Your teeth and gums are more prone to infection during pregnancy so it’s wise to maintain good oral health as best you can.
It’s important for you to take good care of your teeth and gums while pregnant. Pregnancy causes hormonal changes that increase the risk of developing gum disease which, in turn, can affect the health of your developing baby.
Here is some advice to help you maintain good oral health before, during, and after pregnancy.
The main effect of pregnancy is on your gums. Changes in the hormones that occur during pregnancy make your gums swell and become puffy. This makes them more prone to problems with plaque or bacteria and increases the chances of tooth decay. Swollen gums are a problem that can turn up at any time during pregnancy but are most common in the second trimester. Brushing soft, swollen gums can lead to bleeding and pain – a sign that you need to see your dentist.
What can I do?
Start well. If you are planning a pregnancy, do go to see your dentist for a check up and your hygienist for a clean (your dentist may be able to clean your teeth at a check-up). This means that any work that might need to be done can be done before you are pregnant.
This is especially important if you need to have an x-ray or have an old filling replaced.
If you are unlucky enough to have this side effect of pregnancy, you will know that it is better referred to as all-day sickness! Most women will feel nausea but if you get to the point of being sick, then you will be washing your mouth with a lot of acid in the first few months. Do make sure you rinse your mouth well with water after being sick to remove the acid. There is little you can do to avoid morning sickness – rest is one of the best ways to reduce it.
Teeth and calcium
The second effect on teeth during pregnancy can be from poor diet. Lack of calcium may have an effect on the strength of teeth, but it is usually bones that are affected. To be on the safe side, do make sure that you eat plenty of calcium-rich foods during pregnancy. Until recently, it was recommended that pregnant and breastfeeding women take five servings of dairy foods every day but these guidelines were changed and it is now thought that three servings daily will be enough. One serving of dairy is 200ml of milk (low fat, full fat or skimmed); one standard pot of yoghurt or 30g of hard cheese e.g. Cheddar. Remember that softer cheeses often have very little calcium.
If you avoid dairy, consider reintroducing it during your pregnancy unless you have an allergy/ lactose intolerance or have been medically advised to avoid it. It is very difficult to get enough calcium without taking dairy and you may need a supplement if you do avoid it. You need 800mg of calcium everyday. A glass of milk will give you about 225mg, whereas a serving of broccoli will only give you about 52mg.
Teeth and snacking
Another effect of pregnancy is an increased appetite, which often goes hand in hand with an increase in sweets and snack foods. Dentists recommend that we try to limit eating to just four times a day to reduce the amount of acid that our teeth are exposed to. This can be difficult in pregnancy, especially near the end when you may be up in the night to eat, never mind what you might take in during the day! If you can’t eat less often, then do be careful about what you eat. It is very tempting to always go for sweets or biscuits but the sugar in these foods will lead to more acid in your mouth and more problems with teeth. Tooth-friendly snacks are: hard cheese, yoghurts and nuts. Fruit is important during pregnancy, but is best eaten as part of a meal rather than a snack. Try vegetable sticks such as carrots and celery instead – dipped in hummus they make a tasty, tooth-friendly snack.
Brushing makes me gag!
A common problem for many pregnant women is gagging when they are brushing their teeth – especially in the first three months. This means that teeth can often go uncleaned or only lightly brushed. The build-up of food pieces and plaque can then lead to tooth decay.
Preventive dental cleanings and annual exams during pregnancy are not only safe, but are recommended. The rise in hormone levels during pregnancy causes the gums to swell, bleed, and trap food causing increased irritation to your gums. Preventive dental work while pregnant is essential to avoid oral infections such as gum disease. If dental work is done during pregnancy, the second trimester is ideal. Once you reach the third trimester, it may be very difficult to lie on your back for an extended period of time. The safest course of action is to postpone all unnecessary dental work until after the birth. However, sometimes emergency dental work such as a root canal or tooth extraction is necessary. Elective treatments, such as teeth whitening and other cosmetic procedures, should be postponed until after the birth. It is best to avoid this dental work while pregnant and avoid exposing the developing baby to any risks, even if they are minimal.
Consider possible dental health problems during pregnancy:
1. Tooth decay.
During pregnancy, increased acidity in the mouth increases the risk of tooth decay. Vomiting during pregnancy can aggravate the problem by exposing the teeth to more gastric acid.
2. Loose teeth.
Increased levels of progesterone and oestrogen can affect the ligaments and bones that support the teeth, causing teeth to loosen during pregnancy — even in the absence of gum disease.
3. Gum disease.
The hormonal changes of pregnancy can lead to gingivitis, an inflammation of the superficial gum tissue. Left untreated, severe gum disease may be associated with preterm birth and low birth weight.
Tips for dental care during pregnancy
- Let your dentist know you are pregnant.
- It’s recommended that pregnant women eat a balanced diet, brush their teeth thoroughly with a fluoride toothpaste twice a day, and floss daily.
- Have preventive exams and cleanings during your pregnancy.
- Postpone non-emergency dental work until the second trimester or until after delivery, if possible.
- Elective procedures should be postponed until after the delivery.
- If you have morning sickness, rinse your mouth with a solution of baking soda and water after vomiting. Mix one teaspoon baking of soda in one cup of water.
- Ideally, schedule a dental exam before pregnancy to treat any dental problems ahead of time. Also visit your dentist regularly during pregnancy — especially if you develop a dental problem.
Dr Carmen Anastasiu
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