Pregnancy affects nearly every aspect of a woman's life, including her oral health. You may think of your oral health as just one more thing to worry about, but taking care of your mouth and teeth is important during pregnancy.
What are the special oral health concerns of pregnant women?
Pregnancy Gingivitis
Most women notice changes in their gums during pregnancy. Some women notice that
their gums look redder and bleed when they brush their teeth. And some women
have severe swelling and bleeding.
All of these changes are referred to as "pregnancy gingivitis." They
can start as early as the second month. The condition tends to peak around
the eighth month and then taper off after the baby is born.
Pregnancy gingivitis is most common in the front of the mouth. The symptoms
are the same as those for gingivitis, but
some of the causes are different. Increased hormone levels may be partly responsible
for pregnancy gingivitis. During pregnancy, the level of progesterone in your
body can be 10 times higher than normal. This may enhance growth of certain
bacteria that cause gingivitis. Also, your immune system may work differently
during pregnancy. This could change the way your body reacts to the bacteria
that cause gingivitis.
To minimize the effects of pregnancy gingivitis, practice good oral hygiene:
Brush twice a day, for at least two minutes each time. Floss every day. Using
an antimicrobial mouth rinse also may help you control your gum infection.
Some dentists suggest using rinses that don't contain alcohol, but it is not
clear whether alcohol-based rinses have a negative effect on pregnancy.
Be sure to have your dentist check the health of your gums while you are pregnant.
Pregnancy gingivitis usually can be treated with a professional cleaning. This
can be done at any time during your pregnancy, but preferably during the second
trimester. More aggressive treatments, such as periodontal surgery, should
be postponed until after delivery.
Pregnancy Granuloma (Pyogenic Granuloma or Pregnancy Tumor)
A pregnancy
granuloma is a growth on the gums that occurs in 2% to 10% of pregnant
women. It is also known as a pyogenic granuloma or pregnancy tumor. Pregnancy
tumors are misnamed. They are not actually tumors and are not cancerous.
They are not even dangerous, although they can cause discomfort.
Pregnancy granulomas usually develop in the second trimester. They are red
nodules, typically found near the upper gum line, but can also be found elsewhere
in the mouth. These growths bleed easily and can form an ulcer or crust over.
Pregnancy granulomas usually are attached to the gum or mucous membrane by
a narrow stalk of tissue.
The exact cause of pregnancy granulomas is unknown, although poor oral hygiene
is a primary factor. Trauma, hormones, viruses and blood vessel malformations
have also been suspected as co-factors. Women with these growths usually have
widespread pregnancy gingivitis.
Pregnancy granulomas will disappear after your baby is born. If a growth interferes
with speaking or eating, you may need to have it removed before you give birth.
However, about half the time, the growth will come back after it has been removed.
Tooth Erosion
In women with severe morning sickness, frequent vomiting can erode the enamel
on the back of the front teeth. If you are vomiting frequently, contact your
dental office for information on how to prevent enamel erosion.
Dry Mouth
Many pregnant women complain of dry
mouth. You can combat dry mouth by drinking plenty of water and by using
sugarless hard candies or gum to stimulate saliva secretion and keep your mouth
moist.
Excessive Saliva
Less commonly, pregnant women feel they have too much saliva in their mouths.
This condition occurs very early in a pregnancy. It disappears by the end of
the first trimester. It may be associated with nausea.
I've heard that pregnant women lose a tooth for every child. Is that true?
No. This is a myth. People used to think that a developing fetus who did
not get enough calcium would absorb it from the mother's teeth. This is not
the case. If you practice good brushing and flossing habits, you are no more
likely to get cavities or lose teeth during your pregnancy than at any other
time.
How
should I take care of my teeth and mouth while I'm pregnant?
Eat a well-balanced,
nutritious diet with plenty of protein, calcium and vitamins A, C and D. Brush
your teeth twice a day for at least two minutes each time. Use fluoride toothpaste.
Floss at least once a day. Using an antibacterial mouthwash can help destroy
bacteria that contribute to gingivitis. Using an antibacterial mouthwash can
help destroy bacteria that contribute to gingivitis. Some dentists suggest
using a mouthwash that doesn't contain alcohol, but it is not clear whether
alcohol-based mouthwashes have a negative effect on pregnancy. Use as directed.
Is
it safe to visit the dentist while I'm pregnant?
The second trimester is the best time to receive routine dental care. If possible,
major procedures, reconstruction and surgery should be avoided until after the
baby is born.
Try to avoid dental visits during the first trimester and the last half of
the third trimester. During the first trimester, the fetus's organ systems
are developing, and the fetus is highly sensitive to influences from the environment.
In the last half of the third trimester, there is some risk of premature delivery
because the uterus is sensitive to external influences. Also, at the end of
your pregnancy, it can be uncomfortable to sit in a dentist's chair. After
about 20 weeks' gestation, pregnant women should not lie on their backs for
long periods of time because this can put pressure on large blood vessels and
cause changes in circulation.
What
should I do about emergency dental treatment while pregnant?
You should receive treatment if it is necessary to ease your pain, prevent
infection or decrease stress on you and your fetus. Your dentist should consult
with your obstetrician or midwife if there are questions about the safety of
medicines or anesthesia.
Is
it safe to get dental X-rays while I'm pregnant?
Advances in technology
have made dental X-rays much safer. Studies have shown that using a lead apron
will protect you and your fetus from radiation. However, most dentists do not
recommend dental X-rays if you are pregnant or think you may be pregnant. X-rays
usually are taken if they are needed for diagnosis or treatment that cannot
wait until after the baby is born.
Can
I take dental medications while pregnant?
Ideally, you should not take
any medicines during pregnancy, especially during your first trimester. However,
sometimes this is simply not possible because the benefits of a medicine outweigh
the risks related to its use. Most common dental medicines can be used during
pregnancy. However, some — such as sedatives and certain antibiotics — should
be avoided.
The U.S. Food and Drug Administration classifies many prescription drugs at
different levels of risk to the fetus. There are five
categories: A, B, C, D and X. Pregnancy Category A drugs are the safest.
Pregnancy Category X drugs are known to be harmful to the fetus.
Always talk to your dentist about any medicines he or she prescribes during
your pregnancy.
Can
I take dental medications while nursing?
The amount of drug excreted
into breast milk is usually about 1% to 2% of the dose you take. So it is highly
unlikely that any dental medicines will affect your baby.
However, to minimize risk, take any medicines just after your baby has nursed.
Then, try to avoid nursing for at least four hours or as long as you can. This
will minimize the amount of drug that enters your breast milk. Most drugs reach
their maximum concentration in milk one or two hours after you take them.
Your dentist may want to discuss medicine options with your physician and/or
your child's pediatrician.
