Oral Health and Dental Care during Pregnancy – What can You and the Dentist Do?

During pregnancy, having a new life growing within you definitely feel special. There is a bigger commitment to taking care of your well-being. By keeping your health in good condition, the foetus (baby in uterus) can grow and develop healthily. The mouth is part of the body and so oral health is equally important as the body’ health during pregnancy. This article will show you the things that you should and can do for your mouth during pregnancy.

How does Pregnancy affect your oral health?

While oral health can affect the growth of the foetus, the opposite way is also true (pregnancy can also affect your oral health). It is good to know these conditions that may appear during pregnancy so that you can do something about it, or at least you know you should do something about it.

Dental Decay and Erosions

Pregnant women may be more prone to tooth decay due to the change in diet. If you’re eating more carbohydrates than usual, you can get tooth decay more easily. Besides, during the 1st trimester, some pregnant women may experience nausea and vomiting. [3] The vomitus along with the stomach acid can erode the teeth, causing teeth erosion. Constant exposure to this acid can soften and wear down the enamel (outer layer of your teeth), which makes the tooth more likely to have tooth decay and sensitivity.

Here are some tips in caring for your teeth to reduce the risk of teeth erosion:

• Avoid tooth brushing immediately after vomiting, wait for an hour before you brush (the reason is that the teeth are “soft” after being eroded by the acid, and they need time to regain strength by taking in minerals from the saliva)
• Rinse your mouth thoroughly with water
• Rinse using mouthwash containing fluoride

Gum Problems

Changes in hormones during pregnancy can cause you more likely to get gum problems. For example,

• Gingivitis – This is the inflammation of the gums, which happens due to the accumulation of dental plaque – a sticky film containing bacteria around the tooth. Anyone can get gingivitis if the dental plaque is not cleaned away from the teeth and gum. It is a response given by the body’s immune system when it meets the bacteria. In pregnant women, this immune response is amplified, so gingivitis happens more easily. The gums bleed, appear red and swollen.
• Periodontitis – if the gingivitis is left untreated, it can lead to periodontitis, which is a severe form of gum disease. Periodontitis can cause destruction of the bone that supports the teeth, which can lead to “shaky” teeth. Eventually, you can lose your teeth.
• Oral pregnancy tumour or pyogenic granuloma – most often seen during the second and third trimester. [4] They are overgrowths of the gum tissue in between the teeth due to the accumulation of dental plaque and gum inflammation, in addition to the hormonal changes in a pregnant woman’s body. The swelling bleeds easily and appears red, raw-looking and raspberry-like. Professional cleaning and strengthening of your home care routine can help to reduce swelling and inflammation. The swelling usually resolves on its own following the delivery of the baby and no further treatment is necessary. If the swelling persists after pregnancy or is causing discomfort, the dentist may suggest surgical removal.

Therefore, if you experience swelling or bleeding gums when you are brushing, it is important to get them checked by a dentist. There could be other conditions that can cause gum swelling and bleeding.

Click here to find out more about reasons for bleeding gums while brushing.

Tips for good oral health during pregnancy

Now you see that oral health can affect foetus development and pregnancy can also affect oral health. While taking care of your general health, you should remember to care for your oral health. Here are a few things that you can do to manage your oral health care during pregnancy.

• Visit the dentist for a check-up at least once during pregnancy
  • A dentist can advise if there are any problems in your mouth and provide oral hygiene instructions.
• Practice good oral hygiene
  • Brush twice a day for 2 minutes using a soft bristle toothbrush
  • Use toothpaste that contains fluoride to strengthen teeth against tooth decay
  • Clean between teeth at least once a day using a dental floss or an interdental brush
• Eat Healthy Diet
  • Eat a variety of healthy food, such as fruits, vegetables whole-grain products and dairy products.
  • Limit the consumption of sugary and starchy foods to mealtimes only
  • Avoid carbonated soft drinks and fruit juices
  • Drink plenty of water throughout the day
  • If you have nausea, try eating small amounts of healthy food throughout the day

Is it safe for me to go to the dentist during pregnancy?

Generally, yes, it is safe to go for dental visit during pregnancy. In fact, getting your oral health checked by the dentist periodically is a good habit to build on, even during pregnancy. However, there are certain dental procedures and medications that will not be provided at certain stages of pregnancy as they can be harmful to the foetus.

It is hard to give each example specifically here. The main advice is that it is important to inform the dentist regarding your pregnancy, even if you think you may be pregnant. Let your dentist know if you have any medical problems (e.g., high blood pressure and diabetes, etc.) and the medications that you are taking. This is so that the dental team can provide the best and safest treatment for you.

