Dental health for pregnant women

Dental health is always important but dental health for pregnant women is especially essential. Here’s a quick look at general dental health care for pregnant women and the most common questions babyworld members ask on the subject.

A bleeding pain!

As every pregnant woman will attest, you’ll be experiencing some pretty odd hormonal changes during pregnancy. Not all of these involve crying during mobile phone ads (as I did). The most common dental side effect during pregnancy is inflamed and/or bleeding gums, caused by those lovely hormone changes whizzing around your body.

These hormones cause the gums to soften in pregnant women. Soft, spongy gums are prone to infection and plaque (bacteria) will then cause them to bleed. It’s vital that your oral hygiene is excellent during pregnancy, so make sure you have regular check-ups with your dentist. Ask them to show you how to brush and floss effectively to eliminate the chances of
bleeding gums.

What will it cost me?

All pregnant women receive free treatment on the NHS, as long as they are registered as an NHS patient and have a current maternity exemption certificate. In fact, your dental health is so important to the rest of your, and your baby’s, health that free treatment carries on until a year after your baby’s birth. If you are currently registered with a private dentist, ask them about the charges for dental treatment and how often they recommend you visit them for a check-up.

Are treatments safe?

Dental treatment is safe during pregnancy, and routine check-ups and cleaning can be extremely beneficial. However, as with most other medical procedures, treatment is often best left until after the birth, if this is possible. The Department of Health has advised that pregnancy women do not have amalgam fillings replaced until after their baby is born. If you do need a filling done, your dentist will advise you on the safest options.

Dentists also generally prefer to avoid x-rays during pregnancy, although the apron you wear should protect you and the foetus from the radiation. If you are unfortunate enough to need a root canal while pregnant (what a downer!) you may have to have an x-ray. Again, your dentist should be able to advise you on the best way forward.

Old wives’ tales?

There’s a rumour that still goes round that pregnancy will damage your teeth. The Dental Health Organisation says there’s no truth in this whatsoever, and that women do not suffer calcium deficiency or tooth loss because of pregnancy! (So bang goes another excuse to have full-fat ice cream!)

Of course, a healthy, balanced diet is recommended and this alone will provide you with the calcium you need. Opt for milk, cheese and other dairy products, as well as green leafy vegetables and bony fish (such as sardines and tinned salmon), to bump up your calcium intake.

A spokesperson from the British Dental Health Organisation says …

‘The British Dental Health Foundation supports the view of the UK Department of Health that it is sensible to minimise health interventions during pregnancy. For this reason and because mercury can be passed through the placenta and breast milk, it is prudent to avoid placing or removing amalgam fillings during this period.

If a patient is not happy with the advice that they received from their dentist then they could ask the dentist for a written explanation or even seek a second opinion from a different dentist. Alternatively, they could contact the Dental Helpline telephone: 0845 063 1188 for free impartial dental advice.

Expert advice!

We searched our archives for the most common dental worries amongst pregnant women.

Wisdom teeth

Q ‘I have just been told by my dentist that I have two rotting wisdom teeth that need extracting and he is referring me to the hospital for this to be done. He says it is routine to have a local anaesthetic whilst pregnant and not harmful to the baby. Is this true? He offered me antibiotics if the teeth were painful but as they are not I declined them. I asked if I could take them safely if the teeth were to get painful and he also said yes. I’m 10 weeks and very anxious to do things right.’

A. ‘It is generally wise to avoid medication during pregnancy, and this is especially important during the time when the foetus is most likely to be affected by external influences (weeks 3-11). However, there is no evidence that local anaesthetics are harmful in the early stages of pregnancy. Large doses of local anaesthetics can have harmful effects later on in pregnancy, especially around the time of delivery. Procedures to remove wisdom teeth are often carried out under general anaesthetic, and I would advise that you discuss this issue with the oral surgeon to whom you have been referred, to make sure that the operation can be done under a local.’

‘General anaesthetics vary in their potential effects. The main risk associated with these agents is a possible increase in the risk of spontaneous miscarriage. There is no known association with congenital abnormalities. When a procedure requiring a general anaesthetic is necessary, the usual recommendation is to wait until you have passed 11-12 weeks. Should a general anaesthetic be necessary, arrangements can be made for you to see the anaesthetist prior to the operation taking place to discuss the procedure and any possible risks associated with it.’

Jo Lee, babyworld doctor

Feeling sick with toothpaste

Q. ‘I’m around ten weeks pregnant with my second child and, just as with the first, I’m having desperate trouble cleaning my teeth. It doesn’t matter what time of day I try, I always end up being very sick. I mentioned this to my dentist during my last pregnancy and he was unable to offer any help. I’ve tried different toothbrushes, different toothpastes, no toothpaste – but always with the same result. My gums were in a very bad way by the end of my first pregnancy and I would rather this didn’t happen again. Is there anything else I can do?’

