Pregnancy is a beautiful journey for a couple expecting a new addition to their family. But at the same time it is difficult for the expecting mother as her body goes through many pleasant and unpleasant changes and the mouth is no different. The oral cavity goes through its fair share of changes and problems which are overlooked and ignored most of the times but are equally important when it comes to the mother and the baby’s overall health. Ideally, it’s always a good idea to get all major and minor dental issues resolved before pregnancy as any kind of dental treatment gets very difficult during the course of pregnancy so much so that a lot of dentists do not treat pregnant patients due to the risks involved. Tooth ache is anyway a nightmare for many, add to that the discomfort of pregnancy, the trauma can be well imagined. This article aims to give you as much information regarding the correlation between pregnancy and dental health as possible.
Dental conditions common during pregnancy –
1. Gingivitis – ‘Gingivitis’ is a dental disease in which the gums become red, swollen and bleed easily. This happens due to the bacteria present in the plaque and calculus formed over the teeth and gums. This is a common disease but due to the increase in hormonal fluctuation during pregnancy, the gums have an over exaggerated response making the disease even more severe. The treatment of gingivitis is the same as for everyone – visit to a dentist for professional scaling and oral prophylaxis to remove plaque and calculus buildup.
2. Periodontitis – ‘Periodontitis’ is a dental disease which is the next stage of ‘Gingivitis’ and after the gums, the bacteria start to attack the patient’s bone ultimately leading to loss of the teeth. This disease is also more severe in pregnancy, giving rise to the old wives tale, “You lose a tooth for each pregnancy”. It is a serious condition in pregnancy as it has been seen that women with periodontitis are seven times more likely to have premature births. The reason being that the bacteria causing the disease enter the blood stream and induce a rise in the level of a hormone called Prostaglandin. Rise in the hormone tricks the body into inducing labor.
The prevention of periodontitis is the treatment of gingivitis, as mentioned in the previous point.
3. Caries – It is a common tendency to consume snacks during pregnancy which invariably gives rise to more caries. The only way to prevent this is to consume more healthy foods and avoids sugary snacks. Rinsing thoroughly after each snack is also a good way of preventing cavities.
4. Pregnancy Tumor (Pyogenic Granuloma) – Severe gingivitis also leads to enlargement of the gums in certain areas giving the appearance of a tumor. It usually occurs during the 2nd or the 3rd month and resolves on its own with time. Although during the whole time that it is there, it harbors bacteria under it and should be taken seriously.
5. Erosion of teeth – Morning sickness is another common symptom that expecting mothers go through. This is sometimes accompanied with acid reflux or vomiting which erodes the back side of the teeth. It is unavoidable but the only way to prevent permanent damage to the teeth is to rinse the mouth immediately after the vomiting episode with either water / milk / anti-bacterial mouthwash. It would be a good idea to avoid brushing for at least 30 minutes after the vomiting episode as it might smudge the acid on the rest of the teeth even more.
6. Melasma (Chloasma gravidarum) – In a lot of women (approx 70%), hyperpigmentation is noticed on the face, mainly on their forehead, cheeks and upper lip. The reason for this being increase in the formation of melanin due to fluctuating hormone levels. It goes away soon after the baby is born, if it doesn’t it would be better to consult a dermatologist. Preventive measures can be use of a good sun screen lotion suggested by your dermatologist and covering your face when out in the sun.
Treatment of a pregnant patient is difficult for dentists due to the following reasons –
- All elective dental treatments are to be delayed till after pregnancy.
- 2nd trimester is the only period where dental treatment is possible as there are high chances of miscarriage in the 1st and the 3rd trimester for various reasons.
- Although these days in most dental clinics we have digital X-ray sensors (RVG) that need bare minimum radiation, but it still it is advisable to avoid X-rays during pregnancy altogether. In rare cases when X-rays are absolutely necessary, the dentist has to determine whether the risk outweighs the benefits of taking the X-ray.
- Many antibiotics are to be avoided.
- Appointments have to be short as the mother gets uncomfortable sitting on the dental chair for long hours.
- The mother can’t be made to lie down in the 3rd trimester as a major vein can get pressed leading to low BP which is very harmful for both, the mother and baby.
Tips to maintain dental health
- Visit a dentist when you are planning a pregnancy to avoid dental emergencies during pregnancy.
- Brush twice a day.
- Floss regularly to avoid plaque build-up.
- Use anti-bacterial mouthwash as suggested by your dentist.
- Consume calcium as it helps in the development of baby’s teeth.
- Visit the dentist for regular checkups.