REPOST: Ask Ila: Dental care in pregnancy

Ila Shebar answers a question from a concerned pregnant woman regarding oral health during pregnancy. Read about it in this Mass Live article below:

Ila Shebar is a nurse practitioner at Pioneer Valley Urology. | Image Source: masslive.com

 
Q: I am 3 months pregnant and find that my gums are bleeding frequently, especially with brushing my teeth. Is this normal?

Oral health is an important part of overall good health and you must maintain that even during pregnancy. It is very important to take care of your teeth and gums while pregnant, not just for you, but for your baby’s health as well. The hormonal changes that occur during pregnancy can increase your risk of gum disease. This can lead to health issues for you and for your baby.

You should, of course, be taking good care of your mouth even before you get pregnant. It is important to have regular check-ups and cleaning. Before you become pregnant have any oral health issues resolved.

You should schedule a dental examination if it has been more than 6 months since your last examination or if you are having any oral health problems. Prevention, diagnosis, and treatment of oral conditions, including dental X-rays (with shielding of the abdomen and thyroid) and use of local anesthesia is safe during pregnancy. Conditions that require immediate treatment, such as extractions or root canals may be managed at any time during pregnancy with care. Delaying treatment may result in more complex problems.

The increased level of the hormones estrogen and progesterone in pregnancy may make it easier for certain bacteria to grow and make gum tissue more sensitive to plaque. If you already have gum disease before becoming pregnant, pregnancy may make it worse.

After becoming pregnant be sure to let your dentist know that you are, and how far along you are. Postpone elective dental procedures until the pregnancy is completed. Routine dental care such as check-up and cleaning can (and should) be performed during the second trimester. Your dentist will want to know all medications, including prenatal vitamins that you are taking.

The hormonal changes that occur put pregnant women at an increased risk for pregnancy gingivitis. Gingivitis, inflammation of the gums, occurs in about 40% of pregnant women. It can lead to feelings of tenderness or swelling of the gums, often accompanied by bleeding. This occurs most often between the second and eighth months of pregnancy.

To help prevent this from occurring you need to continue to practice good oral hygiene during the pregnancy. It is the bacteria that cause the gingivitis, not the hormones, so you do want to clean your teeth and gums. Brush your teeth gently twice a day, or after every meal, with a fluoride toothpaste, and floss daily. Schedule that dental cleaning during the second trimester.

If you have morning sickness be sure to rinse your mouth with a baking soda solution (1 teaspoon of baking soda dissolved in 1 cup of water) after vomiting to clean the acidity off your teeth and stop stomach acid from attacking your teeth. You may need to switch to bland toothpaste if the one you are using increases nausea. Your dentist or hygienist can recommend a good brand.

You should be eating a healthy well balanced diet during pregnancy, and this is also important for your teeth and the baby’s teeth. Sugary snacks increase your risk of tooth decay. Your baby’s teeth begin to develop around the third month of pregnancy, peaking in the third trimester. Your healthy diet provides the nutrients for this to occur normally.

There have been studies that have demonstrated a link between gum disease and premature birth. One study published in The Journal of the American Dental Association found that pregnant women with chronic gum disease were four to seven times more likely to deliver prematurely (before gestational week 37) and underweight babies than mothers with healthy gums.

Mothers with the most severe periodontal disease delivered the most prematurely, at 32 weeks. This is more evidence of how important good dental hygiene is during pregnancy.

Call your dentist for an appt if you experience a toothache, gums that bleed easily and frequently, swollen, tender, or painful gums, or note any growths in your mouth, even if not painful.

Again, oral health care is an important and safe component of pregnancy and is strongly recommended.

Follow this Dr. John Pasqual Twitter account for more tips on maintaining proper oral health.