Good oral hygiene is important at all times, but especially when you’re pregnant. According to some studies, only 22 to 34 percent of pregnant women see a dentist during their pregnancy.

If you’re expecting, you need to pay particular attention to your dental health, as any issues could affect not only you, but also your baby. In fact, dental problems that arise while you’re pregnant can interfere with your pregnancy.

For example, during the first trimester, dental plaque bacteria can travel through the bloodstream to the placenta and activate the hormones that trigger labour (prostaglandins), causing premature delivery.

Pregnancy and dental health

Pregnancy brings about a whirlwind of physical and lifestyle changes, which can affect your dental health.

For example, hormones such as estrogen and progesterone make gums more sensitive to plaque buildup. They can also affect the bone and ligaments that support your teeth, which can make them feel loose and cause your gums to bleed.

In addition, morning sickness during the first trimester and acid reflux during the third trimester can increase the acidity of the mouth.

Lastly, some women experience intense cravings for sugary snacks during pregnancy. Eating a lot of sugar can increase the amount of harmful bacteria in your mouth.

Gingivitis

Gingivitis, a reversible gum disease, affects roughly half of pregnant women. It’s the most common dental problem during pregnancy.

This is because pregnancy hormones make your gums more sensitive to dental plaque. Pregnancy gingivitis tends to develop after the third month. The gums usually return to normal after the baby is born.

Gingivitis is characterized by red, swollen, bleeding gums. If left untreated, it can develop into a more serious disease that causes tooth loss and permanent gum damage. Gum disease can also lead to high blood pressure during pregnancy, a condition known as preeclampsia.

In addition, according to a recent study, pregnancy gingivitis increases the risk of giving birth to a preterm, underweight baby. Another study even found that, among pregnant women with gingivitis, the rate of preterm delivery was much lower for those who’d had their teeth cleaned and scaled.

If you think you may have gingivitis, schedule an exam with your dentist so they can assess the problem. They’ll be able to give you advice on oral hygiene and do a teeth cleaning to prevent your gums from getting worse.

The most important thing is to maintain good dental hygiene by brushing your teeth regularly with fluoride toothpaste and flossing under your gums to remove plaque and bacteria.

Rinsing your mouth with salt water (1 tsp in a cup of warm water) can also help reduce gum inflammation.

Cavities

Like sugar cravings, vomiting during pregnancy increases your risk of getting cavities. You can counter that risk in a couple of ways:

• If you vomit, rinse your mouth immediately afterward with water or mouthwash, as the acid in vomit can leach calcium from your teeth.
• After vomiting, wait 30 minutes before brushing your teeth with a fluoride toothpaste. Your teeth will be more fragile right after coming into contact with the acid from your stomach, so brushing your teeth straight away could damage the enamel. Waiting a little will allow your teeth to reabsorb minerals from your saliva and help the enamel reharden.

It’s important to treat any cavities or infections that develop during pregnancy. The second trimester (weeks 15 to 28) is usually a good time to get treatment, as morning sickness has generally subsided by then.

In addition, your baby will have developed all its organs, lowering the risk of side effects from the drugs and products used during treatment. Studies have shown that women who undergo a dental procedure (filling, tooth extraction, root canal) during their second trimester are not more likely to experience problems during delivery.

However, dental treatment during the third trimester can be more complicated. Many pregnant women find lying on their back for a prolonged period uncomfortable. It’s also not recommended for the health of the fetus: this position puts pressure on major blood vessels, decreasing blood flow to the womb.

In any case, the dentist will determine whether treatment is necessary right away or whether it can wait until after the baby has arrived.

How to prevent dental problems

The following tips will help you limit dental problems during your pregnancy.

• Brush your teeth at least twice a day, ideally after every meal or snack. Use a small amount of toothpaste (about the size of a pea) that contains fluoride and brush for at least 2 minutes. Be especially careful to brush along your gum line. When you’re done, spit out the toothpaste, but don’t rinse your mouth.
• Floss at least once a day. This helps remove the bacterial plaque that can build up between your teeth.
• Avoid using mouthwash that contains alcohol. You can use fluoride mouthwash to help prevent cavities. It’s important to spit it out after rinsing and not to swallow it.
• Maintain a healthy diet. Make sure to eat foods rich in calcium, vitamins A, C, and D, protein, and phosphorus. Prenatal multivitamins can also help you meet your dietary needs.
• Avoid foods containing added sugar, as they promote the development of bacterial plaque. You should also avoid sticky foods. Instead, opt for snacks such as fresh fruits and vegetables, nuts, and dairy products.
• When you have drinks that contain sugar, such as juice, milk, or carbonated beverages, have them with meals as much as possible, and try not to sip them over long periods. This will reduce your teeth’s exposure to sugar and give them a chance to reabsorb some of the minerals in your saliva.
• Visit your dentist regularly. It’s important to let them know that you’re pregnant. You can make an appointment to have your teeth cleaned and scaled during your first trimester.

Things to keep in mind

• Gingivitis and cavities are more common in pregnant women.
• Dental problems can affect your pregnancy.
• Proper oral hygiene and nutrition can reduce the risk of dental issues.

Scientific review: Dr. Normand Bach, D.M.D., M.Sc., (F)CRCDC, orthodontist and head of the first-year Orthodontics Department in the Faculty of Dentistry at the Université de Montréal Research and copywriting: The Naître et grandir team Updated: April 2020