Pregnancy and dental care: what you need to know

Why pregnancy changes your mouth

During pregnancy, rising hormone levels (oestrogen and progesterone) change blood flow and the way your gums react to dental plaque. The same amount of plaque then causes more noticeable inflammation than before.

Other changes often add to this:

• nausea and sometimes vomiting, especially in the first trimester, which expose teeth to acid;
• food cravings and more frequent snacking, sometimes on sweet things;
• tiredness, which makes evening brushing less thorough;
• for some women, a gag reflex when brushing the back teeth.

None of these changes is inevitable. They simply call for a little more attention, and a dental check-up during pregnancy is a good idea, even if nothing hurts.

Pregnancy gingivitis: how to spot it and calm it

Pregnancy gingivitis is common. It shows up as red, swollen gums that bleed when you brush or even on their own. It often appears from the second month and may increase as the weeks go by.

Less often, a small, red, painless swelling forms on the gum between two teeth: this is called a pregnancy epulis (or pregnancy granuloma). It is benign and usually shrinks after the birth, but it should be shown to your dentist.

To calm the inflammation:

• keep brushing your gums, even if they bleed, with a soft brush and fluoride toothpaste, twice a day;
• clean between your teeth with floss or suitable interdental brushes;
• have a scale and polish if your dentist recommends it: it is perfectly possible during pregnancy.

Gingivitis left untreated can progress to deeper damage of the tissues that support the teeth. Gum treatment then helps to stabilise the situation.

Can you have dental treatment while pregnant?

Yes. Health authorities state that dental care is safe and important during pregnancy. An untreated infection or toothache puts unnecessary strain on the mother.

Some general guidelines, to be adapted to your situation:

• Urgent care (pain, infection, abscess) should not wait, whatever the trimester.
• Routine care (fillings, scaling) is often scheduled in the second trimester, usually the most comfortable time to sit in the dental chair.
• Cosmetic and non-essential treatment, such as whitening, is generally postponed until after pregnancy.
• Local anaesthesia is commonly used in pregnant women; the dentist chooses the product and dose knowing how far along you are.
• X-rays are taken only when needed for a diagnosis, with a low dose and appropriate protection.
• Medicines should only be taken on prescription, with your pregnancy taken into account.

Always mention that you are pregnant, and how many weeks, at the start of the appointment. If your pregnancy is high risk, follow the advice of your obstetrician or midwife: the dentist can coordinate with them.

Morning sickness, vomiting and protecting your enamel

Stomach acid temporarily softens the surface of the enamel. Brushing straight after vomiting means scrubbing softened enamel, which encourages wear.

What helps:

• rinse your mouth with plain water after each episode of vomiting;
• wait about an hour before brushing your teeth;
• use a fluoride toothpaste, which helps strengthen enamel;
• if brushing your back teeth makes you gag, choose a brush with a small head, brush slowly and try a toothpaste with a milder flavour.

If vomiting is frequent or persistent, talk to your doctor. New sensitivity to cold or sweet things is worth a check-up: a small cavity found early is simple to deal with through cavity treatment.

Diet: what matters for your teeth

Pregnancy itself does not cause tooth decay; how often you have sugar and acid does. Repeated snacking keeps your teeth under almost constant acid attack.

A few simple principles:

• keep sweet foods to mealtimes rather than between meals;
• make water your main drink; limit juices, fizzy drinks and sweetened drinks;
• for snacks, choose options low in sugar, in line with your doctor's advice;
• make sure you get enough calcium, vitamin D and the other nutrients recommended in pregnancy; supplements are a matter for your doctor.

The old saying that every pregnancy costs a tooth is not explained by the baby drawing calcium from the mother's teeth. Dental problems during pregnancy are mainly linked to gum inflammation, vomiting and diet, all of which can be prevented.

Preparing for your baby's future teeth

Your child's baby teeth start forming during pregnancy. A balanced diet and good medical follow-up support this process.

After the birth, the parents' oral health matters too: decay-causing bacteria can be passed on through saliva, for example by tasting from the baby's spoon or cleaning a dummy in your mouth. Treating your own cavities before the baby arrives reduces this risk.

From the very first tooth, gentle cleaning and a dentist's advice are recommended. A first children's dental visit helps build good habits early.

At German Dental Clinic in Agdal, we see expectant mothers from across Rabat for a check-up adapted to their pregnancy. For a check-up or bleeding gums, book an appointment and mention how far along you are.

Sources

• World Health Organization: oral health
• CDC: talking to pregnant women about oral health
• American Dental Association (MouthHealthy): dental health during pregnancy