Pregnancy and oral health : Everything you wanted to know

By Dr. Prerna Kalitha

Pregnancy is generally thought of as the time when a woman strives to be particularly aware of the need for “health” and what must be done to achieve the highest degree of well-being for her and her developing child. Most importantly, many women may not be aware of the link that exists between their oral health and their general health, as well as the impact that other factors can have on a developing child.

Despite these goals, neglecting dental health is not uncommon during pregnancy. The difficulty faced in maintaining satisfactory oral and dental health seems understandable when one considers the often frequent bouts of nausea experienced; the physical demands and restraints imposed by weight gain and a growing abdomen; the problems presented by sensitivity and inflammation related to the gum tissues, so-called pregnancy gingivitis; and concerns, that certain aspects of dental treatment may be dangerous to the developing child. This article will explore these important issues.

Healthy Body & Nutrition for Two:
Good maternal nutrition is essential for the development of a baby’s oral health. Children’s primary (baby) teeth begin forming at about the sixth week of pregnancy, and begin mineralizing (forming enamel and dentin) at around the third to fourth month of pregnancy. The mother’s diet must be adequate in all nutrients, especially calcium, phosphorous, and protein to facilitate this process.
Nutritional deficits can cause defects in tooth development, and healthy salivary flow and composition. Deficiencies in protein and calories, Vitamins A, C, D and iodine, excesses in fluoride and Vitamin D, have all been shown to affect the development of your baby’s teeth.

Pregnancy “Cravings” and Tooth Decay — It is not uncommon for women not only to become nauseated by certain tastes and smells, but also to develop cravings for others. These urges are normal and understandable, but it is important to remember that frequent ingestion of sugary and starchy snacks between meals can lead to dental decay and should be avoided, or at minimum kept to mealtimes. If snacking, choose foods that are nutritious for mother and baby such as raw fruits, vegetables and dairy products.

The ‘Calcium Myth’ Dispelled — Calcium is needed for healthy bones and teeth formation. The calcium your baby needs is provided by your diet, not by your teeth. If there is insufficient dietary calcium however, your body will provide this mineral from calcium stored in your bones. The primary source of calcium is provided by an adequate intake of dairy products or from recommended dietary supplements. It is a myth that calcium is lost from the mother’s teeth during pregnancy. Once formed, teeth do not change, unlike bone, which is constantly changing and “remodelling.”

Pregnancy, Hormones and Periodontal (Gum) Disease:
Normal female hormones, of which progesterone is one, are elevated during pregnancy and also in women who are taking certain birth control pills containing high levels of progesterone. In the presence of gum disease, progesterone stimulates the production of substances called prostaglandins, which cause inflammation of the blood vessels in the gum tissues.

Warning signs of gum disease include swelling, redness, bleeding and sensitivity of the gum tissues, common in pregnancy and known as pregnancy gingivitis (gingival – gum tissue, itis – inflammation of). The tiny blood vessels of the gum tissues become dilated (widened) in response to the elevated hormone levels of pregnancy and therefore more susceptible to the effects of plaque bacteria and their toxins. Gingivitis is especially common during the second to eighth months of pregnancy.

Dental Treatment During Pregnancy

It is important to see a dentist for an evaluation of oral and dental health as soon as you know you are pregnant to determine if any dental care is necessary. Dental emergencies should always be managed as they arise to treat pain and infection to eliminate stress and danger to the developing fetus.

If possible, elective (non-urgent) care is best timed if possible, between the first trimester and second half of the third trimester. The first trimester is the period when most of the baby’s organs are forming and when the fetus is most susceptible to environmental influences. In the last half of the second trimester, it may just be less comfortable to sit in the dental chair.

Dental radiographs (x-rays) may be needed for dental treatment or a dental emergency that can’t wait. Untreated dental infections can pose a risk to the foetus, as well as to the mother. Radiation from dental radiographs (x-rays) is extremely low, however, every precaution is taken to minimize radiation exposure. A leaded apron including collar, shields against exposure to the abdomen and particularly the thyroid gland in the neck).

Maintaining Your Oral and Dental Health During Pregnancy
It’s especially important to maintain good oral health during pregnancy. Studies indicate that pregnant women who have severe gum disease may be at increased risk for pre-term delivery, which in turn increases the risk of having a low-birth-weight baby. For individuals who have gum disease there is also increased risk for cardio-vascular disease, diabetes and respiratory disease.

To maintain a healthy body, make sure you maintain your oral health. Prevent tooth decay and periodontal disease by brushing your teeth thoroughly twice a day to remove plaque using fluoride toothpaste. Be sure to clean between your teeth daily with floss or other inter-dental (between teeth) cleaners. Maintain a healthy diet, exercise and get plenty of sleep. See your dentist regularly during your pregnancy and make sure that you take care of any urgent dental treatment. Then visit your dentist regularly throughout pregnancy for routine monitoring and cleanings. If you notice any changes in your mouth during pregnancy, see your dentist.