Why You Should Go to The Dentist During Pregnancy
By Teresa Yang, DDS
Pregnancy is a special time in a woman’s life with welcome - and unwelcome - changes affecting her entire body, including the mouth. You may have heard this: A woman loses a tooth with each pregnancy. While it may have been true in the Middle Ages, it is an old wives’ tale today. There is no reason a single tooth should be lost. Pregnant women do need to take extra care of their gums and teeth, though.
Changes in the Gums
Many of the oral changes are tied to the increase of certain hormones, namely, estrogen and progesterone. During pregnancy, these hormones interact with dental plaque, causing gums to become tender, inflamed, red, and more likely to bleed. And as the mother’s blood volume increases, there’s an even greater likelihood of bleeding gums. Occasionally, a swelling in the gum occurs, called a pyogenic granuloma or “pregnancy tumor.” These are benign growths and usually resolve by themselves. If the swelling persists, it can be removed by your dentist.
Get Your Teeth Cleaned
The key is excellent oral hygiene and plaque control. Plaque is the whitish filmy residue that develops around the teeth after eating and is comprised primarily of bacteria, the culprit that contributes to cavities and gum disease. The more meticulous you are with brushing and flossing, the less likely the gums will exhibit symptoms. This applies at home and in the dentist’s chair.
Many pregnant women shy away from visiting the dentist, possibly out of fatigue, ignorance, or simply medical appointment overload. Yet they should be doing the exact opposite. An expectant woman should have her teeth cleaned at least twice, if not more, during the pregnancy. Historically, insurance companies routinely cover two cleanings per year, but some policies have now expanded this benefit to three cleanings for pregnant women. That speaks to the importance of oral hygiene during pregnancy when an insurance company adds benefits!
Developments in the Teeth
Teeth may become more vulnerable. Perhaps you’ve also heard this? Calcium is leached out of the mother’s teeth into the fetus, making the teeth softer. While pregnant women do require more calcium for normal fetal development, this is also not true. Instead, what likely occurs is a change in a pregnant woman’s eating patterns. She may be eating less but more frequently throughout the day. Chances are her oral hygiene isn’t matching this eating schedule, so her mouth becomes more susceptible to cavities. She may also be vomiting. The mouth becomes very acidic after vomiting, and the acid may damage the teeth.
Avoid the urge to brush immediately and wait 20 to 30 minutes. Brushing right away only serves to brush the acid directly on your teeth. Instead, rinse with a baking soda solution to neutralize the pH in the mouth. Or water. Stay away from acidic mouthwashes.
Nutrition is critical; eat a healthy, balanced diet. Besides calcium, it’s equally important for the mother to get adequate amounts of vitamins, including A, C, and D, which are vital to developing teeth. Fluoride also plays a role in the primary teeth, which develop in utero. A naturally occurring element, fluoride, was accidentally discovered to improve the strength of tooth enamel, making teeth more resistant to cavities. A prescribed concentration of fluoride is added to many municipal water systems. Bottled water containing fluoride is also available. Despite the misinformation around fluoride, especially on social media, the majority of dentists regard fluoride as one important way of ensuring stronger teeth.
Pregnancy is Not a Time to Avoid Dental Care
If dental treatment is necessary, it can be performed safely. Thirty years ago, the thinking and common practice was to defer almost all treatment until after the baby’s birth. Over time, based on data and research, this philosophy has evolved. Now, dentists and obstetricians alike consider dental treatment safe for pregnant women. Ideally, treatment during the second trimester is desirable when the mother may be at her most comfortable. Judicious taking of X-rays is also safe. Many local anesthetics are perfectly safe. What’s potentially harmful is leaving an infected tooth, as this can cause damage to the mother and developing baby.
There are some things to avoid:
Nitrous oxide, commonly known as laughing gas - Any pregnant dentist, dental hygienist, or dental assistant should also refrain from being in the treatment room when nitrous oxide is used.·
Discretionary procedures - Procedures like bleaching should be postponed until after delivery and, if applicable, after breastfeeding is complete. Cosmetic procedures such as veneers should be postponed due to the likelihood of bleeding gums. It’s difficult to get a beautiful result if the gums are not in tip-top condition.
Any pain medication not recommended by your physician - The health of the developing baby is intricately tied to the health of the mother. Maintaining good oral hygiene practices and getting dental care are integral to this process.
ABOUT THE AUTHOR
Teresa Yang, DDS, has practiced dentistry in the Los Angeles area for more than thirty years. She started and developed two practices from scratch, which is unique in today’s insurance-driven world. She has taught clinical dentistry and patient management at UCLA School of Dentistry, has written extensively on dental topics, and is a member of the Forbes Health Advisory Panel. Dr. Yang’s philosophy has always been to put the patient’s interest first: “A person is more than a mouth and a set of teeth.” She is the author of Nothing But the Tooth/An Insider’s Guide to Dental Health (Rowman & Littlefield, August 31, 2023). Learn more at teresayangdds.com.
Cover Photo by Tomaz Barcellos