What To Do And Not To Do When You Are Pregnant

There has been an old popular myth saying that for every child a mother bears, she loses a tooth. This can be very distressing to all those pregnant mothers who hear this but it is completely untrue in this age. This myth is based on the fact that the fetus draws calcium directly from the mother’s teeth and results in weakened teeth which may be lost due to decay. Women are better educated about their teeth and dentists understand their altered state of the body and needs during pregnancy.

Oral Changes During Pregnancy

Hormonal changes during this period may have an effect on teeth, increasing the risk of gum disease. Bad oral health of the mother can affect the health of her developing baby.

• A commonly occurring condition during pregnancy is “pregnancy gingivitis”. Due to the elevated levels of estrogen and progesterone, there is an exaggerated inflammatory response to local irritants, thus gingivitis occurs rather easily in pregnant women. Gingivitis is common from the second to eight months of pregnancy.

• It usually begins in the marginal and interdental papillae in the first trimester.

• Pyogenic granuloma / pregnancy tumor is seen in about 1% of expectant mothers. This appears as an asymptomatic sessile or pedunculated soft tissue mass in the upper anterior region of the mouth. This condition usually resolves after pregnancy with the removal of irritants.

• Even with good dental hygiene, most pregnant women experience inflamed gums.

• Looseness of the teeth may be experienced during the third trimester.

• These gingival changes reverse after the baby is born.

• Cavities may also be on the increase during this period; due to the inflamed, tender gums, brushing and flossing may be avoided thus leading to caries.

• Another fact is, when the fetus increases in size the stomach capacity decreases and to compensate, frequent small meals and sugary snacks will be common. Increased plaque and increased snacking, increases the susceptibility to caries.

Dental Care During Pregnancy

It’s always better to get a dental check up when you start planning to become pregnant. The dentist can examine your teeth and gums and all problems could be eliminated or minimized in advance.

• Always tell your dentist that you are pregnant and which trimester you are in. dental treatments during the first and second half of the third trimester are avoided. The first trimester is that stage at which the baby’s organs are forming and is crucial to development. During the third trimester the dental chair tends to be uncomfortable for the mother. When lying back, the uterus may cut circulation by placing pressure on the vein (inferior vena cava) that returns blood to the heart from the lower part of the body and cause unconsciousness. If any treatment is to be done at this stage the mother’s position should be shifted every 3-7 mins and if stressful, premature labor may be induced. Thus the second trimester seems best to minimize any potential risk.

• Appointments are not usually recommended for the mornings due to vomiting.

• Major dental treatments that aren’t urgent should be postponed until the child is born.

Medications used in dental work during pregnancy

• Antibiotics: such as penicillin and its derivatives and erythromycin are usually fine with the developing fetus. However, tetracyclines, streptomycin, chloramphenical and metronidazole should be avoided.

• Anesthetics: Novocain and lidocaine used in local anesthesia will not adversely affect the fetus. Injected local anesthetics do cross the placenta but the small amounts used in dentistry will not do any harm.

• Pain killers: products containing paracetamol are approved but other drugs such as aspirin and narcotic painkillers are a big NO.

Radiographs During Pregnancy?

The probability of congenital anomalies and childhood malignancies are practically nonexistent with dental x-rays. The double lead shield with thyroid protector will reduce exposure even more. However it is best to avoid all potential risks at this time if possible (especially during the first trimester).

Although there is little concern, the recommendation is to avoid dental work until after delivery just to be safe.