A. ‘Poor you! This is a miserable situation to be in, and I’m afraid I don’t have any magical answers. However, I’ve been thinking around the reasons why cleaning your teeth may be so troublesome, and have a few suggestions to make. Forgive me if you’ve already tried these.

‘Is it the flavour or smell of the toothpaste that makes you sick? If so, have you tried using a children’s toothpaste – either a very bland baby one, or one of the fruit-flavoured variety? (My daughter is rather keen on a raspberry-pink ‘Barbie’ paste…) Or perhaps it is having something in your mouth that brings on the sickness? Perhaps using a toothbrush stimulates your ‘gag’ reflex and makes you heave. If so, maybe simply using a mouthwash would help. If the proprietary ones from chemists don’t appeal, perhaps you could use a simple solution of bicarbonate of soda in warm water. (Experiment to see what strength you can tolerate, and always spit it out afterwards.)

‘You may find it possible to clean your teeth using a cotton wool bud – or even just a dab of toothpaste on the tip of one finger. Even a quick clean of the front teeth would be better than nothing. Alternatively, what about chewing some sugar-free chewing gum? There are even some brands that claim to help clean your teeth. Not ideal in the long run, but perhaps a useful short-term solution. You may like to also think about which foods would be good to eat at the times when you cannot clean your teeth. Avoid sugary foods (such as biscuits) and acidic fruits (such as apples) last thing at night, and reach instead for a stick of celery or a carrot. Good teeth exercise, lots of fibre to clean between your teeth and around your gums – and guaranteed to get the saliva flowing. Finally, is there a dental hygienist attached to your dentist’s practice whose advice you can ask? I hope you find some answers soon and can enjoy the rest of your pregnancy.’

Hannah Hulme Hunter, babyworld midwife

Teeth extractions

Q. ‘Is it safe to have teeth removed during pregnancy? I’m 24 weeks and in a lot of pain with a sore tooth.’

A. ‘Please make an appointment to see your dentist in the near future so that your problem can be properly assessed. You may find that your tooth doesn’t need to be removed and can be left well alone to fight another day. If your perception of the condition should prove to be correct, then it should be quite safe to undergo tooth extraction during pregnancy. Simply ensure that your dentist is fully aware of your circumstances, of any medication you may be taking and of any allergies that you suffer from.’

Bleeding gums

Q. ‘I am 10 weeks pregnant and have bleeding gums. Could you recommend a mouthwash which is safe to use? I have been recommended to use Corsodyl. Is this OK?’

A. ‘Yes, Corsodyl, which is a chlorhexidine-containing mouthwash, is fine to use in  pregnancy and, as it has mild antiseptic properties, should prevent any gum disease.’

Jeni Worden, babyworld doctor

Are mercury fillings safe?

Q. ‘When I was 12 weeks pregnant I visited my dentist, who said I needed three fillings, which he subsequently did the following week. Should I have had treatment whilst being pregnant? Also, because the fillings I had were white, I was charged for these. Was this correct?’

A. ‘I am not an expert on dental matters, but I can tell you that it is considered safe to have fillings in pregnancy.

‘The NHS pays 20% of the cost of dental treatment for those who are on a dentist’s NHS list. In pregnancy, and for the year after delivery, dental care is free. However, any treatment that is considered to be cosmetic will be charged for. Some white fillings will fall into this category, as the NHS would consider amalgam fillings to be the appropriate treatment.

‘There has been a lot of debate about possible risks associated with the use of amalgam fillings. Current opinion is that hypersensitivity to amalgam and toxicity from amalgam are rare. While there is no evidence that having amalgam fillings placed or removed during pregnancy is harmful, we may not yet have sufficient data to be certain that there is no risk. It is probably sensible, therefore, to choose an alternative filling when fillings are required in pregnancy (as you did).’

Dr Jo Lee, babyworld doctor

X-rays

Q. ‘I’m 4 weeks pregnant. At my dental appointment, my dentist gave me an X-ray. I’m very concerned because I’ve now read that it is very dangerous to have X-rays during pregnancy. My dentist was aware that I was pregnant and double draped me with lead aprons and only took one X-ray. What are the chances that this harmed my baby?’

A. ‘The first thing to say is that dental X-rays are directed far away from your uterus. Secondly, the lead apron shields your uterus and your baby effectively from any radiation. Determining the safety of other types of X-rays during pregnancy is more complicated, but it is clear that diagnostic X-rays rarely pose a threat to the embryo or foetus. Problems are only likely to occur at very high doses, and if the X-rays are actually directed at the abdominal area.

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