Pregnancy and Oral Health

How does pregnancy affect my oral health?
It's a myth that calcium is lost from the 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 change is a surge in hormones--particularly an increase in estrogen and progesterone-- which is linked to an increase in the amount of plaque on your teeth.

How does a build-up of plaque affect me?
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 in the second trimester. If you already have gingivitis, the condition is likely to worsen during pregnancy. If untreated, gingivitis can lead to periodontal disease, a more serious form of gum disease.

Pregnant women are also at risk for developing pregnancy tumors, inflammatory, benign growths that develop when swollen gums become irritated. Normally, the tumors are left alone and will usually break on their own. But if a tumor is very uncomfortable and interferes with chewing, brushing or other oral hygiene procedures, the dentist may decide to remove it.

How can I prevent these problems?
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 toothbrushing causes morning sickness, rinse your mouth with water or with anti-plaque 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.

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 check-up 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 procedures I should avoid?
Nonemergency 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. Lastly, elective procedures that can be postponed should be delayed until after the baby's birth.

Sources:
Barbara J. Steinberg, DDS, Professor of Medicine and Surgery, Allegheny University of the Health Sciences, Philadelphia, Pa.; "The Pregnant Dental Patient," Northwest Dentistry, September-October, 1996; "Alteration in Female Sex Hormones: Their Effect on Oral Tissues and Dental Treatment," Compendium of Continuing Education, Vol. XIV, No. 12.; Periodontal Care Report, Dental Products Report, April 1996; "Pregnancy and Oral Health," the American Dental Association.

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