Pregnancy, also known as gestation, is considered to be one of the most beautiful times in a woman’s life when a woman goes through some physiological and psychological changes as well as changes in dental health. Yes… dental health. Although many of us are concerned about gynecological problems during pregnancy, it has a significant effect on dental health too. Dental health or oral health is the health of the mouth that includes teeth, gum, tongue, oral mucosa, alveolar (jaw) bone, and other oral structures. Certain oral diseases are very common during pregnancy due to the changes that occur at this time. Fortunately, many of these problems can be easily taken care of if some precautions are kept in mind and some may regress after the pregnancy period is over.
The common dental problems that may occur during pregnancy:
Gingivitis: Pregnancy gingivitis, otherwise known as gum inflammation is one of the most frequent complications during pregnancy. Usually noticed in the second or third month of pregnancy, it is characterized by gum bleeding, swelling, and color changes, commonly in the anterior region of the tooth. Changes in microflora (good bacteria), improper maintenance of oral hygiene, and alterations in gingival blood vessels, caused by hormonal changes during pregnancy, progesterone in particular, may lead to gingivitis in pregnancy. Pregnancy may also act as an aggravating factor for pre-existing gingivitis. Luckily, it does not cause any permanent damage to the oral tissues and may resolve within a few months of delivery, if strict oral hygiene is maintained, or through professional cleaning, if the case is severe.
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Dental health or oral health is the health of the mouth
that includes teeth, gum, tongue, oral mucosa, alveolar
(jaw) bone, and other oral structures
Periodontitis: Gingivitis, if not treated properly, results in periodontitis, characterized by loss of bone, loose teeth along with the features of gingivitis. The causes of periodontitis in pregnancy are more or less the same as those of gingivitis. But, if not taken into account at the right time, it may lead to adverse pregnancy outcomes like preterm delivery and low birth weight (LBW) of the baby. The good news is, it is totally preventable if taken the right measures, at the right time by maintaining good oral hygiene or by professional cleaning, if necessary.
Dental caries: A small blackish spot or a black or brown line is what dental caries initially look like. However, if left untreated, it may lead to pulpitis, resulting in severe pain. Although being completely preventable, the prevalence of caries is significantly high.
Changes in saliva and microflora, recurrent vomiting, poor dental hygiene are some of the factors that cause pregnant women to suffer from dental caries. Another common reason is the increased consumption of a sucrose-rich diet, commonly seen in pregnant women. Despite that, maintenance of good oral hygiene and the limitation of sugary foods significantly reduces the chances of getting dental caries.
Erosion: Nausea and vomiting are very common during the first trimester of pregnancy, although some women may experience it after the first trimester. The surface layer of the tooth, enamel can be lost by the acid vomit and may lead to acid-induced tooth erosion. Then again, the salivary composition is changed in late pregnancy and may also cause erosion.
Xerostomia and Ptyalism: Although xerostomia or dry mouth is a frequent finding in a child-bearing mother, an infrequent finding during the first trimester of pregnancy is ptyalism or sialorrhoea, commonly known as excessive salivation.
Pregnancy epulis: ‘Pregnancy epulis’ is a painless, tumor-like, non-cancerous growth in the gums, usually seen in the third trimester of pregnancy. Irritation from calculus (hardened dental plaque) and hormonal alterations during pregnancy are the reasons for the development of pregnancy epulis. Removal of the irritating factor and surgical excision should resolve the condition.
How to prevent these problems?
Regular dental check-up: As we all know ‘prevention is better than cure’, it is better to visit a dental professional before a woman is planning to conceive and receive preventive measures plus dental treatments according to need. The dentist should always be informed if the visiting woman is pregnant.
Maintaining good oral hygiene: Brushing twice a day; once after breakfast and once before going to bed and regular flossing can prevent most of the dental problems from arising.
Avoid vigorous tooth brushing: Due to the acidic nature of the mouth during pregnancy, vigorous tooth brushing may cause tooth wearing. While selecting a toothbrush, one with soft bristles is highly recommended.
Avoid tooth brushing after a meal or after vomiting: The oral environment becomes highly acidic after a meal or after vomiting. So, it is recommended to wait for at least thirty minutes after eating or vomiting, before brushing the teeth.
Maintain a balanced healthy diet: Consumption of a healthy balanced diet is undeniably important for both the mother and the baby. Intake of vitamin A and D-rich foods helps in enamel formation. Although the effect of prenatal fluoride use on tooth decay prevention is uncertain.
Avoid a sugary diet: It’s completely understandable that resisting the sugar craving can be difficult sometimes, but foods and drinks rich in sugar, increase the possibility of caries formation.
Avoid smoking: Even though it may seem challenging to some women, it is better to avoid smoking during the period of pregnancy, as it may cause periodontitis, leading to pre-term deliveries or pre-term low birth weight (PLBW) of the baby.
Avoid alcohol: Just like smoking, restraining yourself from alcohol for nine months may seem like a long time for some women, but it is worth it, as consuming alcohol may cause your child to suffer from ‘fetal alcohol syndrome’, a condition that may cause smaller jawbones formation, enamel defects, facial abnormalities, increased tendency of caries and mouth breathing as well as defects in cardiovascular, renal, musculoskeletal, ocular, and auditory systems.
Read more: ‘Prevent unplanned pregnancy during Covid-19’
Dentists can play an important role in preventing these diseases and manage the existing problems to prevent further complications. Physicians and health care workers taking care of pregnant women should also take a look in the oral cavity and the patients with suspicious lesions or having poor oral hygiene should be referred to a dentist to prevent the adverse effects. The early the pregnant mothers seek dental help, the less the chances of getting these problems. Although some dental procedures are contraindicated during pregnancy, it is completely safe to have your oral cavity diagnosed by a dental professional as well as receive emergency treatments like extraction, root canal treatment, or restoration. By maintaining a few measures, the pregnancy period can be as amazing as a woman can expect. Happy pregnancy!!!
- Anmol Fayez Anny, BDS, PGT, MPH, is a dentist.
