DENTAL HEALTH DURING PREGNANCY

KEY POINTS

• Dental health is an important part of your overall health. It’s also an important part of your pregnancy (prenatal) care.
• Pregnancy increases the risk of certain dental health problems that may lead to pregnancy complications, like premature birth.
• Go to your regular dental checkups during pregnancy. Tell your dentist that you’re pregnant. Dental X-rays are safe during pregnancy.
• If you’re worried about your dental health, see your dentist right away.
• Brush your teeth twice a day and floss once a day.

What is dental health and how does it affect pregnancy?

Dental health (also called oral health) is the health of your mouth, teeth and gums. It’s an important part of your overall health. And if you’re pregnant, it’s an important part of your prenatal care (medical care you get during pregnancy).

Being pregnant can increase your risk for oral health problems, and these problems can affect your pregnancy. For example, some studies show a link between gum disease and premature birth. Premature birth is birth that happens too early, before 37 weeks of pregnancy. Premature babies may have more health problems at birth and later in life than babies born full term.

Taking good care of your mouth, teeth and gums during pregnancy can help you have a healthy pregnancy and a healthy baby.

How does pregnancy affect your dental health?

Changes in your body during pregnancy can affect your teeth and gums. For example:

• You have increased levels of certain hormones, like progesterone and estrogen, in your body during pregnancy. These can increase your risk for certain oral health problems.
• Your eating habits may change. You may eat more of certain foods during pregnancy than you did before you were pregnant. The kinds of food you eat can affect your dental health.
• You may brush and floss your teeth less than you did before you got pregnant. This may be because your gums are tender or you’re more tired than usual. For some women, brushing and flossing may cause nausea (feeling sick to your stomach).

These changes can increase your risk for certain dental problems during pregnancy, including:

Cavities (also called tooth decay or caries). These are small, damaged areas in the surface of your teeth. Being pregnant makes you more likely to have cavities. You can pass the bacteria that causes cavities to your baby during pregnancy and after birth. This can cause problems for your baby’s teeth later in life.

Gingivitis. Gingivitis is inflammation (redness and swelling) of the gums. If untreated, it can lead to more serious gum disease. Pregnancy hormones can increase your risk for gingivitis. Sixty to 75 percent of pregnant women have gingivitis. Signs and symptoms include:

• Redness and swelling
• Tenderness in the gums
• Bleeding of the gums, even when you brush your teeth gently
• Shiny gums

Loose teeth. High levels of the hormones progesterone and estrogen during pregnancy can temporarily loosen the tissues and bones that keep your teeth in place. This can make your teeth loose.

Periodontal disease (also called periodontitis or gum disease).  If gingivitis is untreated, it can lead to periodontal disease. This causes serious infection in the gums and problems with the bones that support the teeth. Your teeth may get loose, and they may have to be extracted (pulled). Periodontitis can lead to bacteremia (bacteria in the bloodstream). This is a serious condition that needs immediate treatment. Smoking is a cause of severe gum disease.

Pregnancy tumors (also called pyogenic granuloma). These tumors are not cancer. They’re lumps that form on the gums, usually between teeth. Pregnancy tumors look red and raw, and they bleed easily. They can be caused by having too much plaque (a sticky film containing bacteria that forms on teeth). These tumors usually go away on their own after giving birth. In rare cases they may need to be removed by your health care provider.

Tooth erosion. If you have vomiting from morning sickness, your teeth may be exposed to too much stomach acid. This acid can harm the enamel (the hard surface) of your teeth. Morning sickness (also called nausea and vomiting of pregnancy or NVP) is nausea and vomiting that happens during pregnancy, usually in the first few months.

What are signs and symptoms of dental problems during pregnancy?

If you have any signs or symptoms of dental problems, call your dentist. Signs of a condition are things someone else can see or know about you, like you have a rash or you’re coughing. Symptoms are things you feel yourself that others can’t see, like having a sore throat or feeling dizzy.

