Oral Health Care in Pregnancy

Oral health care in pregnancy is often avoided and misunderstood by physicians, dentists, and patients. Evidence-based practice guidelines are still being developed. Research suggests that some prenatal oral conditions may have adverse consequences for the child.

Pregnancy is a time when women may be more motivated to make healthy changes. Physicians can address maternal oral issues, potentially reducing the risk of preterm birth and childhood caries through oral disease prevention, diagnosis, early management, and dental referral.

Every pregnant woman should be screened for oral risks, counselled on proper oral hygiene, and referred for dental treatment when necessary. Dental procedures such as diagnostic radiography, periodontal treatment, restorations, and extractions are safe and are best performed during the second trimester. Xylitol and chlorhexidine may be used as adjuvant therapy for high-risk mothers in the early postpartum period to reduce transmission of cariogenic bacteria to their infants. Appropriate dental care and prevention during pregnancy may reduce poor prenatal outcomes and decrease infant caries.

Common Oral Problems in Pregnancy

Morning sickness (95 – 100% risk)

Morning sickness is a part of pregnancy for many women. It also brings up concerns about oral health and pregnancy, as the acid from your stomach can be strong enough to contribute to tooth erosion, according to the American Congress of Obstetricians and Gynaecologists (ACOG). If you suffer from heartburn or acid reflux later in your pregnancy, the gastric acid can have the same effect on your teeth. For this reason do not brush your teeth immediately after vomiting as the enamel is softer and can be more easily damaged. Instead rinse with water and rub fluoride toothpaste on your teeth (if you can stomach the taste!). Brush your teeth at least an hour after vomiting as this will allow time for the acid to neutralise.

Pregnancy Gingivitis (30 – 100% risk)

Without hormones, you wouldn’t be able to make a baby. With them, though, you feel a bit moodier, your bladder seems a lot smaller, and for some reasons you constantly crave weird meals like peanut butter and pickles. Hormones also play a part in making your gums swell while pregnant, leading to a condition called pregnancy gingivitis. If you notice that your gums are bleeding more frequently during pregnancy, be proactive about it. Your dentist might recommend more frequent professional teeth cleanings, at least until your baby is born.

At home, keep up the good work. Use a soft-bristled toothbrush to reduce the chance of irritating your gums, and fluoride toothpaste to help prevent plaque, tartar build-up and gingivitis. Also, remember to floss at least once a day; swelling makes it easier for bits of food to get stuck in hard-to-reach places. Also, remember to floss at least once a day; swelling makes it easier for bits of food to get stuck in hard-to-reach places.

Pregnancy tumour (1 – 5% risks)

Some women also develop what is alarmingly called “pregnancy tumours” due to hormonal changes while pregnant. Don’t let the name scare you; pregnancy tumours are not cancerous. According to the American Dental Association (ADA), the growths most often appear during the second trimester, and look like little raspberries that form between the teeth. Your dentist can remove them if they cause you discomfort, but in most cases, the tumours will vanish after your baby is born.

Dental Carries

Tooth decay is an infection that is caused by bacteria and infants are not born with the bacteria that cause your teeth to decay. Children usually acquire these bacteria from their mother before they reach the age of three. The usual ways of transmitting bacteria are through kissing, sharing utensils, cleaning off a pacifier using your mouth, or when an infant puts their hand inside your mouth. Mothers who have active tooth decay are more likely to transmit bacteria to the child. When the child acquires these bacteria, they become more likely to get tooth decay early in their lives.

If you are pregnant and if you have active tooth decay then you should improve your oral health. This will reduce the risk that your child will get tooth decay. You must reduce the cavity-causing bacteria in your mouth so that you do not transmit it to your child.

Top dental care during pregnancy

• Balanced diet: Limit sugary and acidic snacks and increase your calcium and water intake.
• Avoid X-rays: X-rays must be avoided when you are pregnant but if you really need to have an x-ray for an emergency dental treatment, then your dentist will do everything that is needed to protect you and your unborn child. You will be covered with a lead apron and only the minimum amount of x-rays will be taken.
• Avoid use of Tetracycline: It is not often used during pregnancy, particularly in the second or third trimesters, as use during this period is known to cause a baby’s milk teeth to be permanently stained and discoloured when they come through after birth.
• See your dentist regularly: If you are planning to fall pregnant it is easier to get treatment and X-Ray’s done prior to conceiving. If you are already pregnant or there is a chance you might be pregnant then let your dentist know so they can take any precautions to keep your baby safe. This will also let them prioritise your urgent dental treatment around your pregnancy and the birth.
• Brush your teeth twice daily: Good dental cleaning at home will prevent tooth decay and gum disease.
• Floss between your teeth: Our toothbrush cannot access the areas where our teeth touch so flossing is an important part of your dental health.

 Victoria Haruna 

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