We have had several expectant mothers in recently. It is nice that these are women that I have cared for since they were small. To follow our patients from childhood to their impending motherhood is a really rewarding aspect of being in practice for over 30 years.I want to have the ability to avail them of the best that is out there for their children’s teeth. So I have put together a small primer on dental concerns that can arise during your pregnancy.

It’s a myth that calcium is lost from a mother’s teeth and “one tooth is lost with every pregnancy.” But you may experience some changes in your oral health during pregnancy. The primary changes are due to a surge in hormones – particularly an increase in estrogen and progesterone –- can exaggerate the way gum tissues react to plaque.

If the plaque isn’t removed, it can cause gingivitis – red, swollen, tender gums that are more likely to bleed. So-called “pregnancy gingivitis” affects most pregnant women to some degree, and generally begins to surface as early as the second month. If you already have gingivitis, the condition is likely to worsen during pregnancy. If untreated, gingivitis can lead to periodontitis, a more serious form of gum disease.

You can prevent gingivitis by keeping your teeth clean, especially near the gumline. You should brush with fluoride toothpaste at least twice a day and after each meal when possible. You should also floss thoroughly each day. If brushing causes morning sickness, rinse your mouth with water or with antiplaque and fluoride mouthwashes. Good nutrition – particularly plenty of vitamin C and B12 – help keep the oral cavity healthy and strong. More frequent cleanings from the dentist will help control plaque and prevent gingivitis. Controlling plaque also will reduce gum irritation and decrease the likelihood of pregnancy tumors.

Could gingivitis affect my baby’s health?
Research suggests a link between preterm, low-birthweight babies and gingivitis. Excessive bacteria can enter the bloodstream through your gums. If this happens, the bacteria can travel to the uterus, triggering the production of chemicals called prostaglandins, which are suspected to induce premature labor.

When should I see my dentist?
If you’re planning to become pregnant or suspect you’re pregnant, you should see a dentist right away. Otherwise, you should schedule a checkup in your first trimester for a cleaning. Your dentist will assess your oral condition and map out a dental plan for the rest of your pregnancy. A visit to the dentist also is recommended in the second trimester for a cleaning, to monitor changes and to gauge the effectiveness of your oral hygiene. Depending on the patient, another appointment may be scheduled early in the third trimester, but these appointments should be kept as brief as possible.

Are there any dental procedures I should avoid?
Non-emergency procedures generally can be performed throughout pregnancy, but the best time for any dental treatment is the fourth through six month. Women with dental emergencies that create severe pain can be treated during any trimester, but your obstetrician should be consulted during emergencies that require anesthesia or when medication is being prescribed. Only X-rays that are needed for emergencies should be taken during pregnancy. Lastly, elective procedures that can be postponed should be delayed until after the baby’s birth.

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