Signs and symptoms of dental problems include:

• Bad breath
• Loose teeth
• Mouth sores or lumps on the gums
• New spaces between your teeth
• Receding gums (when your gums pull away from your teeth so you can see roots of your teeth) or pus along your gumline (where your gums meet your teeth)
• Gums that are red, swollen, tender or shiny; gums that bleed easily
• Toothache or other pain

If you have pain or swelling, call your dentist right away. If you have an infection, you need quick treatment to help prevent problems for your baby.

How can you prevent dental problems during pregnancy?

Get regular dental checkups before and during pregnancy. At your checkups, tell your dentist:

• If you’re pregnant or planning to get pregnant
• About any medicine you take. This includes prescription and over-the-counter medicines, supplements and herbal products. Prescription medicine is medicine that your health care provider says you can take to treat a health condition. You need a prescription (an order from your provider) to get the medicine. Over-the-counter (also called OTC) medicine is medicine, like pain relievers and cough syrup, you can buy without a prescription. A supplement is a product you take to make up for certain nutrients (like vitamin B or iron) that you don’t get enough of in the foods you eat. An herbal product, like a pill or tea, that’s made from herbs (plants used in cooking or medicine).
• If your pregnancy is high-risk. High-risk means that you, your baby or both of you are at increased risk for problems during pregnancy. Your pregnancy may be high-risk if you have a chronic health condition, you have complications from a previous pregnancy or you have other conditions that can harm your health or the health of your baby.
• If your prenatal care provider has talked to you about your oral health

Dental checkups before and during pregnancy are important so your dentist can find and treat dental problems early. And regular teeth cleanings help keep your teeth and gums healthy.

Are dental X-rays safe during pregnancy?

Yes. X-rays are part of regular dental care. Dental X-rays can show problems with your teeth, gums and the bones around your mouth. An X-ray is a medical test that uses radiation to make a picture on film. Radiation is a kind of energy that can be harmful to your health if you’re exposed to too much.

Dental X-rays are safe during pregnancy. They use very small amounts of radiation, and your dentist covers you with a special apron and collar to protect you and your baby. If your dentist wants to give you an X-ray, make sure she knows that you’re pregnant or trying to get pregnant.

How are dental problems treated during pregnancy?

If you have a dental problem that needs treatment, make sure your dentist knows that you’re pregnant. Depending on your condition, you may be able to wait for treatment after your baby’s birth. Treatments that are safe during pregnancy include:

• Medicine, like pain relievers and antibiotics to treat infections. Your dentist can give you medicine that’s safe for you and your baby during pregnancy. If your dentist prescribes you medicine, tell you prenatal care provider. Don’t take any medicine without talking to your prenatal provider first.
• Local anesthesia. Anesthesia is medicine that lessens or prevents pain. Local anesthesia is used in a specific part of the body, like to numb your mouth for a dental filling or to have a tooth pulled. This medicine is safe to use during pregnancy.

You can have dental treatment any time during pregnancy. If it’s elective treatment (treatment that you don’t need immediately and isn’t necessary to protect your health or your baby’s health), try to schedule it in the second trimester.

What can you do to help prevent dental problems?

Here’s how you can help keep your teeth and gums healthy:

• Brush your teeth with fluoride toothpaste twice a day and floss once a day. Use a toothbrush with soft bristles. Regular brushing and flossing can remove plaque and help keep your teeth and gums healthy.
• If you can’t brush your teeth because of vomiting, use antacids or rinse your mouth with a mixture of 1 teaspoon baking soda in 1 cup of water. Rinsing can help reduce the amount of acid in your mouth. Antacids are medicines that help neutralize stomach acid. You can buy them over the counter without a prescription from your provider. But don’t take any medicine—even OTC medicine—without talking to your provider first.
• Visit your dentist for a regular dental checkup every 6 months (twice a year), even during pregnancy. At your checkup, tell your dentist that you’re pregnant.
• Eat healthy foods and limit sweets. Healthy foods include fruits and vegetables, lean meat, whole-grain breads and pasta and low-fat dairy products. Limit sweets and sugary foods and drink water instead of sugary drinks. Eating healthy foods helps give you and your growing baby important nutrients. Your baby’s teeth start developing between 3 and 6 months of pregnancy. Nutrients like calcium, protein, phosphorus, and vitamins A, C and D, help your baby’s teeth grow healthy.
• Don’t smoke.