Everyone — and especially pregnant women — should visit the dentist. If you’re pregnant, you face a higher risk for gum disease, so make sure to visit your dentist for regular cleanings, exams and any other treatment needed.
Dental treatment can be done at any time during pregnancy. However, the best time to perform elective dental treatment during pregnancy is in the second trimester, weeks 14 through 20. Skimping on dental care could affect your pregnancy, as well as your dental health. Untreated gum disease may be linked to pre-term and low-weight birth.
When should you tell your dentist you are pregnant?
If there’s any possibility you’re pregnant, let your dental office know. If the pregnancy has been confirmed, tell them how far along you are when you make your appointment. It is also important to make your dentist aware if you’re taking any medications, or if you’ve received any special advice from your physician. If your pregnancy is high-risk or you have certain medical conditions, your dentist and your physician may recommend that some treatments be postponed.
Dental emergencies (e.g. uncontrolled pain or bleeding, oral/facial swelling and fractured teeth) will be addressed during any stage of pregnancy, but the safest time to receive scheduled dental treatment (cleaning, exams, etc.) is during the second trimester (13-27 weeks.)
Waiting until the second trimester reduces the risks of interfering in the development of your baby’s vital organs during the first trimester and enduring uncomfortable pressure on your abdomen while reclined, as well as any undue stress which may lead to premature birth during the third trimester (weeks 28 – birth).
Here are dentist’s recommendations to ensure treatment at the safest time for you and your baby:
First Trimester (Weeks 1 – 12)
Dentists do not recommend cleaning or periodontal treatment at this time, except in cases of a dental emergency, such as severe pain, bleeding oral/facial swelling or fractured teeth.
Second Trimester (Weeks 13 – 27)
This is the safest time for periodontal therapy (teeth cleaning) to reduce the amount of harmful bacteria in your body that may lead to gingivitis and other conditions. Emergency treatment and Urgent care (treatment to prevent dental emergencies) are also best performed in the second trimester.
Third Trimester (Weeks 28 – birth)
Dentists do not recommend cleaning or periodontal treatment at this time, however in some cases they may recommend periodontal therapy until week 32 of pregnancy. As throughout pregnancy, dental emergency treatment for conditions such as severe pain, bleeding oral/facial swelling or fractured teeth will be provided.
How will pregnancy affect your mouth?
Although many women make it through their entire pregnancy with no dental discomfort, pregnancy can make some conditions worse or even create new ones. Regular checkups and good dental health habits can help keep you and your baby healthy.
Your mouth can be affected by the hormonal changes you will experience during pregnancy. For example, some women develop a condition known as “pregnancy gingivitis,” an inflammation of the gums that can cause swelling and tenderness. Your gums also be more likely to bleed when you brush or floss. Left untreated, gingivitis can lead to more serious forms of gum disease. Your dentist may recommend more frequent cleanings to prevent this.
Increases risk of tooth decay
Pregnant women may be more prone to cavities for a number of reasons. If you’re eating more carbohydrates than usual, this can cause decay. Morning sickness can increase the amount of acid your mouth is exposed to, which can eat away at the enamel of your tooth.
Brushing twice a dayand flossing once can also fall by the wayside during pregnancy for many reasons, including morning sickness, a more sensitive gag reflex, tender gums and exhaustion. It’s especially important to keep up your routine, as poor dental hygiene during pregnancy been associated with premature delivery, fetal growth restriction, gestational diabetes and preeclampsia.
In some women, overgrowths of tissue called “pregnancy tumors” appear on the gums, most often during the second trimester. It is not cancer but rather just swelling that happens most often between teeth. They may be related to excess plaque. They bleed easily and have a red, raw-looking raspberry-like appearance. They usually disappear after your baby is born, but if you are concerned, talk to your dentist about removing them.
What about the medications?
Currently, there are conflicting studies about possible adverse effects on the developing baby from medications used during dental work. Lidocaine is the most commonly used drug for dental work. Lidocaine (Category B) does cross the placenta after administration.
