completed during pregnancy, the second trimester is the optimum time. Once you reach the third trimester, it may be very uncomfortable and/or difficult to lie on your back for any extended period of time to receive treatment.
-Elective treatments (for example, teeth whitening or other cosmetic dentistry procedures) should be postponed until after the birth of your new child. It is best to avoid exposing the developing baby to any risks, no matter how small they may be.
-Try to maintain good oral hygiene habits during pregnancy. This includes brushing properly after every meal and flossing every day. If you combine this routine with a healthy, well-balanced diet (also limit between meal snacks) and regular dental visits, you will not only help avoid dental problems of your own, but you will also contribute to the healthy development of your coming baby. Your baby’s teeth first begin to develop at about three months or so into pregnancy. Healthy diets containing dairy products, cheese and yogurt are a good source of the essential minerals and are good for the developing teeth, gums and bones of the baby.
-Tell your dentist the names and dosages of all drugs you are taking. This includes any medications and prenatal vitamins prescribed by your doctor as well as any specific medical advice your doctor has given you. Your dentist may make changes your dental treatment plan for your individual case. Certain drugs (for example, tetracycline) can affect the development of your baby’s teeth and should not be prescribed during pregnancy.
Lidocaine is the most commonly used anesthetic drug used for dental work. Lidocaine will cross the placenta after administration. If dental work is needed, the amount of anesthesia given should be as little as needed, but still enough to make you comfortable during your dental work. Request additional anesthetic if you are still experiencing pain. When mom is comfortable, the amount of stress you and the baby will feel will be reduced.
Preventing or removing dental infection often involves the use of antibiotics. Antibiotics such as penicillin, amoxicillin and clindamycin, which are labeled safe in pregnancy, may be prescribed after your procedure with no worries about the health of your baby.
-Dental X-rays should be avoided whenever possible during pregnancy. If X-rays are needed (such as during a dental emergency), your dentist will use extreme caution to protect you and your baby. Advances in technology have made X-rays much safer today than in the past.
The American College of Radiology studies have shown no single diagnostic X-ray has a radiation dose significant enough to cause adverse effects in a developing embryo or fetus. However, during the first trimester is when fetal organ development occurs so it is best to avoid all possible risks at this time if possible.
-Loose teeth. As levels of progesterone and estrogen increase it can affect the ligaments and bones that support and stabilize the teeth, causing teeth to loosen during pregnancy. This can happen even without the presence of periodontal disease.
-If morning sickness keeps you from brushing your teeth regularly, change to a neutral tasting toothpaste during pregnancy. Ask your dentist or hygienist to recommend brands.
-Rinse your mouth out with water or a mouth rinse if you suffer from morning sickness and have bouts of frequent vomiting.
Is a Pregnant Woman at Greater Risk for Tooth Decay?
YES. We have all heard about pregnancy cravings. Sweet cravings are quite common for women during pregnancy. However, keep in mind that the more frequently you snack, the greater the chance of tooth decay developing. Some recent studies have also shown that the bacteria responsible for tooth decay is passed on from the mother to the child. So be careful with what you eat. Also, during pregnancy, increased acidity in the mouth increases the risk of tooth decay. Vomiting during pregnancy (especially during morning sickness period) can make the problem worse by exposing the teeth to a high quantity of gastric acid. If you have morning sickness, rinse your mouth with a solution of baking soda and water after vomiting. Use one teaspoon of baking soda in a cup of water and mix.
Should I Share the News with my Dentist That I Am Pregnant?
Your dentist should know as soon as you believe you are pregnant. It is best to avoid taking any unnecessary X-rays during your pregnancy. You should also let your dentist know if you are trying to get pregnant. Having this knowledge can help in planning X-rays or other treatments that are needed.
After you have had your baby, if you experienced any type of gum problems during your pregnancy, see your dentist soon after delivery to have your entire mouth examined and periodontal health evaluated.
As a mother to be, what you do to take care of your health (including your diet) affects the development of your baby’s teeth and gums as well as their entire bodies. And as your body goes through a process of change, it is also important to pay particular attention to your own oral hygiene. Maintaining a good daily oral routine can help keep potential problems from developing.
Don’t forget that this is a time in your life to enjoy the natural changes that take place in your body, relax, and get ready to welcome your new baby into the world. So radiate health by keeping your smile bright and teeth healthy for many years to come.
By Jody Bardash, DDS
