When advising our patients about prenatal care, health professionals often recommend action such as taking folic acid supplements and seeing their obstetrician for regular checkups. However, an expectant mother’s overall health can also be affected by pregnancy. It’s critical; therefore, that health care providers similarly educate expecting patients on the importance of maintaining good oral hygiene habits to protect both mother and baby alike.
Pregnancy and Periodontal Disease
Hormonal changes during pregnancy can increase the mother’s risk of periodontal disease. These changes also can exacerbate existing periodontal disease.
But what is periodontal disease, and why does it matter during pregnancy? Periodontal disease, or periodontitis, is an inflammation of the gums. Symptoms can range from mild inflammation and slight pain while brushing or flossing to a full-blown health crisis that can cause serious damage to the soft tissues of the mouth. Most dangerously, moderate to advanced periodontitis can allow bacteria, viruses and other toxins to enter the bloodstream, causing permanent organ damage and even death in advanced cases.
If left untreated, periodontitis can cause the inflammation of the tissues that surround your teeth. This includes the outer layer of the roots of the teeth and the alveolar bone where the teeth are attached to the socket. Periodontitis can cause tooth loss as the bone erodes from the bacteria built up around it, which is definitely something an expectant mother wants to worry about on top of the stress of pregnancy.
Additionally, a recent abstract by the National Institutes for Health indicates that in addition to endangering the mother’s health, periodontitis can lead to adverse outcomes during pregnancy. Not to strike total fear into the hearts of preggos everywhere, but there is a direct correlation between periodontitis and premature birth, preeclampsia and low birth weight. Oral bacteria and other pathogens can easily travel through the bloodstream to the placenta and, thus, onto your baby.
Dental Work During Pregnancy
If seeing a dentist regularly is critical to having a healthy pregnancy, health professionals much be able to also explain which procedures are safe to have and which are not. Health professionals should also educate themselves about the best time during a patients’s pregnancy to visit the dentist and have work done.
Ideally, the patient has dental cleanings regularly. But if they haven’t kept up with regular dental checkups, advise patients to start as soon as possible after discovering that they are expecting. It’s also always a good idea to advise patients, pregnant or no, to brush and floss regularly. If a patient experiences bleeding around the gums when they floss, urge them get in touch with their dentist and schedule an appointment immediately in order to avoid adverse outcomes.
While regular dental screenings and cleanings are important,advise patients it’s best to delay any elective dental procedures, such as teeth whitening, until after the birth of their baby. Reassure patients with self-esteem issues that cosmetic procedures will be as effective if completed post-pregnancy as they would during, and that they may also experience less pain by putting the procedures off, as teeth can be especially sensitive during pregnancy.
When it comes to X-rays, they are helpful for diagnostic woes, and the small amount of radiation used during dental X-rays has not been shown to cause any harm to the fetus Advise patients that should they need an emergency dental procedure done, and it requires an X-ray, there’s no need to worry. If X-rays are not absolutely necessary as recommended by their dentist, though, no one will fault them for putting off X-rays until after your baby is born.
Best Time to Have Dental Work Done During Pregnancy
When is the best time to advise patients to have dental work done during their pregnancy? The second trimester is often ideal. Patients generally will be over the worst of the morning sickness that plagued them during the first trimester. Likewise, patients in the second trimester won’t be totally uncomfortable like many are during their third trimester. Plus there won’t be as much pressure placed on the patient’s superior vena cava, an important blood vessel that carries essential nutrients to the developing baby. Indeed, pregnant patients are often advised by their obstetrician to avoid lying on their back at that point in pregnancy.
Procedures such as having cavities filled are safe during pregnancy — just remind patients to inform their dentist that they are expecting, especially if they haven’t yet begun to show. The amount of anesthesia used should be minimal, but there is no indication that mild anesthesia will harm the unborn baby — except for lidocaine, which is a common topical dental anesthetic. Lidocaine has been shown to cross the placental barrier and should be avoided.
Antibiotics labeled as Class B, such as penicillin and amoxicillin are safe to use during pregnancy, and they should be used if any evidence of periodontitis is suspected.
Dental Dos and Don’ts for Pregnant Women
In order to deliver the highest level of prenatal care, healthcare providers may choose to advise patients of some additional dos and don’ts to keep in mind while they are expecting.
Advise patients of the following:
- Do brush and floss regularly
- Do continue to see your dentist for regular checkups, especially since periodontal disease can be exacerbated by hormonal changes during pregnancy.
- Do let your dentist know you are pregnant, and do bring a pillow for additional comfort and support during your dental visit. Suggest bringing along headphones and soothing music to help alleviate anxiety over their dental procedure.
Likewise, advise patients:
- Don’t neglect your dental hygiene while you are expecting.
- Don’t undergo unnecessary dental cosmetic procedures — stick solely to necessary care recommended by your dentist.
- Don’t use over-the-the counter dental pain relievers which often contain lidocaine.
- Don’t put off seeing your dentist, especially if you notice any unusual pain or bleeding in your gums.
With a little bit of planning and the right amount of dental care, your patients will be well on your way to ensuring a safe, happy and healthy pregnancy. And as a healthcare provider, that is the ultimate goal for expectant patients.
