How Does Pregnancy Affect Your Oral Health?

Pregnancy affects nearly every aspect of your life, and strongly affects your body's functioning. Changes in your oral health are just as important to notice as changes in your body's health. During this special time, you should take special care of your dental health for you and your growing baby. Pregnancy does not automatically damage your teeth. If the mother’s calcium intake is inadequate during pregnancy, her bones – not her teeth – will provide the calcium her growing baby needs. This calcium loss is quickly made up after breastfeeding is stopped.

The demands of pregnancy on the body can lead to dental problems in some women. With proper dental hygiene at home and professional help from your dentist, your teeth should remain healthy throughout pregnancy. Dental disease can affect a developing baby. Research has found a link between gum disease in pregnant women and premature birth with low birth weight. Babies who are born prematurely may develop a range of health conditions, including cerebral palsy and problems with eyesight and hearing.

It is estimated that 18 out of every 100 premature births may be triggered by periodontal disease, which is a chronic infection of the gums. If a dental condition does come up, having it treated soon after can reduce the risk of premature birth.

Pre-pregnancy dental health

If you are planning on getting pregnant, but are also planning on having some elective dental procedures, see your dentist first. It is more convenient to have elective procedures done before you conceive. If you need a dental treatment completed during pregnancy, non-urgent procedures are often performed after the first trimester. You are less likely to have dental problems during pregnancy if you already have good oral hygiene habits. These include:

• Brush your teeth at least twice daily with fluoridated toothpaste.
• Floss between your teeth.
• Visit your dentist regularly.

Common causes of dental health problems during pregnancy:

• Gum problems.
• Vomiting.
• Cravings for sugary foods and drinks.
• Difficulty brushing teeth.

The hormones associated with pregnancy can make women susceptible to gum problems, including:

• Gingivitis (gum inflammation) – more likely to occur during the second trimester. Symptoms include swelling of the gums and bleeding, particularly during brushing and when flossing between teeth.
• Undiagnosed or untreated periodontal disease – pregnancy may worsen this chronic gum infection, which is caused by untreated gingivitis and can lead to tooth loss.
• Pregnancy epulis or pyogenic granuloma – a localized enlargement of the gum, which can bleed easily. This may require additional dental cleanings, and rarely excision.

If you have gum problems during pregnancy, it is important to have your gums checked by a dentist after you have given birth. While most gum problems caused by pregnancy hormones resolve after birth, a small number of women may have developed a deeper level of gum disease that will need treatment to resolve.

Morning sickness 

Pregnancy hormones can soften the ring of muscle that keeps food inside the stomach. This can lead to gastric reflux (regurgitating food or drink), or the vomiting associated with morning sickness can coat your teeth with strong stomach acids. Repeated reflux and vomiting can damage tooth enamel and increase the risk of decay.

How to care for teeth with morning sickness:

• Avoid brushing your teeth immediately after vomiting. When the teeth are covered in stomach acids, the vigorous action of the toothbrush may scratch the tooth enamel.
• Rinse your mouth thoroughly with plain tap water.
• Follow with a fluoridated mouthwash.
• If you don’t have a fluoridated mouthwash, put a dab of fluoridated toothpaste on your finger and smear it over your teeth. Rinse thoroughly with water.
• Brush your teeth at least an hour after vomiting.

You may have an increased gag reflex while brushing your teeth. Some pregnant women find that brushing their teeth, especially the molars, provokes their gag reflex. However, not brushing your teeth regularly can risk tooth decay. 

Suggestions include:

• Use a toothbrush with a small head, such as a brush for children.
• Slow down your brushing and take your time.
• It may help to close your eyes and concentrate on your breathing.
• Try listening to music to distract your nausea. 
• If the taste of the toothpaste seems to provoke your gag reflex, switch to another brand. Follow up with a fluoridated mouthwash to rid the taste of toothpaste. 

You will likely have food cravings while pregnant. Some women experience unusual food cravings (and food avoidance) while they are pregnant. Regularly having sugary snacks may increase your risk of tooth decay. Try to snack on low-sugar foods instead. If only sweet foods will satisfy your cravings, have fresh fruits instead. Rinse your mouth with water or an alcohol-free mouth rinse, or brush your teeth after having sugary snacks.

For pregnant women, it is also important to increase your daily calcium intake. By having sufficient calcium levels, it will protect your bone mass and meet the nutritional needs of your developing baby. Good sources of dietary calcium include, milk, cheese, unsweetened yogurt, and calcium-fortified soy milk. Vitamin D also helps the body to utilize calcium. Good sources include, cheese, fortified margarine, fatty fish, such as salmon.

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Dr. Mariliza LaCap lives in Old Tappan and is a Mom of 5 children. She is a dentist who’s mission is to have a community of healthy, beautiful smiles through proper dental care and education. Because she is a Mom herself, she knows how important it is to find a dental home for the whole family. A dental home where children have fun and feel safe. A dental home where parents have peace of mind while also getting their dental work done. She knows the importance of running on time and convenience to accommodate busy schedules. Dr. LaCap and her husband are both graduates of Columbia University School of Dental and Oral Surgery and are owners of Smile More Dentistry and Washington Dental Associates.