Dental care during pregnancy

Article

26. 03. 2018

Do pregnant women suffer from tooth decay more? Is there any truth in the old saying “one tooth for every pregnancy”? And are drugs and injections to alleviate unbearable pain truly taboo?

Common myths and half-truths that circulate amongst pregnant women and subsequently also breastfeeding mothers are brought into focus by Dr. Zdeněk William Pelc of Canadian Medical Care in Prague 6.

When a woman is pregnant, her gums bleed.

Both fact and fiction.

Gums may bleed during pregnancy, but this is not necessarily the case. It all depends on how the woman took care of her teeth before she became pregnant. If certain problems with gums start to appear during pregnancy, it’s merely the case that the hormonal changes (in particular the so-called pregnancy hormone hGC, the level of which rises around the 10th to the 12th week of pregnancy) can potentially exacerbate an inflammation – but only an inflammation which was already there in the first place. Simply speaking: if you visit your dental hygienist regularly and have no inflammation in your mouth, no inflammation will occur during pregnancy. However, if you have even the slightest inflammation and bleeding gums before pregnancy, when you become pregnant this can trigger inflammation processes.

In the case of sickness during pregnancy it is always necessary to clean your teeth properly after vomiting.

Fiction.

As regards dental hygiene, absolutely the worst period is the first trimester – and this is because many pregnant women are unable to avoid nausea during pregnancy (feelings of sickness, urge to vomit) or unable to avoid vomiting several times a day. It’s important to be aware that it is not advisable to clean your teeth after every vomiting. When you vomit, the acidic contents of the stomach are discharged through your mouth, and so acid gets onto your teeth and immediately begins to corrode them. And if you start to clean your teeth, then you scrape the already softened enamel and damage it even more. How can you avoid this? It’s best to just rinse your mouth with water several times immediately after vomiting, and then clean your teeth at least ten to fifteen minutes afterwards, not immediately. By thorough rinsing you dilute the acid to a minimum and thanks to your saliva, within those ten to fifteen minutes the pH in your mouth returns to the standard level.

Tooth decay occurs more during pregnancy.

Fiction.

If you take good care of your teeth, tooth decay should not increase. It’s of fundamental importance for the pregnant woman to devote at least the same standard of care to her teeth as before pregnancy, ideally even more. For example, if the woman frequently vomits at the beginning of pregnancy, she is very tired and worn out and as a result doesn’t take particular care of her oral cavity, neglects her teeth and inter-dental brushing, so tooth decay may increase. The problem is therefore rather the behaviour of the woman and not the pregnancy itself. The standard in pregnancy is: clean your teeth morning and night, brush inter-dental spaces only once a day (night), use toothpaste or mouthwash with antibacterial components which act against inflammation. During pregnancy the woman should visit a dental hygienist twice to check her gums, remove tartar and for any applicable instructions in connection with dental care during this period.

One pregnancy = loss of one tooth?

Fiction.

This used to be said and the explanation was that because the pregnant woman’s body constantly had to supply the foetus with various minerals, the minerals and calcium were sucked out of her teeth, which suffered as a result. However, it’s been demonstrated that the female organism doesn’t suffer from a lack of calcium during pregnancy provided that the pregnant woman eats normally and has sufficient intake of nutrients, minerals and other important substances. If she doesn’t, then her bones rather than her teeth suffer from a lack of calcium and there is a threat of osteoporosis – but not to such an extent that she’ll require treatment in future. It’s a transitional problem and everything returns to normal after childbirth provided that she eats a balanced diet.

X-rays must not be performed during pregnancy.

Fact.

Pregnant women should not undergo an X-ray, and so in the case of pulling teeth the woman must avoid having an X-ray even though her tooth must be pulled out.

Pregnant women must not be given any painkilling drugs (anaesthetics).

Fiction.

In general it’s true that if a woman is pregnant no chemicals are recommended – and it’s therefore always necessary to consult a doctor with regard to any drugs. It applies that small tooth decay need not be treated urgently, but it’s naturally better for teeth to be in an absolutely healthy condition during pregnancy. It then depends what painkilling drugs are provided; some modern anaesthetics are not recommended during the first trimester, but can be used when the pregnancy is more advanced – obviously in the case of a necessary procedure, not every week. In connection with this it’s appropriate to know that if a tooth is treated without anaesthetic and teeth are drilled “live”, this is completely undesirable. When a tooth is painful during drilling, the woman is under such stress that her internal adrenalin is discharged from the exterior of her adrenal glands. During stress and fear, her blood vessels then contract due to the discharged adrenalin and the blood supply to the foetus is impaired. So from this perspective it’s far better to provide an anaesthetic.

We prepared the text in co-operation with our stomatolog Dr. Zdeněk William Pelc. He is a specialist in maintenance stomatology and children’s stomatology.

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