MOUTH MATTERS
There are excellent reasons you need to brush up on your dental hygiene when pregnant.
Your levels of the hormones oestrogen and progesterone skyrocket when you’re pregnant, and this storm of hormones leads to many physical changes in your body, which include the oral cavity. So, visiting your dentist should be on your to-do list.
Your saliva changes in pregnancy, which makes you more likely to get cavities. “The main salivary changes in pregnancy involve its flow (there’s more of it), composition, and pH and hormone levels,” explains Dr Eshaam Abdurahman from Paarl in the Western Cape. Progesterone decreases the pH of saliva, and the increased acidity speeds up the dissolving of the (already compromised) tooth. Other changes alter the natural defence mechanisms of the teeth and create conditions that allow bacteria to flourish.
Plaque control is crucial in pregnancy. Plaque formation can lead to periodontal disease, and research shows a link between this and preterm low birth weight. Research published by the Journal of Periodontology suggests that visiting an oral hygienist or dentist cuts the risks of preterm or low-weight birth by a third. It showed severe gum infections cause an increase in the production of chemicals that induce labour. Consider switching to an electric toothbrush, as they remove more plaque.
MORE MOUTH CHANGES TO WATCH FOR
Morning sickness leading to vomiting in your first trimester, and heartburn in your third trimester, could harm your teeth. “The gastric acids in the vomit or reflux can erode the enamel on the inner surface of the teeth, most commonly the front teeth,” Dr Abdurahman says.
“If you are vomiting frequently, rinse your mouth thoroughly afterwards with a solution that contains sodium bicarbonate. This neutralises the acids, and it prevents the damage.”
If you find you are gagging when brushing, use a smaller toothbrush for the back of your teeth. Pregnancy gingivitis, or inflammation of the gums, is common. It can make your gums appear redder or swollen, and they may bleed a little when brushing. “Because of the increased blood flow to your gums, they have a tendency to be more irritable,” Dr Abdurahman says. Prevent or treat it by sticking to good oral hygiene. You know the drill: brush twice a day, floss once a day, and don’t skip seeing your oral hygienist for a good cleanse. “Pregnancy tumours” can form on your gums. They usually appear as little lumps near the upper gum line that bleed and crust over and can be quite uncomfortable.
“They are caused by plaque, gum irritation and because of the increased vessel growth that happens during pregnancy,” Dr Abdurahman says. “They will regress after the birth.” Your teeth may get loose. Tooth mobility may increase during late pregnancy because of changes to the fleshy tissue between the tooth and tooth socket that holds the tooth in place.
WHEN TO GO FOR WHAT FOR THE FIRST TRIMESTER
Dr Abdurahman recommends that you check in with your dentist so they can assess the state of your teeth but doesn’t recommend any procedures be done during this time. “Some of the anaesthetic agents and painkillers used in dentistry have not been proven to be safe in pregnancy, and the substances could affect the foetus during this crucial stage of development,” he says. You should also avoid radiographs (X-rays), unless they are needed to assess infection or damage, he says. “Depending on the amount of radiation and the stage of pregnancy, damage to the foetal cells may result in miscarriages or birth defects, and while dental radiation exposure of the foetus is negligible, it should be avoided,” he says.
FOR THE SECOND AND THIRD TRIMESTER
Lying on your back for a long period during this phase of your pregnancy is not recommended, and a stint in the dentist’s chair is no exception. Ensure you lie on your left side and elevate the head of the chair to avoid compression of the major blood vessels.
“Scaling, polishing and curettage may be performed in these trimesters if they are necessary. The control of oral disease is important,” Dr Abdurahman says, but again routine radiographs should be avoided. If you do need an X-ray, your dentist will place a lead shield over your abdomen to minimise exposure.