Oral Health in Pregnancy
Over the years I have often received questions about oral health issues and dental treatment during pregnancy and this page deals with the most common oral health issues I've seen arising during a pregnancy and the common questions about dentistry and dental treatment during this very significant period.
Common Problems
Common Misconceptions
- gum bleeding and occasionally swelling
- diet changes can make you more vulnerable to dental caries
- erosion of teeth due to acid reflux especially during the final trimester
- difficulty cleaning due to nausea which can cause gum disease and caries
Common Misconceptions
- You should not see the dentist when you are pregnant
- Bleeding gums are normal
- Loss of calcium causes teeth to deteriorate during a pregnancy
The traditional thinking that an expectant mother should not visit the dentist is probably based real problems which plaqued dentistry in the distant past. For example :
So is it risky for you to visit the dentist?
Modern dentistry has, to a large extent, eliminated these problems. mercury containing amalgam filling materials have never been used in our office, the development of Standard Precautions as a standard for cross infection control in dentistry has drastically reduced if not eliminated the risk that you will catch an infectious disease in a dental office. Modern x-ray machines are designed to use only the very minimum of radiation possible to produce the x-ray images and the advent of digital x-ray sensors has further reduced the dosage as these typically are more sensitive and hence require less radiation than traditional films to produce the same image quality. In addition this has eliminated significant chemicals from the dental setting. Antiseptics are (of course) still commonly used but in our office we have moved to purely heat disinfection of all dental instruments eliminating this issue entirely.
Bleeding gums are normal?
This is definitely NOT normal and can almost always be completely eliminated by good oral hygiene and in particular regular, thorough scaling and prophylaxis to remove dental calculus.
Dental calculus and plaque irritate the gums and cause gum disease. Hormone changes during pregnancy make the gums even more sensitive to irritation so that a woman who already has some unnoticed gum disease (occasional bleeding only etc) will notice that the gums are now more unhealthy. This also causes the gum disease to progress more rapidly and aggressively leading to bone loss and shrinkage of the gums.
However many studies have shown that if your teeth are clean and your gums healthy, the chances of bleeding gums and aggressive gum disease is almost completely eliminated. There is no scientific evidence to suggest that it is in any way detrimental for an expectant mother to visit the dentist especially for routine treatment like scaling and preventive dental maintenance.
Hence, far from being something to avoid, visiting the dentist for preventive maintenance is essential just before and during pregnancy. In fact, it is probably best to visit before your expected delivery date because you will likely be very busy and find it difficult to find time for a dental appointment after that.
Do teeth loose calcium during pregnancy?
There is actually no evidence to suggest that expectant mothers suffer a significant loss of calcium from teeth during pregnancy. However the other changes that occur (acid reflux, diet changes, nausea etc) can make teeth significantly more vulnerable to dental caries which gives the impression that the teeth were weakened by calcium loss.
This is another reason it is important to have regular dental checkups during pregnancy. If these problems are detected measures can be taken to mitigate the problems. Small dental cavities that might develop can be dealt with early (and with perfect safety)
- Infection control was often less than ideal.
- Mercury was a common item in dental clinics. Traditional silver amalgam restorations were made of a mix of silver, tin and mercury with a small amount of other heavy elements like copper and nickel.
- Radiation from x-ray machines
- other chemicals - x-ray processing solution, antiseptics,
So is it risky for you to visit the dentist?
Modern dentistry has, to a large extent, eliminated these problems. mercury containing amalgam filling materials have never been used in our office, the development of Standard Precautions as a standard for cross infection control in dentistry has drastically reduced if not eliminated the risk that you will catch an infectious disease in a dental office. Modern x-ray machines are designed to use only the very minimum of radiation possible to produce the x-ray images and the advent of digital x-ray sensors has further reduced the dosage as these typically are more sensitive and hence require less radiation than traditional films to produce the same image quality. In addition this has eliminated significant chemicals from the dental setting. Antiseptics are (of course) still commonly used but in our office we have moved to purely heat disinfection of all dental instruments eliminating this issue entirely.
Bleeding gums are normal?
This is definitely NOT normal and can almost always be completely eliminated by good oral hygiene and in particular regular, thorough scaling and prophylaxis to remove dental calculus.
Dental calculus and plaque irritate the gums and cause gum disease. Hormone changes during pregnancy make the gums even more sensitive to irritation so that a woman who already has some unnoticed gum disease (occasional bleeding only etc) will notice that the gums are now more unhealthy. This also causes the gum disease to progress more rapidly and aggressively leading to bone loss and shrinkage of the gums.
However many studies have shown that if your teeth are clean and your gums healthy, the chances of bleeding gums and aggressive gum disease is almost completely eliminated. There is no scientific evidence to suggest that it is in any way detrimental for an expectant mother to visit the dentist especially for routine treatment like scaling and preventive dental maintenance.
Hence, far from being something to avoid, visiting the dentist for preventive maintenance is essential just before and during pregnancy. In fact, it is probably best to visit before your expected delivery date because you will likely be very busy and find it difficult to find time for a dental appointment after that.
Do teeth loose calcium during pregnancy?
There is actually no evidence to suggest that expectant mothers suffer a significant loss of calcium from teeth during pregnancy. However the other changes that occur (acid reflux, diet changes, nausea etc) can make teeth significantly more vulnerable to dental caries which gives the impression that the teeth were weakened by calcium loss.
This is another reason it is important to have regular dental checkups during pregnancy. If these problems are detected measures can be taken to mitigate the problems. Small dental cavities that might develop can be dealt with early (and with perfect safety)
Antenatal oral care
From a practical, day to day standpoint there is little difference between routine oral care and antenatal oral care. You should
maintain a sensible, balanced and nutritious diet avoiding excessive sugar intake
maintain good oral hygiene by regular thorough tooth brushing and flossing
visit the dentist regularly for preventive maintenance
From a practical, day to day standpoint there is little difference between routine oral care and antenatal oral care. You should
maintain a sensible, balanced and nutritious diet avoiding excessive sugar intake
maintain good oral hygiene by regular thorough tooth brushing and flossing
visit the dentist regularly for preventive maintenance
Dental Treatment during Pregnancy
Generally, routine dental procedures are perfectly safe during pregnancy. Surgical procedures and more complex treatment are still possible with a high degree of safety. In some situations some modifications will have to be made to the protocols. For example x-ray examination,oral medication and injections (which are also medication) would be avoided as much as possible.
If you have a dental problem like a dental abscess, it is generally better to have the problem treated properly (for example with a root canal treatment) than to avoid dental treatment and take oral medication. Oral medication, when ingested, will spread through your entire body via the bloodstream and will certainly reach your baby. Dental procedures like fillings and even root canal treatment are usually localized to your mouth and involve materials that are inert and non-toxic when fully set so it is probably less risky.
Generally, routine dental procedures are perfectly safe during pregnancy. Surgical procedures and more complex treatment are still possible with a high degree of safety. In some situations some modifications will have to be made to the protocols. For example x-ray examination,oral medication and injections (which are also medication) would be avoided as much as possible.
If you have a dental problem like a dental abscess, it is generally better to have the problem treated properly (for example with a root canal treatment) than to avoid dental treatment and take oral medication. Oral medication, when ingested, will spread through your entire body via the bloodstream and will certainly reach your baby. Dental procedures like fillings and even root canal treatment are usually localized to your mouth and involve materials that are inert and non-toxic when fully set so it is probably less risky.