The belief that pregnancy drains calcium from your teeth and that you lose a tooth for every baby is false, explains Dr Darren Klotnick, a Johannesburg-based dentist. “However, you may experience some changes in your oral health during pregnancy due to a surge in hormones, which can exaggerate the way gum tissue reacts to plaque. If plaque isn’t removed, it can cause gingivitis, which can affect the health of your unborn baby,” he says.
What is Pregnancy gingivitis?
Pregnancy gingivitis affects most pregnant women to some degree, and generally begins to surface during the second month, according to Dr Klotnick. “It’s an increased inflammatory response to dental plaque during pregnancy that causes your gums to swell and bleed more easily. Rinsing your mouth with saltwater (5ml salt dissolved in 125ml warm water) may help with the irritation, but it’s important to consult your dentist at the first sign of any symptoms, as gingivitis can lead to periodontitis, a more serious form of gum disease when plaque adheres to your teeth and releases bacterial toxins. This creates pockets of destructive infection in your gums and bones and your teeth may loosen due to bone loss. Excessive bacteria can enter your bloodstream through your gums. If this happens, the bacteria can travel to your uterus, triggering the production of chemicals called prostaglandins, which have been linked to premature labour.”
Dr Shani Isenberg, a dentist in private practice in Johannesburg, adds that “research has shown an association with [gum disease] and low birth weight and an increased risk of poor hearing, eyesight and cerebral palsy. Since the prevalence of gum-related problems is one of the biggest causes of dental issues during pregnancy, together with vomiting and cravings for sugary foods, professional dental treatment should always form part of your pregnancy plan.”
If you’re trying to fall pregnant, schedule a dental appointment before conception, advises Dr Klotnick. “This will ensure that your teeth are professionally cleaned, gum tissue is carefully examined, and any oral health problems can be treated in advance of your pregnancy.
“If you are already pregnant, it’s important to advise your dentist accordingly and to never skip your dental check-ups due to pregnancy. You should also inform your dentist about what medication and prenatal vitamins you are taking, as well as any specific medical advice your doctor has given you, as your dentist may need to alter your dental treatment plan based on this information,” explains Dr Klotnick. Non-emergency procedures can be performed throughout pregnancy, he continues, “but the best time for any dental treatment is during the second trimester. All dental emergencies that create severe pain can be treated at any stage, but your obstetrician should be consulted if you require anaesthesia and if medication is being prescribed. Delay all elective dental procedures until after the birth.”
Dr Klotnick offers the following tips to ensure good dental hygiene when battling nausea:
- If the taste of the toothpaste seems to provoke your gag reflex, switch to another brand. Go back to fluoride toothpaste as soon as you can.
- Rinse your mouth with water or anti-plaque and fluoride mouthwash.
- Try using a brush with a small head. Slow down the brushing action, close your eyes and concentrate on your breathing.
“Gastric reflux or vomiting associated with morning sickness can coat your teeth with strong stomach acid and repeated reflux and vomiting can damage tooth enamel and increase the risk of decay,” adds Dr Isenberg. Avoid brushing your teeth immediately after vomiting as it may scratch the tooth enamel. Rather rinse your mouth thoroughly with water to clear the hydrochloric acid and then use a fluoride mouthwash.
Three pregnancy dental don’ts
If you don’t have urgent dental concerns, schedule an appointment for about three months after you’ve given birth. If you didn’t go for a dental visit while you were pregnant, let your dentist know that you’ve just given birth and whether you’re breastfeeding. Continue to eat high-calcium foods or take a calcium supplement (discuss the dose with your obstetrician).
Dr Isenberg offers some advice to ensure effective maintenance of your dental health: