(Disclaimer – These are general guidelines for pregnant women. Individual cases may vary depending on the overall general health and other factors. Please consult with your clinician if you are facing any difficulties related to your oral health)
Pregnancy is a life-defining event for all women. Add to it, the physical changes that happen and the hormonal shift, maintaining good health should be a top priority for every pregnant mom. Good dental health during pregnancy is an important prerequisite for a good general health. Though the old-wives tale of ‘gain a baby, lose a tooth’ is not true in the respect that we do not lose calcium from our tooth during pregnancy, research does show that dental problems increase during pregnancy. Hence, I will be outlining a few tips to help you maintain your oral health during pregnancy.
Continue brushing your teeth twice a day with fluoridated toothpaste. But let’s talk reality – (most) pregnant women feel nauseous either due to the flavour of the toothpaste or of the head of the toothbrush in their mouth
- Use a bland (fluoridated) toothpaste so that there is no overpowering flavour or taste.
- Use a small, round head toothbrush and soft bristles if you have gingival bleeding.
- In extreme cases of nausea due to toothbrush/toothpaste, wash your mouth with water and a fluoridated mouthwash. Use a fluoridated toothpaste immediately as and when possible.
Dental caries (Decay of the tooth)
Due to the hormonal shift, the increased acidic environment in the mouth due to hyperemesis gravidarum, increased carbohydrate consumption or extreme gag reflex and hence lack of good oral care, dental caries is common in pregnant women. Poor maternal oral health can also lead to early transmission of cariogenic bacteria to the infant thus leading to vertical transmission of caries.
- Regular brushing with a fluoridated toothpaste, flossing, annual check-ups with your dentist will help in minimizing the effect.
is a condition that affects 0.3-2.0% of pregnant women. Since there is constant vomiting and hence an acidic environment in the mouth, it can lead to the dissolution of enamel structures.
- Washing your mouth with water with a pinch of bicarbonate soda added to it can help neutralize the acids.
- Do not brush your teeth with paste immediately after vomiting.
You might have heard of the phrase ‘pregnant ladies are clumsy‘. As with other joints of the body, the periodontal structures can become slightly lax leading to a very minimal mobility of the tooth.
- If there is no underlying periodontal disease, this is a condition that can be looked beyond and will correct itself after the pregnancy.
There is increased inflammation
of the gums thus leading to bleeding which affects around 70% of pregnant women. The elevation in oestrogen and progesterone enhances inflammatory response and consequently alters the gingival tissue.
- Regular brushing, flossing and a professional cleaning/ scaling can help minimize the effect.
Loosening of the periodontal structures due to inflammation can lead to deep pockets formed between the gums and the teeth. Chronic periodontal conditions not only affect the maternal health but also the fetal health. Periodontal conditions can also have adverse pregnancy outcomes
such as low birth weight babies, preterm babies, GDM etc.
- Treatment by your clinician can help diagnose and manage the disease.
A soft, vascularised pedunculated lesion is seen on the gingiva in about 5% of pregnant ladies. Though it goes by the misnomer ‘pregnancy tumour’, it is benign and harmless.
- This is not a condition that requires medical treatment and usually regresses after pregnancy.
Dental X-rays during pregnancy
Modern dental X-rays do not have an adverse effect on the fetus due to the minimal radiation exposure. Lead body and neck cast should be used before using X-rays. For pregnant women, routine X-rays are not usually taken. Only X-rays that are necessary for the completion of a dental procedure will be taken. As a patient, if you are uncomfortable with the prospect of taking an X-ray while pregnant, you may discuss with your clinician and delay your dental treatment (if not an emergency) until your delivery.
As a pregnant clinician, please follow the regular safety guidelines while taking an X-ray and have the dosimetry badge attached to you so as to monitor that the amount of radiation you are exposed to daily does not exceed the safe limit.
Dental treatment during pregnancy
Patients can undergo dental treatment during pregnancy. The second trimester is ideal for any treatment procedures. While being seated in the dental chair, a left lateral position or your right hip being slightly elevated will reduce the chances of supine hypotension. Anesthetics can be used but in case of pregnant ladies with severe hypertension, uncontrolled hyperthyroidism etc, clinicians use anaesthetics without adrenaline.
Medications during pregnancy
Please inform your clinician that you are pregnant before being prescribed any medications. Over the counter painkillers and other medications should be best avoided lest they are harmful to the growing fetus. Regular painkillers like Brufen should be avoided during pregnancy.
Pregnant women can achieve good oral health through proper diet, regular dental visits during pregnancy, professional cleaning, correct technique for brushing and flossing, as well as any medically required dental work. I reiterate again that a good oral health is important for the general well-being of a person and hence adequate measures should be taken by each individual for the same.
(Dr. Shahira is a registered and licensed dentist in Qatar and India. She graduated with her dental degree from DSCDS, Bangalore, India)