Dental health during pregnancy

Good dental hygiene is always important. But for both your health and your general comfort, it’s an even bigger priority when you’re expecting. That said, according to studies conducted in Canada, France, and the United States, only 33 to 67.5 percent of women see a dentist during pregnancy.

Why is this a concern? Because issues such as bleeding gums, cavities turned abscesses, and dental pain that makes it difficult to chew and eat properly can all have serious consequences.

Pregnancy and dental health

Pregnancy brings about a whirlwind of physical and lifestyle changes, which can sometimes lead to dental problems.

For starters, higher levels of hormones such as estrogen and progesterone during pregnancy increase the risk of gingivitis. Morning sickness and acid reflux can also make your mouth more acidic and cause tooth erosion.

In addition, some women experience intense cravings for sugary snacks during pregnancy, and some medications contain sugar. Unfortunately, sugar can create a favourable environment for cavities to develop.

Lastly, pregnant women sometimes develop a red nodule called a pyogenic granuloma on their gums. Though these bumps appear suddenly, they are not a health risk and will disappear after childbirth. However, in some cases, they can make it difficult to brush your teeth or chew, or alter the look of your smile. Should this occur, your dentist may suggest having the nodule removed during pregnancy.

Gingivitis

Pregnancy gingivitis is a reversible inflammation of the gums that affects more than a third of pregnant women. It’s the most common dental problem during pregnancy.

This is because pregnancy hormones make the gums more vascularized and more sensitive to the irritation caused by dental plaque. Pregnancy gingivitis tends to develop after the second or third month. Gingivitis is characterized by red, swollen, bleeding gums. The gums usually return to normal after the baby is born.

If left untreated, gingivitis can sometimes develop into periodontitis—a chronic inflammatory infection that can damage the bone that supports the teeth. Over time, periodontitis can lead to loosening of the teeth, tooth mobility, and tooth loss.

The most important thing is to practise good dental hygiene habits every day by brushing your teeth regularly with a fluoride toothpaste and flossing.

If you think you may have gingivitis, make an appointment with your dentist so they can examine your teeth and make a diagnosis. They’ll also be able to give you advice on oral hygiene and do a dental cleaning to help keep your teeth in good shape.

Cavities

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

The acidity of vomit can decalcify tooth enamel. If you throw up, rinse your mouth immediately with water or water mixed with a bit of baking soda (1 tsp in a cup of water), or with a fluoridated mouthwash.

After rinsing, wait 30 minutes before brushing your teeth with a fluoride toothpaste. Avoid brushing right away, as decalcified enamel is softer and more prone to damage from abrasion. Waiting half an hour lets your saliva continue to neutralize the acidity in your mouth, allowing your teeth to remineralize and reharden.

In addition, try not to eat sticky, soft, or sugary snacks. These foods contain carbohydrates that significantly increase the risk of cavities.

Most over-the-counter chewable antacids (e.g., TUMS^®, Rolaids^®, Gaviscon^®, Alka-Seltzer^®, Mylanta^®) contain sweeteners in their list of non-medicinal ingredients. This hidden source of sugar can also play a role in the development of cavities.

Treating dental problems during pregnancy

If cavities, infections, or other dental problems develop during pregnancy, it’s important to treat them as soon as possible. Rest assured that dental care is safe during pregnancy.

Your dentist may want to speak with your doctor or midwife to plan certain treatments, but most dental procedures do not require prior consultation. For example, certain antibiotics and local anesthesia can be administered safely during pregnancy. If necessary, X-rays can also be performed without risk to you or your baby.

However, dental treatments can be more complicated during the first and third trimesters. The second trimester (weeks 15 to 28) is usually the best time to go for procedures such as dental exams, fillings, tooth extractions, and root canals.

In general, by the second trimester, pregnant women experience less nausea, and it’s still comfortable to lie down. By contrast, during the third trimester, many 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, your dentist will determine whether treatment is necessary right away. For non-urgent dental care, it’s preferable to 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 with fluoride toothpaste for 2 minutes at least twice a day. Be especially careful to brush along your gum line. When you’re done, spit out the toothpaste, but don’t rinse your mouth.
• Floss or use an interdental brush 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, protein, phosphorus, and vitamins A, C, and D. 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 the amount of sugar your teeth are exposed to and give them a chance to remineralize.
• Visit your dentist regularly. Remember to let them know that you’re pregnant.

Things to keep in mind

• Gingivitis and cavities are more common in pregnant women.
• Proper oral hygiene and nutrition can reduce the risk of dental issues.
• During pregnancy, going to the dentist for preventive care and the diagnosis and treatment of dental problems, including local anesthesia and X-rays, is safe and important for you and your baby.

Scientific review: Dr. Gisèle Mainville, Associate Professor, Faculty of Dentistry, Université de Montréal Research and copywriting: The Naître et grandir team Updated: November 2023

Photo: 123rf.com/luckybusiness