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Oral Hygiene For Pregnant Women

Dear Dr D,
I am 8 weeks pregnant and I have a dental cleaning and checkup that was scheduled in advance as part of my regular recall schedule of 6 months. I will be 13 weeks at that time. Should I cancel that checkup and push it off until after the baby is born? Is it dangerous to see a dentist during pregnancy?

- Michal W.

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Dear Michal,

Pregnancy is a very special time. You'll want to think about taking good care of yourself and getting your baby's life off to a healthy start. Your oral health is an important part of your overall health. Not only does it help to prevent oral problems during pregnancy, it also affects the health of your unborn child. Preventive dental cleanings and exams during pregnancy are not only safe, but are recommended. Preventive dental work is essential to avoid oral infections such as gum disease, which has been linked to preterm birth.

You have so much to think about during pregnancy, but don't overlook your oral health, which can be adversely affected by the hormonal changes you will experience during this time. During pregnancy, your body's hormone levels rise considerably. Gingivitis, especially common during the second to eighth months of pregnancy, may cause red, puffy or tender gums that tend to bleed when you brush. This sensitivity is an exaggerated response to plaque and is caused by an increased level of progesterone in your system. Left untreated, gingivitis can begin to form puss, produce foul odors and eventually affect the supporting tissues that hold your teeth in place. There are times that I may even recommend more frequent cleanings during the second trimester to prevent uncomfortable gingivitis during ones pregnancy.

Recently a young expecting mother presented with fear in her eyes as she had noticed some "large, raw lumps" along the gum line and between her teeth. What she presented with were, commonly known as, "pregnancy tumors". Occasionally these overgrowths of gum tissue appear on the gums during the second trimester. These localized swellings are usually found between the teeth and are believed to be related to excess plaque. They bleed easily and are characterized by a red, raw-looking mulberry-like surface. Although these growths are called "pregnancy tumors," they are not cancerous. They usually go away on their own after pregnancy, but they can be removed under a local anesthetic and the use of a diode laser, if indicated.

There is an old wives tale that one loses a tooth for every pregnancy. Although there is no direct link between pregnancy and tooth loss, your diet plays a large role in cavity development during pregnancy. During pregnancy, many women have the desire to eat between meals. While this is a normal urge, frequent snacking on carbohydrate-containing foods can be an invitation to tooth decay that is caused by plaque, a sticky film of bacteria that forms constantly on teeth. The bacteria convert sugar and starch that remain in the mouth after eating to an acid that attacks tooth enamel. The longer the sugars remain in your mouth, the longer the acid producing bacteria attack. After repeated attacks, tooth decay can result.

Your diet not only plays a role in your own oral health during pregnancy but eating a balanced diet is necessary to provide the correct amounts of nutrients to nourish your child as well. What you eat during the nine months of pregnancy affects the development of your unborn child, including the development of its teeth. Your baby's teeth begin to develop between the third and sixth month of pregnancy, so it is important that you receive sufficient amounts of nutrients, especially calcium, protein, phosphorous, and vitamins A, C, and D.

On that note, it is also a myth that calcium is lost from the mother's teeth during pregnancy. The calcium your baby needs is provided by your diet, not by your teeth. If dietary calcium is inadequate, however, your body will provide this mineral from stores in your bones. An adequate intake of dairy products, the primary source of calcium, or the supplements your obstetrician may prescribe will help ensure that you get all the calcium you need during your pregnancy.

Dental work such as cavity fillings and crowns should be treated to reduce the chance of infection. If dental work is done during pregnancy, the second trimester is ideal. Once you reach the third trimester, it may be very difficult to lie on your back for an extended period of time. The safest course of action is to postpone all unnecessary dental work until after the birth. However, sometimes emergency dental work such as fillings, a root canal or tooth extraction is necessary.

In regards to elective treatments, such as teeth whitening and other cosmetic procedures, those should be postponed until after the birth. Routine x-rays, usually taken during annual exams, can usually be postponed until after the birth. X-rays are necessary to perform many dental procedures, especially emergencies. According to the American College of Radiology, no single diagnostic x-ray has a radiation dose significant enough to cause adverse effects in a developing embryo or fetus.

So in conclusion, No, you should not cancel your upcoming dental appointment. Be sure to take good care of your teeth with proper brushing and flossing and much luck and happiness!

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