Dentistry for the Pregnant Patient
During pregnancy, women are particularly attuned to health matters, and dental considerations included. Fortunately, relatively few dental procedures need to be handled differently during pregnancy.
When pregnant, it’s especially important to have a dental checkup, dental cleaning, and any necessary treatment because pregnant women are particularly susceptible to gingivitis (inflammation of the gums). Therefore, pregnancy is a time to pay greater attention to dental care, not less.
“Gain a child, lose a tooth”
This ominous adage, usually seen as an old wives’ tale, contains a grain of truth, but is nonetheless not a cause for great concern. While pregnancy-induced hormonal changes can lead to an occasional increase in dental problems such as gingivitis or tooth decay, these are things that can be managed with good dental care.
A related concern is that unchecked gum disease can lead to premature birth. Of course, unchecked gum disease should always be a concern, but pregnant women need to therefore give treatment of periodontitis especially high priority.
Medications, anesthesia, X-rays
Dentistry is a practice characterized by frequent use of medications and chemicals. Knowing what medications are safe for pregnant women and what are not leads to a general recommendation to avoid procedures using chemicals and medications with unknown effects on a developing fetus.
Local anesthesia during pregnancy is considered innocuous, since no real evidence of harmful effects to the fetus exists. However, this is not a widely studied area, so dentists will generally take a conservative approach and schedule work involving local anesthetics to happen either outside the pregnancy or in the latter phases of the pregnancy.
A dentist may put off taking x-rays until after a baby is born. If x-rays are unavoidable, the dentist can ensure x-rays consider your baby’s safety.
During pregnancy, increase calcium intake. Calcium protects bone mass and assists in the nutritional needs of developing babies. Dietary calcium can be found in milk, cheese, unsweetened yoghurt, and calcium-fortified soymilk. Also, increase Vitamin D intake, as it helps the body incorporate calcium. Sources for Vitamin D include cheese, fortified margarine, fatty fish (salmon, sardines), and eggs.
Food cravings are sometimes a trait of pregnancy. Cravings for sugary snacks should be managed by snacking on low-sugar foods instead, frequent rinsing and brushing, and choosing healthier options, such as fresh fruits.
Scheduling dental work
Much of managing dental work during pregnancy is a matter of scheduling and timing. Communication and coordination with your dentist are very effective ways to navigate dentistry both before and while pregnant.
If a pregnancy is being planned, it is a relatively simple matter to complete complicated dental work before becoming pregnant. Doing so removes any potential for complications. However, such planning is not always possible; in those cases, choosing when to deal with dental issues is a matter of timing work to coordinate best with pregnancy.
The first semester is the time to let your dentist know you are pregnant if you have not already. As this is the time of the most sensitive fetal development, the first trimester is best avoided for dental work involving medications and chemicals.
Morning sickness is also most prevalent in the first trimester, so pregnant women experiencing vomiting or reflux need to take care that the acid in vomit or gastric reflux does not harm the teeth. Avoid brushing immediately after regurgitation (while the enamel has been softened by acidity) but rinse immediately to remove the acid. Brushing with a smaller brush and in slower, smaller motions might also reduce gagging impulses.
The second trimester is a good time to handle dental work that has been deferred from the first trimester.
The second trimester is also the time when pregnancy-induced gingivitis is most like to appear. Another effect of pregnancy on the gums can be “pregnancy epulis” or “pyogenic granuloma,” a localized enlargement of the gums composed of a cluster of blood vessels. Pregnancy epulis requires care not to irritate the swelling when brushing, and usually disappears after pregnancy.
Switching to a softer toothbrush and regular brushing at least twice a day will help with the gum problems of pregnancy.
Congratulations! You’re almost there! The usual considerations apply for dental care, but now you might also need to limit your time in the dentist’s chair simply as a matter of comfort: a long dental appointment might be better broken into two or more short ones.
Now is the time to follow up with your dentist to ensure that all dental issues (such as gingivitis or swollen gums) are resolved and that deferred dental work is completed.
Handling dental work during pregnancy requires some modification of procedures and adjustments of schedule. With a little planning, these can be easily managed, and the dental complications caused by pregnancy are temporary. Enjoy your pregnancy!