Oral Health During Pregnancy

Safe Oral Treatments During Pregnancy

Oral health care, including having dental radiographs taken and being given local anesthesia, is safe at any point during pregnancy. Further, the American Dental Association and the American Congress (formerly “College”) of Obstetricians and Gynecologists agree that emergency treatments, such as extractions, root canals or restorations can be safely performed during pregnancy and that delaying treatment may result in more complex problems.

Pregnant woman sitting in the dentist chair for examination

Common Oral Health Conditions During Pregnancy

During pregnancy, several oral health conditions are more common:

  • Gingivitis may result from hormonal changes that exaggerate the response to bacteria in the gum tissue.
  • Dental caries may occur due to changes in diet such as increased snacking due to cravings, increased acidity in the mouth due to vomiting, dry mouth or poor oral hygiene stemming from nausea and vomiting.
  • Pyogenic granuloma (aka. Granuloma gravidarum) is a round growth, usually connected to the gingivae by a thin cord of tissue, that may develop due to hormonal changes.
  • Erosion stemming from vomiting as a result of morning sickness may be detected.Patients should be encouraged to avoid toothbrushing immediately after vomiting, which exposes the teeth to stomach acids. Instead, they should opt for rinsing with a diluted solution of 1 cup water and 1 teaspoon of baking soda to neutralize the acid.

Due to the increased risk of gingivitis and caries, the importance of good daily oral hygiene should be emphasized to pregnant patients. Brushing twice a day with a soft-bristled brush for two minutes, using a fluoride-containing toothpaste, and cleaning between the teeth once a day should be encouraged. If it is determined that a topical fluoride treatment is needed to minimize the effects of erosion, fluoride varnish may be preferred over gel treatments due to nausea.

Pregnant woman holding a toothbrush with toothpaste on it

Periodontitis and Adverse Pregnancy Outcomes

Much has been written in recent years about the relationship between maternal periodontitis and pregnancy outcomes.  While findings of individual studies have been mixed, an overview of 23 systematic reviews conducted through 2016 concluded that associations exist between periodontitis and pre-term birth, low birthweight babies, low birthweight babies born prematurely and the development of pre-eclampsia.

More research is needed to determine the relationship between periodontitis and pregnancy outcomes, however, should periodontitis develop during pregnancy, scaling and root planing is recognized as safe to perform.

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