Most dental procedures including scaling, filling, removal of tooth, small surgery and others can be done during the second trimester. Some procedures like removal of the tooth are not carried out in the first trimester and third trimester. The reason being during the first trimester, the foetus cells are immature and growing at a fast pace, so the stressful dental procedures and certain medications or even X-rays can disturb the growth of foetus. In the third trimester, stressful procedures like tooth removal and surgeries are not recommended as the stress may trigger child labour. [7,8,9]

Below are a few medications or dental procedures that may need consideration when carrying out during pregnancy:

Medications

Bring a list of all the prescription and over-the-counter medications you are taking when visiting the dentist. This information will help the dentist to decide what type of medication, if any, to give you. The dentist may consult with your gynaecologist to choose the medications – such as pain killers or antibiotics – that are safe to take during pregnancy.

X-rays

Modern dental X-rays use a very low dose of radiation, and when used properly, it is generally safe to take dental X-rays during pregnancy. However, the dentist may avoid taking any X-rays for you unless it’s an emergency. When a dental X-ray is necessary, a lead apron will be worn around your abdomen to prevent any unnecessary radiation.

Local Anaesthetic

A dentist may need to give you a jab to numb part of your mouth before doing any treatment such as filling and tooth extraction. This numbing injection solution is called a local anaesthetic. The dentist will choose the local anaesthetic agent that is proven safe to be used for pregnant women.

Fillings

Dental decay can be treated safely at any time during the pregnancy. If dental decay is left untreated, it will continue to grow in size and cause serious dental infections. Fillings placed during pregnancy do not increase the risk for adverse birth outcomes, compared to those that do not seek dental treatment during pregnancy. [10]

What will happen if you leave tooth decay untreated? Click here to find out.

Tooth Removal

Can you get a tooth pulled during pregnancy? Yes. An untreated tooth infection can spread to other places in your body, which is dangerous to life. When you require extraction, the dentist will try to schedule the procedure during the second trimester. However, if you have a dental infection or swelling, it doesn’t matter what trimester you’re in, the tooth can and should be removed. For wisdom tooth extraction, if the tooth isn’t causing any problems, the dentist will prefer to postpone the procedure until after delivery.

Teeth cleaning

It is safe to do teeth cleaning (teeth scaling) during pregnancy. Pregnancy gingivitis is a common problem encountered during pregnancy, and it can be prevented or treated by regular teeth cleaning. Signs of pregnancy gingivitis include red swollen gums and bleeding gums during brushing or flossing. Regular dental cleaning is a good preventive measure against pregnancy gingivitis and its harmful effects on health.

Summary

Do not avoid dental care just because you are pregnant! Issues that arise from lack of dental care can cause problems to your pregnancy. Good oral hygiene practices and follow-up are important to keeping your mouth and developing foetus healthy. By involving the dentist, you can help prevent and treat dental problems in advance of your pregnancy.

Reference

1. Komine-Aizawa S, Aizawa S, Hayakawa S. Periodontal diseases and adverse pregnancy outcomes. J Obstet Gynaecol Res. 2019;45(1):5-12. doi:10.1111/jog.
2. Corbella S, Taschieri S, Del Fabbro M, Francetti L, Weinstein R, Ferrazzi E. Adverse pregnancy outcomes and periodontitis: A systematic review and meta-analysis exploring potential association. Quintessence Int. 2016;47(3):193-204. doi:10.3290/j.qi.a34980
3. Herrell HE. Nausea and vomiting of pregnancy. Am Fam Physician. 2014;89(12):965-970.
4. Nair V, Giri P, Debnath T, Rudra A, Mandal R. Oral Pyogenic Granuloma in Pregnancy: A Predicament. International Medical Journal. 2016;23(1). 64-65.
5. American Dental Association. Pregnancy [Internet]. 2017 [cited 15 December 2021]. Available from https://www.ada.org/resources/research/science-and-research-institute/oral-health-topics/pregnancy
6. Committee Opinion No. 569: oral health care during pregnancy and through the lifespan. American College of Obstetricians and Gynecologists. 2013;122:417–22.
7. Hemalatha VT, Manigandan T, Sarumathi T, Aarthi NV, Amudhan A. Dental considerations in pregnancy-a critical review on the oral care. J Clin Diagn Res. 2013;7(5):948-953. doi:10.7860/JCDR/2013/5405.2986
8. Chaveli Lopez B, Sarrion Perez MG, Jimenez Soriano Y. Dental considerations in pregnancy and menopause. J Clin Exp Dent. 2011;3(2):e135–44.
9. Nayak AG, Denny C, Veena KM. Oral health care considerations for the pregnant woman. Dent update.2012;39(1):51–54.
10. Berge TLL, Lygre GB, Lie SA, Björkman L. Polymer-based dental filling materials placed during pregnancy and risk to the foetus. BMC Oral Health. 2018;18(1):144. Published 2018 Aug 22. doi:10.1186/s12903-018-0608-1