Dental Care & Pregnancy

Pregnancy is one of the most crucial period in the life of a woman . She not only needs to care of herself but it is directly related to the well being of the developing life within her . So how the dental health is related to the state of pregnancy ? Well it is very much related . Just as a good oral hygiene  is important in day to day life , it becomes more important in the period of pregnancy.  Accd. to American Dental Association as well as WHO this is the period when women don’t take proper care of their teeth and gums, which can lead to a lot of problems to the dental health, which complicates the general health and pregnancy too. Here are a few tips, facts and things to remember during pregnancy.

As with any other medical type treatment, let your dentist know you are pregnant before your checkup begins or when making the appointment. He or she may ask how far along you are to help determine what they feel is appropriate for you. They may recommend waiting a few months until later in your pregnancy or until after you have delivered (assuming you do not have any concerns and delivery is not too far off).

Expectant mothers who suffer from periodontitis (also referred to as periodontal disease) are seven times more likely than those expectant mothers without this disease to go into labor before their term. It has been theorized that a chemical present in oral bacteria known as prostaglandin causes labor to be induced early. A premature birth can be dangerous to the health of the newborn. These babies exhibit a low birth weight which also makes them susceptible to health problems from the start of their lives.

Simple Sloution

To begin, always, always keep you regular dentists appointments when you are pregnant; the hormones and other physical changes in your body can do some pretty strange things to your teeth. Pregnancy gingivitis is a very common condition among pregnant women that involves the swelling of the gums. Because the gums are extra sensitive during this time, it is common for women not to brush at intently as they should in an attempt to avoid discomfort, but cavities can start to form under the swollen gums leaving cavities behind as the gums return to normal after delivery. Your dentist will be able to suggest some products for you to promote optimal care during pregnancy. It is extremely important to stick to brushing twice daily and flossing once daily when you are expecting.

Dental Treatments

Most of the dental treatments that include extractions, fillings, root canal treatments or placement of crowns etc. are to be carried out during the 2nd trimester of pregnancy (i.e. the 4th-6th month), and only if they can’t be avoided. If the 3rd trimester is entered, then its best to delay any treatment procedure till the birth of the child, and get it done later. Sitting on your back for long time is not possible during the 3rd trimester of pregnancy, so any treatment procedure has to be canceled. Also, the stress sometimes due to bigger treatment procedures can affect pregnancy a lot.
Maximum try is to reduce the exposure of the child to any treatment motions, and any medication that may cross the placental barrier. One of the examples is tetracycline drugs. If these drugs are taken during the pregnancy period, it affects the child’s teeth by forming tetracycline stains.

X-Rays During Pregnancy

Taking X-rays during pregnancy, should be avoided as much as possible. The radiations are not only dangerous for the mother, but also the developing child in the 1st trimester. Although sometimes X-rays are needed compulsorily, to come to a proper diagnosis of the problem, care should be taken to reduce the exposure of the developing child to the radiations. One should always remember that prolonged exposure can cause mutation.

Oral hygiene measures to be taken

As usual, the best treatment is prevention when it comes to oral health. Brush and floss regularly especially if you experience vomiting at any time during your pregnancy. Doing so may decrease the effects of stomach acid in your mouth. Though it is not uncommon to have sore or bleeding gums during pregnancy or even a toothache (you can thank hormone changes for that), it is important to let your healthcare provider(s) know so that they may address any issues that need attention.

Use a soft toothbrush, to avoid pressure on the gums, and don’t worry if your gums are bleeding. Give a scheduled visit to the dentist during the 2nd trimester of pregnancy to get your teeth cleaned professionally, by scaling procedures. Use a good ADA-approved toothpaste to brush your teeth, which contains fluorides so that adequate amount of fluorides are supplied to the child.
Flossing would help in keeping the gums healthy, and the areas between the teeth where plaque accumulation can lead to tooth decay.

Effect Of Pregnancy On Dental Health

During pregnancy, the blood flow increases by about 30-50%and the hormonal production is also high. The condition ofPregnancy Gingivitis is common and half of the total pregnant women experience it. In this, the gums appear glowing pink/red because of the higher circulation of blood, which can provide good nutrition and house for bacterial growth, and although good oral hygiene is tried to maintain, bleeding while brushing the teeth is common. Its also because of higher levels of estrogen and progesterone, that leads to sensitivity of gums.

The gingivitis that occurs in the gums, sometimes develop into mass or lump in the gum called aspyogenic granulomas, or “pregnancy tumors”, although its not any cancer/tumor. This also occurs sometimes, but regresses as child birth occurs.

Could gingivitis affect baby’s health?

  • New research suggests a link between pre-term, low birth weight babies and gingivitis
  • Excessive bacteria, which cause gingivitis, can enter the bloodstream through your mouth
  • The bacteria can travel to the uterus
  • This can trigger the production of prostaglandins, which are suspected of inducing premature labor
  • Women with periodontal disease may be seven times more likely to have a baby that is born too early and is too small

If dental treatment is needed , what drugs are safe?

  • Be extremely cautious of all drugs during pregnancy
  • If you have gingivitis or periodontal disease, your dentist may want to treat you more often to achieve healthy gums and a healthy baby
  • Although dental anesthetics such as novocaine or lidocaine can enter the placenta, which filters out most drugs, the doses used in most dental procedures are considered safe
  • If you need to have dental treatment done during your pregnancy, some acceptable antibiotics include penicillin, amoxicillin, and clindamycin
  • It is important to avoid tetracycline, which can cause discoloration of your child’s temporary and permanent teeth
  • Pain products containing acetaminophen, such as Tylenol, are approved, but you should be wary of other over-the-counter medications such as aspirin or ibuprofen
  • Avoid using narcotics for dental pain until your child is carried to term

Precautions in Dental Office

Drugs during pregnancy should be be very carefully taken . Below a general list of drugs during pregnancy that includes many of the common drugs related to dental procedures.

When you visit a dentist during your pregnancy phase, you should let them know what drugs you have been using since the start of your pregnancy period, so that the appropriate medication is given, if required, after any simple dental treatment procedure.
You feeling comfortable would reduce the stress on the developing baby. And when the anesthesia is given for any treatment, the lesser would be better to keep you comfortable. Higher amounts of anesthesia should be given only if required.

Antibiotic drugs like Penicillin, amoxicillin, and clindamycin are safer drugs to be taken during pregnancy, if any infections occur. Avoid taking tetracycline, as already said they would cause stains to child’s baby teeth as well as the permanent teeth.
Avoiding a dental visit only because you are pregnant is not a good choice. Just oral problems can lead to many complications.

Women get pregnant usually at an age of around 20-24 and this is when the wisdom tooth eruption occurs, in a normal or abnormal position. So if there is a problem, then delaying the removal of the wisdom tooth should be best postponed to after the child birth.

CONCLUSION :

So as dentists its our duty to take proper care during the treatment of pregnant ladies . Its also very important to give proper oral hygiene instructions. Also NO dental treatment should be carried out  without the written consent of the treating the pregnancy case.

Below are some related videos and a very simple and informative presentation.

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