Dental Health During Pregnancy

There are several issues regarding how a woman should care for her teeth during her pregnancy that can affect both the health of the woman and her baby. Most women who have a healthy body go through pregnancy and have their baby without developing problems with their teeth and gums. But this is not always the case. Some women develop bleeding gums and cavities during their pregnancy. This is because the woman’s body is tired due to excess weight, lack of sleep, hormone changes, etc. All these changes can decrease the woman’s ability to fight bacteria found in her body, especially her mouth. This means a woman that always had great checkups at her dental cleanings now has sore, swollen, bleeding gums, bad breath, cavities, and sensitive teeth. Once the baby is born, many of the problems, except the cavities, reverse themselves. But if the woman does not have a healthy mouth before she becomes pregnant, these problems can be even worse and remain after her baby is born. I often talk to patients in my office that tell me how they had perfect teeth until they had children or that their teeth became “chalky” during their pregnancy. Studies have also shown that the bacteria in a woman’s mouth can get into her blood stream and cause other health problems such as increasing the severity of heart problems and diabetes. Studies have also shown that the bacteria can travel through the placenta and cause the baby to be born with health problems including low birth weight.

If a woman believes she is pregnant it is good advice for her to see her family doctor or OBGYN as soon as possible and have any medical problems treated. She should also see her dentist for a cleaning and have any infections in her mouth treated as soon as possible. I suggest to all my female patients that are pregnant to come in for a cleaning during their first trimester. If they have no gum or tooth problems I usually recommend they call me only if they develop any problems. If they have bleeding or sensitive gums I may suggest different treatment options. One option is to have a “deeper cleaning” where my hygienist cleans the tarter under her gums with an ultrasonic cleaner and eliminate the bacteria with a laser. A mouth rinse may be prescribed that can reduce the amount of bacteria in her mouth. Antibiotics are sometimes prescribed as well. If your dentist prescribes tetracycline and you believe you may be pregnant tell him/her immediately. Tetracycline can cause severe staining of your babies permanent teeth. Any cavities that could lead to abscesses should be treated as well. While routine dental work can be done safely during pregnancy, keep in mind that as you get into your second and third trimester you may not be able to lie comfortably in a dental chair, therefore see your dentist early.

Having radiographs taken during pregnancy is always a big concern for expecting mothers. In the past they were right to be concerned. Prior to the 1970’s most dental radiograph machines did not focus the radiation just at the patient’s mouth, but covered most of the patient. This is what led most OBGYN to begin recommending their patient’s not get dental radiographs. Lead aprons were then developed to protect the patient’s body. Today dental radiograph machines focus the x-ray only at the patient’s mouth making them very safe. Digital radiographs have also greatly reduced the amount of radiations used in dental radiographs even further making them perfectly safe. I do respect that most expecting mothers are concerned about the radiation. My advice is to talk with your dentist about the safety of dental radiographs.

So here is my advice for expecting moms and women who are planning on getting pregnant with regard to their teeth and gums:

• See your dentist for a cleaning and checkup early in your pregnancy and even better, before you become pregnant.
• Follow your instincts with regards to dental radiographs and trust your dentist.
• If you need any dental treatment, have it done early.
• Don’t forget to bring pictures of your baby with you to your dental office. Both the dentist and dental team love to see them.