Pregnancy and dental health —what to expect when you are expecting

Pregnancy is a very exciting and challenging time in a woman’s life. It’s a journey that involves psychological, physical and emotional changes in the body which can also impact the developing child. What you may not know is that the mouth can also be affected. A decline in oral health during pregnancy can lead to premature birth, low birth weight babies, pre-eclampsia, gum tissue ulcerations, pregnancy granuloma, gum disease, dry mouth, tooth decay and tooth wear. Oral health should therefore be considered an integral part of prenatal care. 

Gums

Pregnancy brings about changes in the level of hormones in the body. Hormones can easily irritate gums, increasing redness, tenderness, soreness, and bleeding. The hormonal imbalance during pregnancy heightens the response to inflammation causing a common condition called pregnancy gingivitis. The severity of pregnancy gingivitis is seen during the second trimester. 

By the end of the third trimester, high levels of hormones (progesterone and estrogen) can also cause ligaments and bone that support teeth to loosen causing tooth mobility. This usually subsides after the pregnancy. 

Occasionally, overgrowth of gum tissue called pregnancy tumours (pregnancy granuloma) can also occur due to hormonal changes, irritation or trauma. These are benign growth of gum tissue and can occur in 5% of pregnant women. It normally appears in 2nd or 3rd trimester and has a tendency to bleed. These lesions usually resolve by themselves or can be removed after delivery of the baby. 

Gestational diabetes

Glucose production increases in pregnant women with an increased amount of glucose transferring to the baby promoting fetal growth and maintaining the mother’s nutritional status.

During this period, insufficient production of insulin can result in the development of Gestational diabetes. Pregnant women that are diabetic or who experience gestational diabetes are at higher risk of gum disease. 

Morning sickness

One of the common symptoms in pregnancy is morning sickness. Repeated reflux or vomiting can cause stomach acids to coat enamel and increase the risk of tooth erosion and decay. It is important to rinse the mouth immediately with water/bicarb solution to neutralise the acid. Chewing sugar-free gum also stimulates saliva and neutralises the acid. It is important to wait at least 30mins before brushing to avoid damage to the softened enamel surface. 

Tooth Decay

Pregnancy cravings and an increased appetite could initiate a yearning for starchy and sweets foods which can increase the risk of tooth decay in pregnant women. Nutritional snacks such as raw fruits, vegetables or dairy products are better alternatives for snacking during this time. 

Studies have shown that oral bacteria and its byproducts have the ability to cross the placenta. This can affect the baby by developing an inflammatory response in the mother initiating pre-term birth of babies. It is imperative that mothers maintain optimum oral health and seek regular dental care during this time. 

The bacteria in the mother/father’s mouth can also be transferred to the baby once they are born through salivary contact. This can occur from kissing the baby, sharing utensils, blowing on a baby’s food etc. To prevent or delay the transmission of bacteria, it is best for caregivers to have good oral health and low levels of oral bacteria. 

Other changes

Taste changes occur during pregnancy due to hormonal changes. A decrease in taste can occur in the first trimester while some women experience a metallic taste in their mouth called dysgeusia. After the birth of the baby, the taste sensation will return to full capacity. 

Dry mouth is commonly seen in women during pregnancy or while breastfeeding. This can put women at risk of tooth decay or dental infections. Drinking plenty of water and chewing sugar-free gum can stimulate saliva and help reduce the risks caused by dry mouth. 

Smoking 

Smoking during pregnancy can be harmful to you and your baby. Smoking affects the development of babies’ heart, lungs and brain. It can also cause preterm delivery and low birth weight. Tooth development starts in the fetus after six weeks of conception. Smoking habits have been linked to children being born with missing teeth or cleft lip and palate. Smoking in pregnant women can also lead to gum disease. 

Dental visit during pregnancy

A dental checkup during early pregnancy can help to ensure oral health is at its best. During early pregnancy, nausea or morning sickness can occur, hence afternoon appointments might be better suited. If later in pregnancy, laying supine can be uncomfortable hence an upright position with a pillow under right hip is recommended. 

Fluoride toothpaste can be used safely during pregnancy, but fluoride supplements are not recommended. If there is any treatment to be done during pregnancy, local anesthetics are safe to use. X-rays are best to be avoided during this time but if necessary, they can be done with the help of a lead apron to keep babies safe. 

Maintaining good oral health is important for both the mother and the baby during this journey. If you are pregnant or planning to get pregnant, be sure to let us know when you come and see us at Bite Dental. Together we can ensure you have a safe and exciting journey ahead.