Over the last few years, several of our staff members have started their families, so inevitably, we have spent a lot of time talking about all the preparations and precautions that take place during pregnancy. What “travel system” to buy (they’re no longer called car seats or strollers) and whether or not a diaper genie is fantastic or disgusting are common topics. Hearing about all the foods on the don’t eat list is amazing – cold cuts, blue cheese and sushi are off limits. In my day (yes, I’m that old), you just couldn’t drink or smoke. We’ve also been talking about the importance of dental care during a pregnancy and I thought it would be worth sharing with everyone.
Many pregnant women think that they should avoid the dentist for nine months, but in fact, a Surgeon General’s 2000 report focused on the importance of dental health during pregnancy as a way to improve both maternal and infant health. All pregnant women should have a dental exam and maintain their regular cleaning schedule. Some women may even need to be seen more frequently for cleanings.
Let’s review some specifics for pregnant women:
• A mother’s oral health can impact her child because the oral biofilm can be transferred to her child. The recommendation is that during pregnancy, women incorporate xylitol into their daily routine to reduce the amount of bacteria in their mouths. (My next blog will be all about xylitol – stay tuned).
• Hormonal changes can cause swelling of the gums and lead to an increase in gingivitis or a localized swelling called pyogenic granulomas. Gingivitis is treated with cleanings and rinses at home. Pyogenic granulomas normally resolve after pregnancy.
• There is an association between maternal periodontal (gum) disease and preterm birth, another reason why regular cleanings are critical.
• Morning sickness can create excess acid and put mothers at higher risk for cavities or erosion of their teeth. Don’t brush immediately after vomiting, when enamel is at its softest. Instead, rinse with a water/baking soda mixture to neutralize acids and wait at least half hour to brush.
• Frequent meals lead to an increase in cavities. Combat the constant exposure to food with regular brushing and use a fluoride rinse daily to protect teeth.
• Try to keep your dental appointments short because you might be uncomfortable.
• Studies show that x-rays are safe at any point; however, I think routine films should be delayed until after pregnancy. If there is an emergency, be sure the x-ray apron has a thyroid collar and ask to have an apron underneath you as well as on top.
• Necessary treatment can be done at any point during pregnancy, the second trimester tending to be the most comfortable for the patient. Also, by then, all fetal organ
development has happened and the baby is just growing. Elective treatment should wait until after pregnancy.
• My suggestion is that if you are planning to get pregnant, include a dental exam as part of your preparation. That way, if there are any issues that need to addressed, they can be done prior to pregnancy.
• Many patients ask me about whitening their teeth but no studies have been done on bleaching teeth during pregnancy so I would recommend against it.
Congratulations if you are pregnant! Best of luck to those of you who are trying to get pregnant. It’s an exciting time when you’re starting or adding to your family. Don’t get overwhelmed with all the things you have to do – it all works out in the end. And certainly, don’t worry too much about the “travel system” you need to purchase – my assistants have informed me that most systems have iPod connections in them. Whatever happened to umbrella strollers and stuffed animals for entertainment?