Dental Care During Pregnancy

Regular dental care is important for everyone, but it can be especially important if you are an expecting mother. Did you know that your dental health is altered by pregnancy hormones? In fact, pregnant mothers are more susceptible to various dental issues and these dental issues can also affect the pregnancy, as well as the baby.

This is primarily due to the fact that a woman’s body changes drastically during pregnancy. More specifically, certain hormones associated with pregnancy are increased while pregnant. Namely these pregnancy hormones are estrogen and progesterone.

Estrogen levels start to increase during the first trimester and are the primary cause of morning sickness, or overall nausea. Throughout pregnancy, estrogen levels will continue to increase and hit their highest point during the third trimester. In a single pregnancy, more estrogen is produced than a female produces in the rest of her non-pregnant lifetime. Estrogen is essential because it allows the uterus and placenta to form blood vessels, facilitate the transfer of nutrients to the fetus, and provide support to the fetus during its development and maturation.

Pregnant woman suffering from morning sickness

Progesterone levels also increase to unusually high levels during pregnancy. While estrogen is primarily responsible for fetal development, progesterone is associated with ligament laxity. The loosening of ligaments allows the uterus to increase in size as the fetus grows. It also causes the ureters between the bladder and kidneys to increase in size.

In addition to the increase of estrogen and progesterone, several hormone levels also fluctuate in response to a pregnancy. These hormones include human chorionic gonadotropin (HGC), relaxin, oxytocin, and prolactin. Although these hormone changes are essential to facilitating the pregnancy, they can affect your oral health.

What dental issues affect pregnant women?

The most common dental issues that affect pregnant women are pregnancy gingivitis, tooth decay, and pregnancy tumors. The Centers for Disease Control (CDC) notes that about 60-75% of women are affected by pregnancy gingivitis and one out of every 4 pregnant women have cavities, while WebMD notes that only 10% of pregnant women are affected by pregnancy tumors. Ultimately, everyone is different and so certain conditions may affect some, while others may not be affected at all. However, pregnant women are more susceptible to the following dental health issues:

Pregnancy Gingivitis:

Gingivitis is a mild form of gum disease caused by the buildup of plaque on the tooth’s enamel. The bacteria within plaque can cause the gums to become inflamed, tender, and even bleed when flossing or brushing. The main concern with gingivitis is that it can progress to periodontitis if not treated. Periodontitis is a more severe form of gum disease that can cause tooth loss. In fact, gum disease is the top cause of tooth loss in adults.

Symptoms of gum disease can include:

  • Bleeding gums (during flossing or brushing)
  • Gums that are red, tender, or swollen
  • Bad breath or taste
  • Receding gums
  • Enlarged or deep gum pockets
  • Loose teeth
  • Changes in the bite or shifting of teeth

Tooth Decay:

Pregnancy also increases the risk of developing cavities. This is primarily because morning sickness increases the acidity in the mouth and wears away the teeth’s enamel. Additionally, some women tend to crave and eat more carbohydrates during pregnancy, which contain excess sugars that feed the bacteria responsible for tooth decay.

Symptoms of tooth decay can include:

  • Toothache
  • Tooth sensitivity to hot and cold temperatures, as well as sugar
  • Visible pits in the tooth
  • Brown, black, or white staining on the tooth’s enamel
  • Pain while biting or chewing

Pregnancy Tumors:

Although less common than gum disease and tooth decay, some women are also affected by small gum tumors known as pregnancy tumors, pyogenic granuloma, granuloma of pregnancy, lobular capillary hemangioma, or pregnancy epulides. These are non-cancerous tumours that are red in color and have a raspberry appearance. They often form on the gums between teeth during the second trimester and are often caused by excess plaque. In most cases, they will resolve themselves once the baby is born, however they can cause discomfort and interfere with eating or speaking.  

How Do Dental Issues Affect Pregnancy?

According to the American Dental Association (ADA), dental issues can cause premature delivery, intrauterine growth restriction, gestational diabetes, and preeclampsia. Although the exact relationship between the two is still being researched, there has been a correlation between periodontitis and premature delivery as well as low birth weight.

The American Academy of Periodontics has published a study about the connection between the two, as well as the American Academy of Family Physicians. The Oral Health Foundation also notes that women who experienced premature labor were one and a half times more likely to have gum disease. They also note that premature birth was also more likely to occur in women who had untreated cavities.

Dental Care Tips During Pregnancy:

During pregnancy, you should visit your dentist regularly. Ideally, you should be already visiting Pasha Dental at least once every six months. However, when you become pregnant, you should schedule an additional appointment to have Dr. Pasha begin monitoring your oral health during your pregnancy. Depending on how your initial consultation goes, Dr. Pasha will advise you on how often to visit because some people may require more frequent exams and cleanings than others. Generally, preventative dental care is the type of dental care you can expect to receive during pregnancy. Preventative dental care services at Pasha Dental will consist of dental exams, x-rays, and a professional teeth cleaning.

During a dental exam, Dr. Pasha will examine your teeth, gums, and bite to ensure there are no signs of gum disease or tooth decay. He will also measure your gum pockets to ensure there is no gum recession present. Your medications and any prenatal vitamins you’re taking will also be discussed, as this can affect treatment.

Digital dental x-rays may also be used as an additional diagnostic tool if needed. Finally, a professional teeth cleaning will remove plaque, tartar, and bacteria from your mouth which will decrease the likelihood of developing tooth decay, gum disease, or pregnancy tumors.

Before you leave, Dr. Pasha will also provide you with information on how to take care of your teeth in-between appointments. The basics include brushing your teeth twice a day and flossing once a day. He may also recommend a bland tasting toothpaste and mouth rinsings during morning sickness periods. It is also important to eat a balanced diet and to try and limit the amount of sugary snacks since your teeth are more likely to develop cavities.

Is Dental Care During Pregnancy Safe?

Yes! Dental care during pregnancy is not only safe, but it is highly recommended by dentists and physicians alike to increase the odds of a smooth pregnancy. Most dental care during pregnancy consists of preventative services, but it can also consist of restorative services.

Pregnant woman looking off in the distance with her hands on her belly

It is also important to note that both dental x-rays and local anesthetics are safe for the mother and developing fetus. Compared to regular x-rays, digital dental x-rays use a much smaller amount of radiation that has not been found to cause any problems with pregnancy. As an additional measure, you will also be asked to wear a lead apron to further minimize the amount of radiation that reaches the abdomen.

In August 2015, the Journal of the American Dental Association published a study about pregnant women who were exposed to local anesthetics during dental treatment. Within this study two groups of pregnant women were compared: those who had been given local anesthetics and those who had not. Ultimately the study concluded that there were no differences in miscarriage rate, birth defects, prematurity, or birth weight.

If you plan on becoming or already are pregnant, schedule a consultation with Dr. Pasha Javaheri Saatchi of Pasha Dental today for your pregnancy dental care appointment. Pasha Dental is proud to provide dental services for pregnant women residing in the Brooklyn, NY area as well as to residents of Staten Island, Queens, and Manhattan.

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