KOCHI: Pregnancy and oral health are very closely connected; pregnancy alters oral health and an altered oral health can affect pregnancy.
Almost 70 per cent of women have nausea or vomiting during the first trimester of their pregnancy, which can cause erosion of enamel. This is due to the regurgitation of gastric acids into the mouth. A sodium bicarbonate rinse can help reduce these effects.
However, one shouldn’t brush teeth immediately after nausea. It can further cause demineralisation of teeth. Regular use of fluoridated toothpaste or topical fluoride application is also recommended in such situations.
Pregnant women suffering from morning sickness often are advised to snack or consume multiple meals a day, which again poses a challenge to prevent dental decay. Proper oral hygiene measures such as brushing twice a day and rinsing the oral cavity after every meal would reduce the risk of dental decay.
A small population of pregnant women also complain of dryness of mouth, for which increasing water consumption and chewing of sugarless gum is recommended.
Signs of gum diseases (redness, bleeding, swelling, tenderness) become evident from the second trimester and generally peak around the eighth month of pregnancy.
This is mainly due to hormonal changes. Occasionally, some pregnant women will develop a localised swelling on the gum, known as pregnancy granuloma. They are harmless red swellings on the gum that often bleed easily. They generally become smaller or disappear after childbirth. Removal of the gum growth would be necessary only in certain situations.
Adequate oral hygiene measures which include home care as well as dentist-recommended cleaning during the second trimester can reduce the effects of gum.
Pregnancy periodontitis, when gum disease progresses into destructive inflammation, affects 30 per cent of women during pregnancy. There has been a proven link between periodontitis and adverse pregnancy outcomes such as pre-eclampsia, premature birth and low birth weight.
Oral health is a part of general health, and it is of even greater importance during this period because it concerns both the mother and the baby. Neglecting oral and dental health during pregnancy not only causes problems such as tooth decay and tooth loss but may also lead to problems such as premature birth, low birth weight in infants and pre-eclampsia.
Dental treatments during pregnancy are safe. The best time for treatment is between the 14th and 20th weeks. Treatment options may include diagnostic X-rays, dental prophylaxis, periodontal treatment, and restorations with the administration of local anaesthetics containing epinephrine.
Dental restorations during pregnancy are mostly safe. Antibiotics and analgesics for treating infection and controlling pain may be administered. Acute conditions, such as pain and swelling, should be treated as soon as possible.
A delay in necessary treatment could pose significant risk to the pregnant woman and foetus. The consequences outweigh the possible risks presented by most of the medications required for the treatment.
Due to patient positioning, comfort is a consideration for treatment during the third trimester. In these cases, elective treatment sometimes is best deferred until after delivery.
Also, mother’s oral health will significantly and positively affect the infant’s oral health and will reduce the infant’s risk of developing early childhood caries.
Keep in mind
Treat gum diseases: If there’s any sign of gum disease, it can be treated safely during the second trimester
Prevention: Practicing oral hygiene measures by brushing with fluoridated toothpaste twice a day and routine dental checkups for early management of dental decay are essential
Diet: Cut down on sugar and have fresh fruits and vegetables
X-rays: Inform your dentist if you are pregnant. Dental X-ray radiation is minimal and does not pose greater risks, but repeated exposure is not recommended. Ensure the use of thyroid collars and lead aprons, if it’s mandatory
Painkillers and antibiotics: It is generally safe to use common painkillers such as paracetamol. But consult a gynaecologist
Mind and body
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The writer is an associate consultant (pediatric and preventive dentistry) at Apollo Adlux Hospital, Angamaly, Ernakulam