The Dentist Visits You - 2016


Managing Women's Dental Health During Pregnancy

By Vatsal Suthar

Five years ago, my wife and I entered the phase in our lives when seemingly all our friends and family members were getting married. Every weekend was a trip somewhere to celebrate the union of two people over a three-day weekend complete with the band, baaja, and baraat. Now, those same couples are beginning a family and there are many pregnancies to commemorate. As I think about these women who go through an abundance of changes during the nine months, I want to iterate that one health component mom needs to attain total wellness for herself and baby is in the mouth.

There is so much to think about during pregnancy, no doubt, but the oral health cannot be overlooked. Hormonal changes at this time can affect the condition of the mouth, specifically your gums. For example, women are more likely to develop gingivitis during pregnancy. Gingivitis is an infection of the gums that can cause swelling and tenderness. You may even notice some minor bleeding when you brush or floss. Because your body is creating more blood vessels as well as a richer blood supply, the highly vascular gums show bleeding before other tissues. Left untreated, gingivitis can affect the supporting structures that hold your teeth in place. Your dentist may even suggest more frequent cleanings during this time.

Sometimes lumps appear along the gum line and between your teeth. These swellings are harmless but they bleed easily and appear dark red. These growths can even be a purple hue and are sometimes called “pregnancy tumors" even though they are not cancerous at all. They go away on their own after pregnancy but can be removed with local anesthetic if it is overly bothersome. In truth, dental infections must be addressed sooner than later. Dental infections may be responsible for up to 5% of low birth-weight pre-term babies.

You should keep up with visiting the hygienist for a professional cleaning as well as getting the dental exam. This will provide you an opportunity to discuss any specific concerns or questions you have. It is strongly advised that no dental treatment be rendered during the first trimester or late third trimester. Fetal growth and development is the most critical at these times and any medical treatment, large or small, can increase the risk of interference. The safest time for seeking dental care is the second trimester. Notify the dental office you are past 12 weeks pregnant and consider bringing a medical referral from your obstetrician.

Your cleaning, a filling, crown, root canal, extraction, and braces adjustment can all be done safely at this time, even with anesthetic. With infection or pain, your dentist will almost always give you Amoxicillin or Acetaminophen, respectively, as they are both considered safe for use during pregnancy. If possible, x-rays can be deferred until after the baby is born to reduce the risk of radiation exposure. However, x-rays are still safe to take because a lead apron will be used to shield your abdomen and neck. The amount of radiation you are exposed to with digital format x-rays is considerably less than the amount you are exposed to if you took a flight from Atlanta to New York. Talk to your dentist or physician if you have any concerns about this.

Some women even encounter dry mouth during pregnancy. Drinking water frequently and chewing on sugarless gum with Xylitol can help alleviate this symptom. It is safe to use any over the counter toothpaste with fluoride. Using prescription toothpastes with extra fluoride is not harmful but should be used under the guidance of your dentist. Women often encounter morning sickness and need to brush more than twice a day to cleanse the stomach acids that end up coating your teeth. Even if a toothbrush initiates a gag reflex, be sure to rinse thoroughly with water or an antiseptic mouthwash as the next best substitute for not brushing. Leaving the acids on the teeth can cause permanent erosion of your enamel that is lost forever. Green tea or black tea, like Indian tea that is sugarless, has shown to reduce cavities and prevent gum disease.

During pregnancy, dietary needs and snacking frequency increases. Eating schedules are altered and variations to your normal menus are common. There are certain women that have cravings that often can be unhealthy choices like sweets, candy, or baked goods. Snacking can increase the amount of plaque, sticky film of bacteria that is constantly on your teeth, which in turn can cause tooth decay. It is important at this time to be conscious of the snacks you are choosing be wholesome and nutritious. High fiber foods like apples, carrots and celery help stimulate saliva flow and help fight plaque formation. Citrus fruits and juices like oranges, grapefruit, or lemonade must be cautiously consumed because they have high amount of acid that can erode your enamel.

Dairy products are very beneficial to your oral health as well as your overall health. The calcium, phosphates and vitamin D in cheese, milk and other dairy products are important minerals for the health of your teeth. Your teeth are made mostly of calcium, and without enough in your diet, you risk developing tooth decay and other problems. An added benefit is that the calcium in these foods mixes with plaque and sticks to teeth, protecting them from acids that cause decay and helping to rebuild tooth enamel on the spot. There are many calcium-fortified juices, soymilks and other foods available that can supply as much calcium to your diet as milk does if you are lactose intolerant or do not like milk.

Your oral health is a big part in your overall health and untreated dental diseases can be detrimental to the pregnant mom and baby. Be sure to include the care of your mouth in your daily routine and notify your dentist of any oral changes during your pregnancy. I hope all the new moms have a happy and healthy pregnancy in 2016.