Pregnancy and Oral Health

Being pregnant affects nearly every aspect of your life, including your oral health. The condition of your gums may affect your pregnancy and the health of your baby. And preventing tooth decay in your own mouth can help your baby have healthier teeth, too. Here's what you need to know to protect yourself and your baby.

Tooth decay and your baby’s oral health

Children are more likely to get cavities before age 5 if their mothers have untreated tooth decay. Why? Tooth decay is an infection caused by certain types of bacteria. Moms with untreated cavities have high levels of these bacteria. So chances are higher that they will pass them on to their children.

Babies can get these bacteria through:

Kissing
Sharing utensils
Using a pacifier that someone has cleaned off with saliva
Putting the baby's hand in your mouth, and then in the baby's own mouth

What you can do

Here’s what you can do to reduce your baby’s risk for early tooth decay:

Get cavities treated – before pregnancy, if you can. If not, it’s important to get treatment starting in the first trimester. The only things to be avoided during the first trimester are routine X-rays and nitrous oxide anesthesia. You can safely receive treatment throughout your pregnancy.
Brush at least twice a day.
Floss every day.
Use chewing gum and mints that contain xylitol, a natural sugar substitute. Studies have shown that it destroys decay-causing bacteria.

Periodontal disease and your baby’s health

Periodontal (gum) disease is also a bacterial infection. At first, gums become red and swollen. They often bleed when you brush. Dentists call this gingivitis. With time, gums can pull away from the teeth. Teeth can become loose. Without treatment, periodontal disease can lead to tooth loss.

During pregnancy, many women notice puffy gums that may bleed during brushing. This usually starts during the second month of pregnancy. It usually goes away after the baby is born. This is called pregnancy gingivitis. This bacterial infection is triggered by changes in your hormone levels and immune system. That is why good oral hygiene may not totally prevent it.

Gum disease that exists before pregnancy can increase the risk of problems such as:

Premature birth (before 37 weeks)
Low birth weight (less than about 5.5 pounds)

A common treatment for periodontal disease is scaling and root planing. This involves cleaning the visible parts of the teeth, as well as the roots. Some studies have found that pregnant women who get this treatment have a lower risk of premature birth. Other studies have not shown such an effect. However, the studies do show that treatment given during pregnancy is safe for both the mother and the unborn baby.

Periodontal disease also may contribute to preeclampsia. This condition increases blood pressure. Preeclampsia affects about 5% of pregnant women. It can be dangerous for both the mother and baby. The only cure is giving birth. This can put the baby at risk if the pregnancy is not full term yet.

A few studies have linked preeclampsia with periodontal disease. More research is needed to discover whether there is a cause-and-effect relationship.

What you can do

If you are planning a pregnancy, visit your dentist for a check-up. He or she can tell you if you have gingivitis or periodontal disease. Getting treatment early may reduce your risk for problems later.
If you are already pregnant and concerned about periodontal disease, visit your dentist as soon as possible.

Pregnancy-related conditions of the mouth

Pregnancy granuloma: This is a growth on the gums that occurs in 2% to 10% of pregnant women. It’s also known as a pregnancy tumor, though it is not cancerous. These growths are not dangerous, but they can be uncomfortable. They are often found near the upper gum line. They are caused by hormonal changes, and disappear after the baby is born. There is no reason to have them removed unless they interfere with speaking or eating.

Tooth erosion: If you have severe morning sickness, the enamel on some of your teeth may become eroded. This happens when stomach acids wash over the teeth during vomiting. If you vomit, do not brush right away. Instead, rinse your mouth with a mixture of baking soda and water. Or use an over-the-counter rinse made for reducing the acid level in your mouth.

Dry mouth: To help dry mouth, drink plenty of water. You can use sugarless candy or gum to stimulate your saliva flow. Experts recommend gum or candy that contains xylitol. This sugar substitute also destroys cavity-causing bacteria.

Visiting the dentist while you’re pregnant

Check-ups – Visit your dentist as soon as possible. In your first trimester, avoid routine X-rays and nitrouis oxide anesthesia.

Emergencies – You should get emergency dental treatment at any point during your pregnancy if it will relieve your pain, decrease stress or prevent infection. Your dentist should consult with your obstetrician or midwife if there are questions about the safety of medicines or anesthesia.

Other treatment – You can get routine dental care throughout your pregnancy. Routine care includes cleanings and treatment of gum disease and cavities. The only things to be avoided at this time are routine X-rays and nitrous oxide anesthesia. In the last trimester, lying down in the dental chair may become uncomfortable.

X-rays – If dental X-rays are needed during your pregnancy, it is usually due to an emergency that cannot wait until after the baby is born. Advances in technology have made dental X-rays much safer. Digital X-rays use much less radiation than older systems that use dental film. Studies have shown that using a lead apron will protect you and your fetus from radiation.

Medicines – Ideally, you should avoid taking any medicines during pregnancy, especially during your first trimester. However, sometimes this is simply not possible. Most common dental drugs can be used during pregnancy. However, some — such as sedatives and certain antibiotics — should be avoided. Your dentist will know what to prescribe, or will discuss it with your obstetrician.