pregnancy oral health
Health

Pregnancy oral health

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.

Morning sickness

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.

expert advice

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

More like this:

Symptoms of morning sickness
How to treat heartburn
Supplements in pregnancy

Ask Sarah

Q I’ve heard a lot about the Paleo diet and as I am very interested in reducing the amount of processed foods and grain based meals my family eats, we are considering following this diet. From what I read it seems to be a back-to-basics type of eating. Is a Paleo diet safe for children? My kids are aged seven and nine.

A The Paleo diet is one of the most fashionable diets around at the moment. It is also known as the ‘caveman diet’ and is based on cutting out processed foods, starchy foods like bread and potatoes and eating more meat, vegetables and fruit.
As fad diets go, it is not the worst but there are some good and bad sides to it. Reducing the amount of processed foods we eat is always a good idea and by doing that you will usually reduce the amount of fat, salt and sugar you eat, which is a good thing! The problem with the Paleo diet is that it also cuts out dairy (on the basis that cavemen didn’t drink milk) and this means that the diet is very low in calcium. For this reason it is really not suitable for children who do need a lot of calcium for growing bones. How did cavemen manage without dairy? They ate a lot more food than we do (up to 10,000 calories per day compared to the 2,000 most of us eat). By eating that amount of food they were able to pick up just enough calcium from green vegetables and seeds. To put it in perspective, you would need to eat 16 servings of broccoli a day to get all the calcium you need. This is easier to do if you eat 10,000 calories per day rather than 2,000.
The other problem with the paleo diet is that it is not entirely based in science. Many of the Paleo diets out there say you should not eat wheat, even though we know that cavemen did in fact eat wheat and other grains. These diets also don’t recommend that you eat blubber and the big lumps of fat that were also a large part of the caveman diet!
A final problem is that many Paleo diets encourage people to cut out beans and lentils and to get their protein from meat and fish instead. Many studies over the last few years are clear that eating too much animal protein is linked with more cancer and heart disease. Eating some vegetarian meals based on beans and lentils is a great way to get your protein without always going for meat.
Is this a diet we should follow? I think there is a lot we can learn from the Paleo diets. We could all do with eating less salt, sugar and processed foods and adding in more nuts and seeds as well as more vegetables. However, I think following a strict Paleo diet could lead to low levels of calcium and vitamin D and so it is not suitable for children or teens and adults would need to think about a calcium supplement.

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ASK LUCY

Q My son is 18 months old and has just started saying his first words. It is an extremely exciting time in our house and my husband and I are eager to encourage his speaking as much possible. What advice would you give us on how we can foster this without bombarding and confusing him?

AThere is nothing better than hearing your baby begin to talk. All the hard work you have put in over the last two years is coming back tenfold.
Toddlers will vary significantly with ability and speed of which they talk however a guide would be about 50 words by 2 years of age. The most important thing to watch for is that your baby/toddler is cooing and babbling and begins to string sounds together like “Mama/Dada” They should have a wide range of speech sounds and like to imitate you and things they hear.
There are many ways that you can promote Speech and Language development at home:
1. Slowing down your own speech and taking time over conversations with your little one. Every day is a new experience when you are 18 months, nappy changes, bath time, baking a cake brings endless opportunity for you to interact and offer new words for them to hear and repeat. Make eye contact, smile and use exaggerated tones to keep things interesting and fun for your tot.
2. Review the toys that you have on offer to your tot and ensure that they give plenty of open ended play opportunities. Role play is a wonderful way to allow children to take the lead. Kitchens with lots of plates, cups and pots. Fill the pots with dry pasta and allow your child to cook and serve you. Playdoh, painting, gardening and sandpits are also great for allowing your child to take the lead and babble about what they are doing. Read plenty of books together and point and allow them time to answer any questions that you ask.
3. Limit screen time. Overuse of televisions and iPads do not give your child opportunity to interact in a two way manner.
4. Ask your child lots of open ended questions “What’s that?” “Where are we?” Point at things they know the answer to for boosting confidence (Car/ Car, etc.) When they don’t know the answer, explain it to them. Limit baby talk and speak clearly with good pronunciation, remember you are the teacher and they will copy you.
If you are concerned about your child’s speech and language development, be sure to speak with your GP or developmental Health Nurse. They are very skilled at understanding the difference between speech delays and spotting something that may require professional attention.
Enjoy watching their little brains absorb the world around them and listen to what they have to say. It won’t be too long before they won’t stop talking to you, asking “Why Mummy/ Daddy?” every 5 minutes….