Teeth and pregnancy: a delicate balance not to be underestimated
We have often said it and heard it: mouth during pregnancy must never be neglected.
The periodontal disease has long been called into question as a risk factor for premature birth, miscarriage, low weight of the baby or intrauterine growth restriction.
All the above can occur due to bacteria causing periodontitis. These bacteria produce a variety of chemical inflammatory mediators which negatively influence the normal course of the pregnancy.
We should also consider that often during pregnancy, besides nausea and morning vomiting, it is common to take altered eating habits and possible gaatroesophageal reflux. All these factors increase the risks of demineralization and erosion of dental elements and therefore the outbreak of caries and inflammatory complications.
These conditions find fertile ground in a pregnant woman because of hormonal, vascular and immunological alterations and a salivation with reduced detergent action. It is therefore normal that the gum tissues have an emphasized inflammatory response to microbes.
Pay attention to hygiene and health condition of teeth and gums!
Teeth and pregnancy: what we recommend in addition to daily home hygiene
- First of all remember to inform your dental hygienist that you are expecting a baby. You will avoid X-rays that are not strictly necessary and only take the necessary ones with the leaded protections.
- If you have a healthy mouth, a professional hygiene session every quarter will be enough to keep the health condition of teeth and gums under control and to feel safe.
For the daily hygiene keep in mind to avoid products containing alcohol, cetylpyridinium chloride and chlorhexidine. You can only use them if prescribed by your doctor.
- Because of typical hormonal changes during pregnancy and even if your daily dental hygiene is scrupulous, you could develop a pregnancy gingivitis. This means an inflammation with reversible bleeding thanks to an accurate home and professional hygiene.
You will notice a close link with hormonal cycles.
The risk of gingivitis increases at the beginning of the pregnancy and is constant between months 4th and 8th with a noticeable reduction in month 9, when there will be a drastic reduction of hormone secretion.
>>In this case we recommend to: keep an accurate oral hygiene and, if you cannot brush your teeth, at least rinse them with water.
Case by case:
- Se presenti problemi parodontali (o se insorgono in questo periodo) con tasche gengivali infette o perdita ossea devi prestare più attenzione all’igiene, monitorando sempre lo stato infiammatorio. In questo caso ti consigliamo di effettuare una 1° seduta di igiene dentale non appena è confermata la gravidanza e una 2° igiene il mese successivo. In questo modo avrai un’idea precisa dell’evolversi della situazione. Se non si evidenziano alterazioni, ti sarà sufficiente proseguire con 1 seduta di igiene e un controllo in studio ogni 2 mesi. Nei casi problematici meglio se programmai 1 seduta al mese.
>>Ti consigliamo anche di effettuare un risciacquo con collutorio alla clorexidina 0,1% una volta al giorno dopo aver lavato i denti.
- If you present periodontal problems (or if they arise now) with infected periodontal pockets or bone loss, you should be more accurate with your hygiene and always monitor the inflammatory state. In this case we suggest you have the 1st dental hygiene session as soon as pregnancy is confirmed and a 2nd hygiene session the following month. In this way you will have a precise idea of how the situation is evolving. If there are no alterations, it will be enough to have 1 hygiene session and a check up every 2 months. In problematic cases, it is better to plan one session per month.
>> We also advise you to rinse with a 0,1% chlorhexidine mouthwash once a day after brushing your teeth.
- If you have a high propensity to develop caries (carioreceptivity), it would be good to undergo a hygiene session every 3 months, along with a salivary test which monitors the saliva acidity level and composition. Remineralizing fuoride varnishes or compresses are also very useful to protect teeth.
>> Also in this case our advice is to rinse with a 0,05% chlorhexidine mouthwash added with 0,05% fluoride once a day after brushing your teeth.
- In these months you could notice the so-called epulis gravidarum (in 9% of the cases). This is a benign granuloma similar to a small bubble which grows at dental papilla level. It can be painful and bleed. In most inflamed cases, it can be removed with surgery under local anesthesia to be done preferably in the 2nd quarter. You should consider that the lesion usually regresses by itself.
Teeth and pregnancy: some food tips for safe teeth
- Pay attention to nutrition and choose non-cariogenic foods – which do not increase the mouth acidity level – with few complex sugars, without preservatives, rich in vitamins and mineral salts. Prefer fresh foods such as well washed fruits and vegetables and drink a lot of water to keep your mouth hydrated.
- Also keep in mind to eat foods containing fluoride, such as spinach, fish, carrots, potatoes, green beans and asparagus, as they will help in the process of tooth formation in the fetus (between weeks 4 and 5) and in the enamel mineralization process (between weeks 9 and 12).
- in case of vomiting episodes, rinse your mouth right away with water and ½ a spoon of sodium bicarbonate and wait for half an hour to brush your teeth with a soft toothbrush and an anti-inflammatory toothpaste.
- in case of frequent snacks, if you are not able to brush your teeth, rinse your mouth with water.
Teeth and pregnancy: if treatment is needed
Pregnancy should not become a reason to avoid or postpone your routine cares, but not even the treatment of severe affections which could degenerate if neglected.
In case of need, however, some medications usually used for orthodontic procedures and oral diseases such as antibiotics, anti-inflammatories and oral antiseptics are safe for both the mom’s and the baby’s health.
For some therapies, however, it is good practise that the orthodontist directly speaks with the gynecologist to ensure the absence of side effects related to the use of specific drugs.
If therapies are necessary and cannot be postponed to after giving birth, the best time to proceed is at the beginning of the 2nd quarter (between weeks 14 and 20). In this moment, indeed, the risk for the unborn is very low, the organ formation is complete and you usually find yourself in the best physical condition.
If you are undergoing an orthodontic treatment
It is not necessary to suspend it. It is important to inform your orthodontist of your new condition. You will plan together more frequent check ups and will be more accurate in your oral hygiene because the presence of the appliance could facilitate the formation of plaque and tartar.
If you are planning to start a treatment, we advise you to postpone it to after giving birth.
Breastfeeding is also a time when you should not ignore your smile. You can proceed with the same routine adopted during pregnancy and plan a professional hygiene session every 3 months.
Teeth and e pregnancy: which toothpastes to use and avoid?
Remember not to use whitening toothpastes nor those with microgranules. Prefer those containing aloe, marigold, zinc and saline ones.
Choose a toothbrush with a small head to avoid the feeling of nausea and, in case of poor salivation, chew xylitol gums.