Southwest Florida's Health and Wellness Magazine Health and Wellness Articles
By Dr. Amanda Rizner
Dental care during pregnancy is crucial for both the mother’s health and the baby’s well-being. The changes that occur in a woman’s body during pregnancy can have significant implications for oral health, making regular dental check-ups and proper oral hygiene practices essential. Listed below are some common topics and considerations that one should be aware of when going through a pregnancy.
Hormones and the Affects on Gingival Tissue
Pregnancy is often accompanied by hormonal changes, particularly an increase in progesterone levels. These hormonal shifts can contribute to an elevated risk of developing gingivitis which is defined as a inflammation and tenderness of the gums. Commonly known as “pregnancy gingivitis”, an increased amount of blood flow can leave the tissue red, inflamed and swollen. If left untreated it can progress to more serious gum conditions such as periodontal disease, which has been linked to adverse pregnancy outcomes. Periodontitis, the proper term for gum disease, can lead to preterm birth and low birth weight babies. Gum disease has also been associated with an increased risk of preeclampsia, a potentially serious condition characterized by high blood pressure and protein in the urine. Managing and preventing periodontal disease through regular dental visits and good oral hygiene practices can help mitigate these risks. It is recommended that patients keep their six month cleaning intervals (or shorter if history of periodontal disease in the past) to maintain their gingival health.
Patients can also experience “pyogenic granulomas” on their gingival tissue due to hormonal changes. Also known as “pregnancy tumors,” these bumps are noncancerous raised lesions made of abnormal blood vessels. They can bleed very easily and usually last until delivery. Some lesions can be excised during pregnancy if they cause discomfort, however most will disappear after hormonal shifts with delivery.
Beyond the potential complications for the mother, oral health during pregnancy is also important for the baby’s health. Research suggests a link between maternal oral health and the risk of preterm birth and low birth weight. Poor oral health, particularly untreated gum disease, may contribute to systemic inflammation that could affect the developing fetus.
Bacteria and Oral Health
Dental care during pregnancy involves more than just routine check-ups and cleanings. It also includes educating expectant mothers about maintaining good oral hygiene habits at home. For example, women with poor oral health may harbor higher levels of certain bacteria (Streptococcus mutan) in their saliva. These bacteria can be transmitted to their infants during common parenting behavior like sharing foods and kissing. Helping to minimize the amount of S. Mutans in the mothers oral cavity can help decreased the spread to the infant and ultimately lowers the caries risk for them later in life. Once established, these bacteria can persist and increase in number over time, especially if conditions in the mouth are favorable for their growth such as frequent sugar exposure or inadequate oral hygiene.
When to Seek Treatment
Some pregnant women may hesitate to seek dental care due to concerns about potential risks to the baby. However, routine dental visits and necessary treatments such as fillings or root canals can generally be performed safely during pregnancy. This is especially true after the first trimester. The second trimester tends to be the safest time period to have dental work completed, as it may become increasingly more difficult to lie reclined in later stages of pregnancy. However, conditions that require immediate treatment due to pain or swelling may be managed at any time during pregnancy. This may include extractions, root canals, or very large cavities which may lead to infection if not treated quickly.
Dentists previously took precautions such as using lead aprons and minimizing exposure to radiation to ensure the safety of both mother and baby. Earlier this year, an expert panel established by the American Dental Association Council on Scientific Affairs determined that it was not necessary to use a lead apron/thyroid collar for dental radiographs regardless of age or health status such as pregnancy. This conclusion came after reviewing multiple studies regarding radiography and stated that modern digital X-ray equipment restricted the beam size only to the area that needs to be imaged, which better protects patients against radiation exposure to other parts of their body.
Another reservation some patients may have about visiting the dentist is the anesthetic which can be used safely. Lidocaine with epinhephere is the most commonly used anesthetic and can be safely used during pregnancy. It is usually preferred by dentists for its vasocontrictive effects at the site of injection, which leads to prolonged anesthesia. For those patients who have a previous sensitivity to epinepherine, mepicvicaine without epinipherine can be used as an alternative. However, mepivicaine tends to be shorter acting than lidocaine and it may be best to discuss with your dentist which option is ideal for each situation.
Addressing dental issues promptly during pregnancy not only promotes oral health but also contributes to overall maternal well-being. Untreated dental problems can cause discomfort, difficulty eating, and sleeping disturbances, all of which can impact a pregnant woman’s quality of life. Most dentists will work quickly to determine a plan that allows the pregnant patient to seek treatment in as quick and as little appointments as possible for optimal comfort.
Nausea and Vomiting in Pregnancy
Women commonly experience morning sickness throughout their pregnancy which can lead to a buildup of acid in the oral cavity. It is recommended to drink or rinse with water directly after vomiting to eliminate as much acid as possible. We recommend waiting thirty minutes after each event before brushing in order to preserve as much enamel as possible. Avoidance of drinks high in sugar as well as acidic drinks such as diet or probiotic sodas is recommended.
Conclusion
In conclusion, dental care during pregnancy plays a crucial role in maintaining both maternal and fetal health. Regular dental visits, proper oral hygiene practices, and a nutritious diet contribute to preventing gum disease and other oral health issues that can potentially affect pregnancy outcomes. By prioritizing oral health during pregnancy, expectant mothers can reduce their risk of complications and promote a healthy start for their babies. Therefore, integrating dental care into prenatal health routines is essential for ensuring overall well-being during this important stage of life.
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