Pregnancy and Oral Health | ExpatWoman.com
 

Pregnancy and Oral Health

Finding out you are expecting is a joyous time for parents. Mothers, of course, have the challenges...

Posted on

8 January 2017

Last updated on 2 January 2018
Pregnancy and Oral Health

Finding out you are expecting is a joyous time for parents. Mothers, of course, have the challenge of making sure they have a healthy pregnancy and problem-free childbirth. During pregnancy, your body goes through many changes, particularly hormonal alterations that can exacerbate the development of diseases such as gingivitis (gum disease) which, in turn, if not treated, can affect the health of your developing baby. Preventative, diagnostic and restorative dental care is safe throughout pregnancy and is effective in maintaining and improving oral health.

Health professionals often do not provide oral health care as a matter of course to pregnant women, however,  and at the same time pregnant women themselves often avoid obtaining it. Oral health care is not routinely included in perinatal care and many women with obvious signs of oral diseases do not receive or seek care. In many cases, neither pregnant women nor health care professionals realise that oral health care is an important component of healthy pregnancy. 
 
For years, the mouth has been viewed as a separate part of the body with no connection to general health. Recent studies have associated poor dental health with diseases such as cardiovascular disease, diabetes, respiratory disease, as well as adverse pregnancy outcomes such as premature deliveries and pre-term low birth weight babies.


Common Dental Problems Associated with Pregnancy

 

ORAL LESIONS

During pregnancy, the oral cavity is exposed more often to gastric acid that can erode dental enamel. Morning sickness is a common cause of this in early in pregnancy; Management strategies aim to reduce oral acid exposure through dietary and lifestyle changes.


CARIES

A quarter of women of reproductive age have dental caries, a disease in which dietary carbohydrate is fermented by oral bacteria into acid that demineralises enamel. Pregnant women are at higher risk of tooth decay for several reasons, including increased acidity in the oral cavity, sugary dietary cravings, and limited attention to oral health.


PREGNANCY ORAL TUMOUR

Pregnancy oral tumour occurs in up to five percent of pregnancies. It is caused by increased progesterone in combination with local irritants and bacteria. Pregnancy tumours are most common after the first trimester, grow rapidly, and typically recede after delivery. 
 

GINGIVITIS

Gingivitis is the most common oral disease in pregnancy, with a prevalence of 60 to 75 percent. One-half of women with preexisting gingivitis have significant exacerbation during pregnancy. Gingivitis is inflammation of the superficial gum tissue. 
 


PERIODONTITIS

Periodontitis is a destructive inflammation of the periodontium affecting approximately 30 percent of women of child-bearing age. Elevated levels of inflammatory markers have been found in the amniotic fluid of women with periodontitis and preterm birth compared with healthy control patients. It seems probable that inflammatory cascade alone prematurely initiates labour. Women with a pre-existing periodontal disease can reduce the risk of recurrence or worsening disease during pregnancy through proper oral hygiene. The American Academy of Periodontology recommends that all women who are pregnant or planning to become pregnant undergo a periodontal examination and any necessary treatment.

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Oral Care and Pregnancy 

Dentists now agree that it is safe to get dental treatment during pregnancy. However, since 80 percent of spontaneous miscarriages occur during the first trimester, it is advisable to avoid any non-urgent treatment until the second or third trimester. By the second trimester, the major layers of the internal organs of your baby have developed, thereby reducing the risk of exposure to any harmful or necessary medications that may be needed.
 


Before Pregnancy:

It is important in all stages of your life to have a good dental care routine with proper brushing, flossing and six-monthly professional cleanings. However, before you plan to start your family, you should make a dental appointment to have your teeth cleaned, checked and your gum tissue carefully examined.  At this time, x-rays can be done to assess for unseen cavities and any problems can be treated in advance of your pregnancy. This is a good time to talk to your dentist about removing amalgam fillings (silver) because of the mercury content and the potential for travelling through breast milk. Having your teeth in great shape is the first place to start.
 

During Pregnancy:

Make sure your dentist knows that you are expecting a baby. Except in the case of a dental emergencies (root canal treatments or extractions), and apart from cleaning and a routine dental visit, dental treatment should be avoided or postponed until after the delivery to prevent infectious risks.
 
You will need to keep your regular check-ups with your dentist to monitor changes in your gums such as tenderness, bleeding and swelling. Inform your dentist about all types of medication you may be taking including the prenatal vitamins. Based on that information, your dental treatment plan can differ. As baby’s teeth begin to develop in the third month of your pregnancy, what you eat affects their development. Be careful to avoid certain medications such as antibiotics (tetracyclines) because they can stain your baby’s teeth. 
 
If you are experiencing vomiting with morning sickness, it is highly important that you brush and floss your teeth more frequently to prevent stomach acid from damaging your tooth enamel.
  • Don’t brush your teeth right after vomiting, first, rinse your mouth out with a bit of water and once you feel better, you can brush your teeth.
  • If morning sickness keeps you from brushing your teeth, ask your dentist to recommend a bland-tasting toothpaste and a soft toothbrush with a small brush to prevent the gagging reflex.
  • You could also use a fluoride rinse to protect your teeth enamel.
Maintaining a healthy and balanced diet will help you building strong teeth for your baby. Healthy diets containing dairy products, cheese, and yogurt are a good source of essential minerals and are good for baby's developing teeth, gums, and bones. Vitamin C, Vitamin B12, Vitamin B9 (folic acid) and Calcium are the main components of a rich diet during your pregnancy. Folic acid will also help you to cope with morning sickness. Ask your doctor for more information.
 

X-rays and Pregnancy

With modern digital radiology, exposure to radiation is extremely low. You and your unborn child are generally at a higher risk from gum disease or tooth infection, than you are with radiation exposure. X-rays can be done if genuinely required, else routine x-rays should wait 'till the end of pregnancy.  Other areas you are exposed to radiation include the sun, microwaves and your cell phones.
 

Once the baby is born

You can help prevent your baby from getting cavities or developing what is called Baby Bottle Tooth Decay or Early Childhood Caries, by beginning an oral hygiene routine within the first few days after birth.
 
In order to make your child feel comfortable and familiar with oral hygiene habits, it is recommended that from 0-6 months, you use a gauze or a finger brush to wipe your baby’s gums even if no teeth have erupted yet. On average, baby teeth begin to erupt around six months. Once a tooth erupts you should clean it each day with a baby toothbrush and water, it will also massage the gums and help baby with teething.
 
From 6-12 months, you should visit the dentist with your child (before the first birthday). Children who go to the dentist by age 1 tend to need fewer fillings than those who wait. Even though your child’s teeth will fall out it is important to look after them to protect the permanent ones and to develop the good hygiene habits that he or she will have for a lifetime. These visits will help to establish a confidence and easy relationship with your dentist.  Ask your dentist or hygienist about a soft-bristled child’s toothbrush and fluoride-free toothpaste.
 

Helpful tips for healthy teeth:

  • Do not put your baby to bed with a bottle filled with anything but water
  • Feed your child with food low in sugar
  • Do not dip a pacifier in sweet items (honey).
  • Do not clean a dropped pacifier in your mouth - use hot water
Dr Ritul Agarwal, MDS, MProsth, RCS (Edin) is a specialist prosthodontist at Mediclinic Beach Road.
 
 
 

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