Congratulations! What an exciting, and overwhelming time of your life, especially if this is your first time at the rodeo! During pregnancy, you’ll experience changes to your body, emotions, health, energy levels, sleeping patterns. And of course, if you didn’t like pickles before, now you probably will…
There’s so much to learn about this journey that you are on but thankfully, there’s also a wealth of information out there. All you have to do is Google “pregnancy” and 743 million searches will appear!
But even with all of that info out there, it can be hard to find good stuff related to your mouth and oral health.
When you’re pregnant, just like the rest of your body, your teeth, gums and mouth are affected by hormonal changes. And at around the 2 month mark is when you might begin noticing some changes.
Find out how these hormonal changes affect your oral health during pregnancy and how you can keep your mouth healthy! And by the end, you’ll understand why your dentist should join your GP, obstetrician and midwife on your list of health professionals that you consult regularly.
Gingivitis while pregnant
During pregnancy, there are high levels of circulating oestrogen (hormones) and a reduced immune response and that means you’re at a higher risk of experiencing inflamed gums (gingivitis). You can even get overgrown gums (gingival hyperplasia). Swollen and bleeding gums, especially when you brush or floss, is one of the most common dental problem a pregnant woman faces.
What to Do:
Continue visiting your dentist for your regular check-up and cleaning while you’re pregnant to keep your gums healthy. Warm salty water rinses can also help with any irritation. Your dentist may even recommend using a chlorhexidine mouthwash to help keep the inflammation under control.
Also known as gum disease, periodontitis affects almost 30% of pregnant women in Australia. During pregnancy, changes to your hormone levels can affect your body’s response to plaque (the sticky film of bacteria on your teeth). When gingivitis is left untreated it can progress to become periodontitis. And this is where it becomes a much bigger problem.
Firstly, gum disease often leads to tooth loss. This is because the structures that hold the teeth in place (gums, ligaments and bone) get destroyed by the chronic inflammation around the tooth.
Secondly, there is now a wealth of evidence on the connection between gum disease and premature labour and low birth weight. We know that babies who are born prematurely are at risk of a range of health conditions including cerebral palsy and problems with eyesight and hearing. Estimates show that up to 18 out of every 100 premature births may be triggered by gum disease. That’s a staggering number!
What to do:
It is super important to maintain good oral hygiene, especially while you’re pregnant. Brushing twice a day with a soft bristled brush, for 2 minutes will help to keep your teeth and gums healthy. Flossing once a day (at night, before brushing) should also form part of your oral hygiene routine.
Keeping your regular recall appointment with your dentist is also crucial. That’s because your check up is an opportunity to identify any potential issues early and get on top of them before your baby arrives.
If you do suffer from gum disease, make an appointment with your dentist straight away. Gum disease treatment can be performed at any stage during pregnancy. The sooner the disease is under control, the less likely it is to affect your long term health and the health of your baby.
Dental erosion and morning sickness
In your first trimester, you probably spend half your time trying to digest everything that’s just happened and the other half staring into a sink or toilet bowl.
When you’re pregnant, changes in hormone levels soften the ring of muscle that keeps food inside the stomach. As a result, you’re more prone to gastric reflux (regurgitating food or drink) and of course vomiting associated with morning sickness. All of a sudden, your teeth are repeatedly exposed to stomach acid, which of course never happened until you became pregnant. This in turns strips away your enamel, making your teeth prone to sensitivity and tooth decay.
What to do:
You might be tempted to brush your teeth immediately after each bout of morning sickness but STOP! This actually makes it worse.
Brushing your teeth within an hour of vomiting can actually strip your enamel away even more and as a result, cause more damage. Instead, try these tips:
– Rinse your mouth with ¼ teaspoon of sodium bicarbonate mixed in with 1 cup of water.
– Chew sugar-free gum.
– Have some dairy (if possible) foods like hard cheese or milk.
The main goal is to neutralise the acid in your mouth as soon as possible so dental erosion can be halted.
You can also rinse your mouth with a fluoridated mouthwash after a bout of morning sickness to help fortify the enamel. We recommend waiting at least 30 minutes after a bout of morning sickness before brushing your teeth.
Tooth Decay and pregnancy
As you’ve already read, dental erosion from morning sickness puts you at a higher risk of developing tooth decay.
To make matters worse, you’re now craving chocolate at 2AM in the morning and will only eat a jar of pickles for lunch! Unusual food cravings are a fact of life for many pregnant woman. These cravings, combined with acid reflux/morning sickness, increase your risk for tooth decay!
And here is where it gets serious.
If tooth decay is left untreated, your child is very much at risk of developing infant caries (tooth decay in infants and toddlers up to 6 years of age). This is because the germs that cause tooth decay in your mouth will be passed on to your child, even before they have teeth!
What to do:
If nothing but sweetness and sour will satisfy your cravings, try choosing healthier options like fresh fruits or greek yoghurt with a little bit of honey.
Brush twice a day with fluoridated toothpaste to help strengthen your enamel, floss at night and keep up with your regular checkup and clean appointment at the dentist.
See your dentist right away if you suffer from tooth decay and you’re planning on becoming pregnant. This way treatment can be performed while you’re as comfortable as possible and your mouth will be healthier for when bub arrives.
Pyogenic Granulomas during pregnancy
Also known as pregnancy tumours, these are red, lumpy lesions that appear along the gums and between teeth. They generally occur after the 3rd month of pregnancy and about 1-5% of pregnant women experience this condition.
What to do:
Don’t worry, these usually resolve on their own after the baby is born. However, if there’s plaque along the gums, gingivitis or you’ve had pregnancy tumours in previous pregnancies, you may be at risk of developing pyogenic granulomas. This is why it’s so important to maintain good oral hygiene practices when you’re eating for two.
When is it safe to have dental treatment during pregnancy?
Good news! You can get a check-up and clean at any stage during your pregnancy. This means you’re able to maintain your regular recall appointments which is so important in ensuring yours gums and teeth are as healthy as possible. This not only impacts on your health, but also the health of your baby in the short and long term.
More complex treatment however, should be postponed (if possible) until the second trimester. This is because in the first trimester, your baby is undergoing some important developments so any stresses put on your body during this time can risk complications.
Of course, if you have a dental emergency, then treatment must be performed straight away. That’s because the risk of not treating infection and pain could mean much more stress on your body and could be more harmful for the baby.
Your oral health affects your baby’s overall health
Oral healthcare in pregnancy is often avoided and misunderstood and unfortunately, that can lead to serious consequences.
The thing is, a lot of us still seem to think our mouth exists and functions separately from the rest of our body. But your mouth IS a part of your body. Your oral health affects your general health.
How you care for your oral health during pregnancy can affect both yours and your baby’s health in the long run.
For even more information, here are our favourite oral health and pregnancy resources on the web:
Dr. Grant McGrath BDSc
Jasmine Ooi BPharm