Dental work often requires antibiotics to prevent or treat infections. Antibiotics such as penicillin, amoxicillin, and clindamycin, which are labeled category B for safety in pregnancy, maybe prescribed after your procedure.
Is it safe to get local anesthesia?
If you’re pregnant and need a filling, root canal or tooth pulled, one thing you don’t have to worry about is the safety of the numbing medications your dentist may use during the procedure. They are, in fact, safe for both you and your baby. They cause no difference in the rate of miscarriages, birth defects, prematurity or weight of the baby. It may be more uncomfortable to sit in a dental chair for these procedures as your pregnancy progresses, so schedule dental work in your second trimester, if possible. Cosmetic procedures, like whitening, should wait until after baby arrives. If you need an emergency procedure, work with your dentist on the best plan for the health of you and your baby.
Are dental x-rays safe?
Routine x-rays, typically taken during annual exams, can usually be postponed until after the birth. X-rays are necessary to perform many dental procedures, especially emergencies. According to the American College of Radiology, no single diagnostic x-ray has a radiation dose significant enough to cause adverse effects in a developing embryo or fetus. According to the ADA and ACOG, having dental X-rays during your pregnancy is considered safe with appropriate shielding.
Some women may elect to avoid dental work during the first trimester knowing this is the most vulnerable time of development. However, there is no evidence suggesting harm to the baby for those electing to visit the dentist during this time frame.
Also, if non-emergency dental work is needed during the third trimester, it is usually postponed until after the birth. This is to avoid the risk of premature labor and prolonged time lying on your back.
What damage can morning sickness do?
As many pregnant women know all too well, morning sickness can hit any time of the day. Vomit contains stomach acids that can eat away at your teeth, so waiting to brush after you’ve rinsed your mouth can help prevent those acids from doing damage. Instead of brushing, first swish and spit. You can use water or a diluted mouth rinse. Spit it out, and brush your teeth about 30 minutes later.
During a time when anything (and possibly everything) may make you gag, take it slow and figure out what works for you. Changing your flavor of toothpaste, using a brush with a smaller head, or brushing at different times of the day may help. If you need to swish and spit before coming back to brush your teeth, try that as well. The important thing is to keep up your routine, because you’re slightly greater risk for cavities during pregnancy.
How to Avoid Oral Health Problems During Pregnancy
- Fortunately, these oral health conditions can be prevented if you practice proper oral hygiene throughout your pregnancy. During pregnancy, women tend to snack more often yet leave their oral hygiene habits the same. Dentists best advice is to add an additional time to floss and brush daily to compensate for the additional snacking. Floss, then brush at least twice a day with a toothpaste containing fluoride. Flossing should be a part of your routine as often as you brush, otherwise you are only cleaning three of the five sides of the teeth in your mouth. Brushing will clean the tongue side, cheek side and the top of your teeth but only floss will adequately remove food particles and plaque along the front and back surfaces of your teeth. A Waterpik Water Flosser is also very helpful, but we do not recommend it as a complete substitute for flossing with string floss.
- Using a very soft toothbrush will help limit the loss of enamel. The GUM 516 Technique Sensitive Care Toothbrush (full or compact) and Oral-B Advantage Sensitive 40 Extra Soft Toothbrush are two good soft toothbrushes and both are available on Amazon.com.
- Any properly formulated fluoride toothpaste will make enamel more resistant to acids in your diet.
- Drinking water throughout the day is also a good way to lower the level of acid in your mouth as well as limiting your intake of acidic beverages, including carbonated beverages and acidic fruit juices, such as lemon juice and grapefruit juice. Cherries and oranges are also fairly high in acidity.
- Maintain a healthy diet as well. Please seek guidance from your medical doctor regarding this. Note, foods which offer plenty of calcium, vitamin B12 and C will keep your teeth and gums healthy and strong.
- Of course, don’t forget your routine dental cleaning while you are pregnant (during the suggested time below). A professional, thorough cleaning will control plaque and keep gingivitis at bay. Keeping plaque under control will also minimize gum irritation and decrease the chances of developing pregnancy tumors (granulomas).