Oral Health During Pregnancy

Finding out you have a bundle of joy on the way is a very exciting time. But did you know pregnancy can lead to dental problems in some women? Some of these problems include gum disease and increased risk of tooth decay. An increase in hormones during pregnancy can affect your body’s response to plaque (the layer of germs on your teeth).

There is an old wives’ tale that warns a woman to expect a lost tooth for every baby which could not be further from the truth. Pregnancy does not automatically damage your teeth. During pregnancy, if the mother’s intake of calcium is inadequate her bones – not her teeth – will provide her baby with the calcium it needs. This calcium loss is fast recovered once breastfeeding has stopped. In some women, Pregnancy can lead to particular dental problems. By ensuring you carry out proper dental hygiene at home and by seeking professional help from your dentist, your teeth should remain healthy throughout the duration of your pregnancy.

Dental disease can affect a developing baby

Extensive research has found a link between gum disease in pregnant women and premature birth with low birth weight. Babies who are born prematurely may risk a range of health conditions including cerebral palsy and problems with eyesight and hearing. Estimates have found that up to 18 out of every 100 premature births may be triggered by periodontal disease. Periodontal disease is a chronic infection of the gums. Appropriate dental treatment for the expectant mother may reduce the risk of premature birth.

Pre-pregnancy dental health

During pregnancy, you are less likely to develop dental problems if you already have good oral hygiene habits. Suggestions include:

• Brushing your teeth twice daily with a toothpaste containing fluoride.

• Floss between your teeth daily.

• Visit your dentist every 6 months.

If you are planning on getting pregnant, but you have plans to have elective dental procedures, it is much more convenient to have these procedures carried out before you conceive. If you are pregnant and require dental treatment non-urgent procedures are often performed after the first trimester.

Tell your dentist if you are pregnant

In some cases, pregnancy may affect your dental care. An example of this may be, the dentist may put off taking x-rays until after the birth of your baby. If dental x-rays are unavoidable, the dentist is able to take precautions to ensure your baby’s safety. If your dental condition happens to require general anaesthesia or medications, talk to your dentist, doctor or obstetrician for advice.

Causes of dental health problems

Some common causes of dental health problems during pregnancy can include:

• Gum problems

• Vomiting

• Cravings for sugary foods

• Retching while brushing teeth.

Gum problems

Hormones that are associated with pregnancy can make some women susceptible to gum problems including:

• Gingivitis (gum inflammation) – During the second trimester, this is more likely to occur. Symptoms include swelling of the gums and bleeding, particularly during brushing and when flossing between teeth.

• Undiagnosed or untreated periodontal disease – During pregnancy, this may worsen. This chronic gum infection, which is caused by untreated gingivitis and can lead to tooth loss

• Pregnancy epulis or pyogenic granuloma – This is a localised enlargement of the gum, which may bleed easily. This may require additional professional cleaning, and rarely excision.

During pregnancy, the gum problems that occur are not due to an increase in plaque, but a worse response to plaque due to an increase in hormone levels.

If you are experiencing gum problems it is important to mention this to your dentist. It may help to switch to a softer toothbrush and brush your teeth regularly, at least twice every day. Use toothpaste that contains fluoride (if you’re not already doing so) as this will help to strengthen your teeth against decay.

If you suffered gum problems during pregnancy, it is also very important to get your gums checked by a dentist after the birth of your baby. While most types of gum problems caused by pregnancy hormones resolve after birth, a small number of women may have possibly developed a deeper level of gum disease that will require treatment and management.

Vomiting can damage teeth

The ring of muscles that keep food inside the stomach are softened due to pregnancy hormone. Gastric reflux (regurgitating food or drink) or the vomiting associated with morning sickness can coat your teeth with strong stomach acids. Repeated reflux and vomiting can damage tooth enamel and therefore increase the risk of decay.

Suggestions include:

• Avoid brushing your teeth immediately after vomiting. While the teeth are covered in stomach acids, the vigorous action of the toothbrush may scratch and damage tooth enamel.

• Rinse your mouth thoroughly with plain tap water.

• Follow up with a fluoridated mouthwash.

• If you don’t have a fluoridated mouthwash, put a dab of fluoridated toothpaste on your finger and smear it over your teeth. Rinse thoroughly with water.

• Brush your teeth at least an hour after vomiting.

Retching while brushing teeth

Some pregnant women find that brushing their teeth, particularly the molars, provokes retching. However, as hard as this may be you risk tooth decay if you don’t brush regularly.

Suggestions include:

• Using a brush with a small head, such as a brush made for toddlers.

• Take your time. Slow down your brushing action.

• It can help to close your eyes and concentrate on your breathing.

• Try other distractions, such as listening to music.

• If the taste of the toothpaste seems to provoke your gag reflex, try switching to another brand. Alternatively, brush your teeth with water and then follow with a fluoride mouthwash. Go back to brushing with fluoride toothpaste as soon as you can.

Food cravings while pregnant

During pregnancy, some women experience unusual food cravings (and food avoidance). Some women desire sugary snacks however this may increase your risk of tooth decay. It is recommended to try and snack on low-sugar foods instead.

If nothing but sweetness will satisfy your craving, try to sometimes choose healthier options such as fresh fruits. Rinse your mouth with water or milk, or brush your teeth after having sugary snacks.

Increase your calcium during pregnancy

It is important to increase your daily amount of calcium during pregnancy. Sufficient calcium helps to protect your bone mass and meet the nutritional needs of your developing baby.

Good sources of dietary calcium include products include:

• Milk.

• Cheese.

• Yoghurt.

• Calcium-fortified soymilk.

Increase your vitamin D during pregnancy

It is important to ensure you are getting sufficient vitamin D. This helps the body to utilise calcium. Good sources include:

• Cheese.

• Margarine.

• Fatty fish, such as salmon.

• Eggs.

Things to remember

• The demands of pregnancy can lead to particular dental problems in some women.

• You are less likely to have dental problems during pregnancy if you already have good oral hygiene habits.

• With proper dental hygiene at home and professional help from your dentist, your teeth should stay healthy during pregnancy.