Healthy Teeth and Gums in Pregnancy
As most of you know, the lovely Dr Fahreen Barkatali is currently on maternity leave after having another daughter. She is a cutie and we couldn't be happier for Dr Barkatali and her little family!
We have therefore decided to re-post her original blog that she wrote whilst she was pregnant with her first daughter. It is so important to be extra conscentious with your oral health during your pregnancy. See her original blog post below:
Oral Health During Pregnancy
Many first-time mothers do not realise how much pregnancy can wreak havoc on your teeth and gums!
During the first trimester, and for some the whole pregnancy period, many women suffer from “morning sickness”. Pregnancy hormones soften the ring of muscle that keeps food inside the stomach. Gastric reflux or vomiting associated with morning sickness can coat your teeth with strong stomach acids. This acid can cause erosion of the teeth (thinning of the teeth) resulting in sensitivity and increasing risk of dental decay. Do not brush your teeth straight away as this would in effect be rubbing the acid into your teeth, causing them to soften further. Ideally, use a fluoridated mouthwash; this will help strengthen your teeth and freshen your breath. If you do not have access to mouthwash, rinse with plain water. You may brush your teeth an hour later.
Retching Whilst Brushing
Some women find they gag or retch whilst brushing their teeth, especially the molars at the back of the mouth. However, if you do not remove all the plaque around all the teeth, this can increase the risk of gum disease and dental decay. Try to use a small head toothbrush, perhaps one designed for toddlers. If the taste of the toothpaste makes you gag, use plain water and follow with a fluoridated mouthwash, returning to the use of a fluoridated toothpaste again once you can tolerate it. Try not to hit the soft tissues at the back of the mouth and also concentrate on breathing or other distraction techniques.
Some women experience unusual food cravings while they are pregnant. A regular desire for sugary snacks may increase the risk of tooth decay. Try to snack on low sugar foods instead and if that does not satisfy your craving, try to choose healthier options such as fresh fruits. Where possible, rinse your mouth immediately with water afterwards or a fluoridated mouthwash. Always use a fluoridated toothpaste.
Most commonly during the second trimester, increased progesterone and oestrogen can cause your gums to soften and become more vulnerable to plaque (bacteria). During pregnancy, the body’s blood flow increases by 30-50% which explains the increased blood flow to your gums. If there is a build up of plaque on the teeth, the gums will become inflamed and bleed. In the UK, half of all pregnant women suffer from pregnancy-induced gingivitis (gum disease) which left untreated could affect both mother and baby. If you have undiagnosed or untreated periodontal disease (chronic gum infection), pregnancy may worsen this. This is a more serious form of gum disease that can, in extreme cases, lead to early tooth loss. Some research also suggest a link between periodontal disease and premature birth with low birth weight. If you have gum disease, the dentist will clean your teeth or refer you to a dental hygienist. You will then be expected to maintain a good oral hygiene routine at home yourself.
A small proportion of women may develop a pregnancy epulis. This is essentially an enlarged “bleeding lump” on the gum that is soft and that tends to increase in size throughout the pregnancy. Treatment is careful cleaning by both the dentist and the patient which will usually prevent the lesion from becoming larger. It generally resolves post partum.
If you had gum problems during pregnancy, it is important to get your gums checked by a dentist after you have given birth. While most types of gum problems caused by pregnancy hormones resolve after birth, a small number of women may have developed a deeper level of gum disease that will need treatment to resolve.
Treatment during Pregnancy
Discuss with your dentist whether any new or replacement fillings could be avoided until after your baby is born. Although there is no evidence to suggest amalgam (mercury) fillings are a health risk to pregnant women, the Department of Health advises that they should not be removed during pregnancy, where possible, thus they are generally avoided until post partum. If you need a dental x-ray, your dentist may wait until you’ve had the baby, even though dental x-rays do not affect the abdomen or pelvic area. Make sure your dentist knows you are pregnant! Some women worry about dental injections. There are one or two types of anaesthetic that the dentist will choose to avoid; however, the most common ones used are perfectly safe during pregnancy as they do not cross the placenta.
The best way to prevent dental problems during pregnancy is to have healthy teeth and gums before you fall pregnant! Here’s how you can help look after your teeth and gums:
Brush your teeth twice a day with a small soft toothbrush, removing plaque from all surfaces. Ask your dentist to show you a good brushing technique if you feel you are not achieving this and also read our 7 Steps To Brushing Your Teeth Like A Pro.
Floss daily to remove plaque from in between the teeth and see our post on How To Use Dental Floss Correctly.
Use a fluoridated toothpaste and mouthwash, but at separate times of the day. Remember; do not rinse your mouth after brushing as you will have removed all the fluoride!
Avoid sugary snacks and foods – try to keep them to mealtimes only. If you do need to snack, opt for low sugar foods.
Do not smoke – this can make gum disease worse.
Visit the dentist and the hygienist on a regular basis.
Dental care by the dentist is free under the nhs during pregnancy and for up to one year after your due date. Get your maternity exemption certificate from your gp, nurse or midwife and book your appointment with your dentist.