Pregnancy and Oral Health

During pregnancy,  there is a special need for good oral hygiene because pregnancy may exaggerate some dental disorders. 

DENTAL CARIES.  Many people believe that a tooth is lost for every pregnancy.  This is not true.  Decay results from repeated acid attacks on the tooth enamel, not from repeated pregnancies.  The decay process begins with plaque, the invisible, sticky layer of harmful bacteria that constantly forms on your teeth.  These bacteria use fermentable carbohydrates - sugars and starches - to produce damaging acids.  Each time you eat, acid attacks your tooth enamel for at least 20 minutes.  Thus, if you snack often on sugar-rich foods throughout the day, you could be having acid attacks all day long!

To avoid the unnecessary loss of teeth, brush thoroughly with an ASA-accepted fluoride toothpaste twice daily.  Clean between your teeth daily with floss or interdental cleaners.  Ask your dentist or hygienist to show you how to brush and floss correctly. 

GINGIVITIS.  Unmoved plaque on your teeth can irritate the gums, making them red, tender and likely to bleed easily.  This condition is called gingivitis and can lead to  more serious periodontal diseases affecting the gums and bone that anchor your teeth in place.  During pregnancy, gingivitis may be more pronounced due to a rise in your body's hormone levels. 

This hormonal increase exaggerates the way that gum tissues react to the irritants in plaque.  The important point to remember is that plaque, not fluctuating hormone levels, is the major cause of gum disease.  Even though hormone changes are occurring, you can prevent gingivitis by keeping your teeth clean, especially near the gum line.  Thoroughly brush and floss your teeth daily to remove plaque, and eat a balanced diet to help keep your gums healthy.

Nutrition
What you eat during the nine months of pregnancy affects the development of your unborn child's teeth.  Your baby's teeth begin to develop between the third and sixth months of pregnancy, so it is important that you receive sufficient amounts of nutrients -especially vitamins A,C, and D, protein, calcium and phosphorus.

It is a myth that calcium is lost from the mother's teeth during pregnancy.   The calcium your baby needs is provide by your diet, not by your teeth.   If dietary calcium is inadequate, however, your body will provide this mineral from stores in your bones.  An adequate intake of dairy products - the primary source of calcium - or the supplements your obstetrician may recommend will ensure that you get all the calcium you need during your pregnancy. 

Eating a balanced diet is necessary to provide the correct amounts of nutrients to nourish both you and your child.  A recommended daily diet for a pregnant woman usually includes the following foods:

• 3 servings of foods such as milk, cheese or yogurt
• 2 to 3 servings of meat, poultry or fish
• 6 or more servings of breads, cereals and other grain products
• 3 or more servings of vegetables
• 2 or more servings of fruits

Following your physician's advice regarding diet is your wisest course.
During pregnancy, many women have the desire to eat between meals.  While this is perfectly normal frequent snacking on foods rich in fermentable carbohydrates can be an invitation to acid attacks and the resultant tooth decay.  The longer sugars are retained in your mouth, the longer the acids attack.  Some research indicated that certain foods, such as cheese, peanuts, or sugar-free chewing gum may help to counter the effects of acid attacks.  One way to avoid this is to clean your teeth after snacking. 

Professional Dental Care
As part of your regular medical history, inform your dentist that you are pregnant, suspect that you are pregnant, or are planning to become pregnant soon.  Also, be sure to tell your dentist if there is any change in your health, any change in the medications you are taking, or any particular advice your physician has given you.  This information will help your dentist determine the best time for treatment and whether to modify your treatment plan to better suit your needs.  Your dentist may also talk with your obstetrician to coordinate treatment plans. 

You should continue regular dental visits throughout your pregnancy, and non-emergency treatment generally can be preformed safely during this time.  However, you may be advised to avoid elective treatment during the first three months of your pregnancy for a number of reasons.  If you have a history of miscarriage, an elevated risk to miscarry, or if you have some other medical condition, your dentist may recommend that treatment be postponed. 

Finally, during the last months of your pregnancy, you may find it uncomfortable to sit in the dental chair for extended periods. In addition, if you have a history of premature delivery, you should avoid receiving treatment during this time.  For your peace of mind and comfort, remember that the  fourth through sixth months of pregnancy are usually the best time for treatment. 

Drugs
Some drugs and anesthetics can be used during and after dental treatment to make you more comfortable.  Your dentist will consult with your physician and use expert judgement to determine what drugs can be safely given at different times during pregnancy.  Also be sure to inform your dentist of any prescribed drugs you are taking.  This will help him or her to determine what type of drug, if any, will be prescribed during or after treatment.  Take only the correct amount of the drug prescribed.  This includes aspirin or any other over-the-counter medication.  If you are concerned about the effect any drug might have on your pregnancy, feel free o discuss your concerns with your dentist and physician.  Both are concerned about you and your child's health.

X-Rays
X-rays are important tools a dentist uses to help detect dental caries and other oral health problems.  Only the X-rays that are necessary for treatment will be taken.  The amount of radiation produced from a dental X-ray is minute and the beam is limited to a small region of the face.  Your dentist may also suggest that you wear a special protective apron during the X-ray procedure. 

A Lifetime of Healthy Smiles for the Entire Family 
As a parent-to-be, you can help yourself and your unborn child achieve the rewards of good oral health.  The special care you take now should not stop when your baby is born!  Continue to follow these good dental health guidelines: 

• Brush thoroughly with an ADA accepted fluoride toothpaste twice daily.
• Floss, or clean between your teeth with interdental cleaners, each day.
• When choosing oral hygiene products, look for the American Dental Association Seal of Acceptance.  The ADA Seal of Acceptance means the product is safe and effective for its intended use.   The ADA reviews all advertising claims for any product bearing the Seal.  Only those claims that can be supported by appropriate clinical and /or laboratory studies and scientific data are allowed. 
• Eat a balanced diet.  Snack in moderation and choose foods that are nutritious for you and your baby. 
• Schedule regular dental visits and periodic professional teeth cleanings.

Remember, parents are role models for their children's behavior, and your baby's dental health is just beginning.  Discuss infant dental care with your dentist and become familiar with good dental practices as your child grows.  These will include appropriate pacifiers., teething, proper oral hygiene for gums and new primary teeth, use of fluoride, and the first dental visit.  Give your child a good foundation for healthy smiles and enjoy a lifetime of good oral health.

Article from Pregnancy & Oral Health
American Dental Association
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