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Dental care during pregnancy

Dr. Tiina Kurrik, dentist at Merimetsa Hamba Kliinik

I often hear female patients complain that pregnancy has ruined their teeth. The saying that “you lose one tooth per child” is largely an exaggeration. Problems are usually rooted in insufficient knowledge, unhealthy diet, poor oral hygiene and lack of treatment.

 

How often should I visit the dentist during my pregnancy?

It is common to start paying more attention to your health during the pregnancy and usually it also reminds people to visit the dentist. Ideally, you should have good oral hygiene and your teeth should be healthy and calculus free already before the pregnancy. But naturally you should have your teeth check at least once during the pregnancy; the second trimester would be the best time to do it. However, if you are having problems with your teeth, you should see your dentist before that. During the routine check-up the dentist can also clean your teeth, if necessary.

You should definitely inform you dentist of your pregnancy. In case you need treatment, your doctor can decide which problems need immediate treatment and which can be dealt with after you have given birth. Although most procedures are safe to perform during the pregnancy, there are several factors that can impede treatment. During the first half of the pregnancy, most suffer from nausea and vomiting; during the second half, it can be too wearisome to sit in the dentist’s chair for a long time due to obstruction in blood circulation.

X-rays during the pregnancy should be done only in case of the utmost necessity. If it really is necessary, a special protective apron that covers both the thyroid and the abdominal area needs to be used. That way, the risk of radiation is minimal and the procedure is safe for both the mother and the child. Since the information provided by X-rays is crucial for a correct diagnosis in modern dentistry, it is one of the reasons why you should have your teeth checked before the pregnancy. X-rays done while nursing do not have an effect on the child’s health. Usually the use of anesthetic injections is also safe during the pregnancy.

 

What is pregnancy gingivitis?

During the pregnancy, the body goes through hormonal changes. The raised levels of oestrogen and progesterone increase the sensitivity of gums. Your gums become more vulnerable to dental plaque, which, in turn, may lead to the inflammation of gums also known as gingivitis.

The common symptoms of gingivitis are

  • red, lush gums
  • frequent bleeding of gums
  • bad breath or taste in your mouth.

If you were having trouble with your gums prior to you pregnancy, the situation might deteriorate during it. People often get too careful when they notice blood during brushing and instead of taking better care of their oral hygiene, they start brushing less in fear of “damaging” their gums. If you have good oral hygiene, your teeth are healthy and calculus free, pregnancy gingivitis is a passing phenomenon. However, if the problem is left unnoticed, the calculus remains unremoved and you have poor oral hygiene, pregnancy gingivitis can progress into periodontitis, a disease that permanently damages your gums and leads to tooth loss.
Some patients also suffer from overgrowing gums as a result of pregnancy gingivitis. Those are benign growths caused by the body’s reaction to stressors, in this case, dental plaque. Usually they disappear after the birth of your child.

Can my oral hygiene also have an effect on my baby during the pregnancy?

Studies show that gum diseases can also damage the health of the unborn baby. Women with severe gum inflammation suffer from an elevated risk of premature labour, its effect is equivalent to smoking or drinking alcohol. Premature babies have much more health issues, both right after birth as well as later in life. In case of gingivitis, it is easier for the bacteria who live in dental plaque to enter the bloodstream. Your body reacts to the infection by releasing prostaglandin, this, in turn, can lead to contractions and premature labour. Also, a correlation between pregnancy gingivitis and the baby’s weight has been discovered. Women with gum diseases are more likely to give birth to underweight babies, even if they are not premature.

 

What should I do?

Most women pay more attention to their health during their pregnancy: they try to eat healthy, move more etc. But do not forget your teeth. Good oral hygiene and a balanced diet ensure healthy teeth. You should brush and floss your teeth twice a day. When you experience vomiting, you should not brush your teeth right after, since gastric fluid dissolves the surface of teeth and by mechanically rubbing them you damage your teeth even more. It can also increase nausea. If you do get nauseous while brushing your teeth, you should try to breathe deep. You can also occasionally brush without toothpaste or try to find a paste that causes less irritation.
During the pregnancy you need more nutrients, including minerals. Sometimes it is necessary to take mineral supplements, but your gynaecologist will advise you on this matter.
One important thing to remember is that new-born babies do lack the bacteria that cause dental caries. Unfortunately, they usually get them from their mother, who kisses them, “cleans” their pacifier in her mouth or tastes their food.

Therefore, if you have healthy teeth prior to you pregnancy, you baby will not rob you of that. Instead your baby will give you many reasons to smile.