Dental Concerns During Pregnacy

Common Dental Concerns During Pregnancy
by Kimberly Loos, D.D.S.

Pregnancy can be an exciting time of joyous anticipation. It can also trigger unexpected physical changes in oral health.

Pregnancy Gingivitis:
Changing levels of estrogen and progesterone hormones increase blood flow to the gum tissue and cause an exaggerated inflammatory response to plaque. Puffy, red, bleeding gums are relatively common throughout pregnancy. Healthy gums appear pink and do not bleed. The severity of pregnancy gingivitis increases between the second and third trimesters, peaking during the eighth month of pregnancy and decreasing during the ninth month.

Home care and professional cleanings are particularly important during pregnancy when swollen gums make oral hygiene difficult. Remove plaque by brushing and flossing after each meal and before bedtime. If brushing triggers morning sickness, anti-plaque and fluoride rinses can be soothing. However, mouthrinse is not a substitute for regular brushing and flossing.

Pregnancy Tumors:
Gums that are tender from pregnancy gingivitis sometimes develop pregnancy tumors (a.k.a. pyogenic granulomas). These tumors are not cancerous and normally resolve without dental intervention. If a tumor is uncomfortable or makes it difficult to speak or swallow, visit your dentist for an evaluation.

Dental Nutrition:
Pregnant women crave unusual and sometimes unhealthy foods. Pickles, ice cream, or any other food can cause tooth decay if it is not immediately removed from teeth. Try to eat the foods you crave during regular meals instead of constantly snacking.

A healthy diet including vitamins B12 (meats, fish, and diary products) and C (citrus fruits) will increase dental health. Dietary calcium builds strong teeth and bones. Contrary to popular belief, the calcium present in the milk of lactating women is not taken from their teeth. Pregnancy gingivitis, snacking, and poor oral hygiene are the main reasons women experience an increase in tooth decay following pregnancy.

Fluoride Supplements:
It is unclear whether fluoride supplements taken during pregnancy improve the oral health of the developing fetus. When given in the correct dosage, fluoride does help prevent cavities in young children.

Silver Filling Toxicity:
Pregnant women, in particular, express a heightened concern about mercury toxicity from silver (amalgam) dental fillings. Unnecessary removal or replacement of amalgam should always be avoided; however, numerous scientific studies conducted over the last 150 years show that mercury toxicity is not linked to dental amalgam. If you are uncomfortable about having silver fillings placed, there are viable alternatives. For example, composite (white) filings are made of resin instead of metal. They generally require less tooth preparation and provide a more aesthetic restoration.

Radiographs and Anesthesia:
Out of an abundance of caution, x-rays should be taken during pregnancy only if there is a dental emergency. Dental procedures requiring general anesthesia should also be avoided. A toothache is considered a dental emergency. Infections, which often cause toothaches, can spread systemically and potentially complicate a pregnancy if left untreated. Any elective dental procedures should be postponed until after delivery. Elective treatments include cosmetic dentistry. Other dental treatments are best completed during the second trimester.

Most antibiotics used by the dentist during pregnancy are safe. However, dentists should avoid prescribing tetracycline and narcotic pain medication during pregnancy. Non-prescription pain relievers like aspirin and ibuprofen (Advil®) should also be avoided. Penicillin, clindamycin, and amoxicillin are generally acceptable medications. Acetaminophen (Tylenol®) can be used to treat acute, mild dental pain.

Special Treatment Planning:
If you are planning a family, it is ideal to complete a dental examination and treatment before you become pregnant. If you are already pregnant, it is still not too late to optimize your oral health. If you suspect you are pregnant, inform your dentist before your next appointment. Continuing care, including a professional teeth cleaning, is best scheduled during the second trimester.

Pregnancy, like a visit to the dentist, can cause some people to become anxious. It is possible to minimize dental problems during pregnancy so you can relax and focus on the joys of motherhood.

Kimberly Loos, D.D.S.
Family and Cosmetic Dentistry
4110 Moorpark Avenue, Suite B
San Jose, CA 95117 USA
Phone: 408-985-6779
Fax: 408-985-6884