It is certainly safe – indeed important – to see your dentist during pregnancy. However, if you’re intending to conceive it’s best to have your dental health assessed in advance. This will enable your dentist to attend to any infected teeth or elective procedures (such as crowns) or cosmetic work (such as tooth whitening) before you become pregnant.
During pregnancy, it’s important to maintain good oral hygiene and attend your regular six-monthly check-up-and-cleans.
A number of changes can occur in the mouth during pregnancy. To safeguard the health of your unborn baby, it’s important to have these oral changes assessed (and treated if necessary) and any risk of infection eliminated.
Oral changes during pregnancy
The three most common oral changes experienced by pregnant women are gum disease, pregnancy epulus and erosion of tooth enamel.
Fluctuations of hormones during pregnancy make the gums more reactive to bacteria present in the mouth, causing them to become red and inflamed and to bleed more easily. The toxic effects of bacteria can be transported via the blood stream and in severe cases can cause rupture of the placenta. Other gum disease responses by the body’s immune system can also cause pre-term or low-birth-weight babies. It is therefore important to ensure that plaque and calculus are removed from the teeth with good oral hygiene at home and also regular professional cleaning.
Occasionally women might develop a red, localised swelling on the gum during pregnancy; this is called a pregnancy epulus. Although this benign swelling will usually go away after pregnancy, it should be assessed by your dentist and in some cases may need to be removed.
Erosion of tooth enamel
Morning sickness causes stomach acid to enter the mouth and this can lead to erosion or thinning of tooth enamel. To avoid such an outcome, always rinse with tap water or a teaspoon of bicarbonate of soda in a glass of water to neutralise the pH of the saliva after vomiting. As well, you can help recover minerals lost from the tooth surfaces by smearing toothpaste or tooth mousse over your teeth with your finger after rinsing.
What are other dental considerations during pregnancy?
Dental X-rays do not adversely affect a developing embryo or foetus. However, while most dentists will take the precaution of minimising X-rays for pregnant patients, they may still use a digital form to help detect and manage significant dental disease, infections and trauma.
Digital dental X-rays emit radiation equivalent to a short one to two hour aeroplane flight and, relative to manual X-rays, reduce exposure to radiation by 80 to 90%. At Smile Solutions, we also routinely use a lead apron with a thyroid collar to reduce exposure even further.
In Australia all medications are classified by the Therapeutic Goods Administration (TGA) according to their safety for use during pregnancy. If you’re experiencing oral pain or significant oral infection during pregnancy, your dentist might recommend certain over-the-counter medications such as paracetamol or prescribe medication such as an antibiotic. Your dentist will not recommend or prescribe any medications unless the TGA guidelines state that they are safe to use in pregnancy.
Local anaesthetic used in dental procedures is safe for pregnant patients as long as it is below the maximum dosage. The dentist will ‘aspirate’ the anaesthetic to reduce the amount that goes into your bloodstream.
Timing of dental treatment
Dental treatment of an urgent nature can be performed at any time during pregnancy, but the best time to have this treatment is towards the start of the second trimester.
Professional cleaning can be performed at any time during pregnancy and should be conducted regularly to maintain the health of the gums and prevent pregnancy gingivitis.
As already mentioned, dental treatment of an elective nature or any cosmetic procedure should be conducted before pregnancy if possible – or delayed until afterwards.