Pregnancy is a key part of many women’s life. Your dental health before and during the pregnancy can have an effect on your growing child and of course your own dental health. The best treatment is of course prevention, so anyone planning on having children would be well advised to have a full dental check and clean, including x-rays to ensure everything is healthy and have treatment prior to starting to try for a baby. Of course this is not always possible.
It is a common misconception that the baby will leach calcium from the teeth and cause you to lose teeth. However, changes during pregnancy can increase your risk of dental problems. 
Gum health is extremely important. Hormonal changes during pregnancy can cause an increase in bleeding from the gums. This is called pregnancy gingivitis. It is not caused by the pregnancy, so those with healthy gums will not get bleeding. However, those with even a mild gingivitis, which is very common, can get a lot of bleeding and swelling. This can even lead to a localised lesion, like a gumboil, called a pregnancy epulis. An epulis will normally go away after the pregnancy, but may need removal. Pregnancy gingivitis can be treated with a general cleaning and good oral hygiene practices, including brushing twice daily and flossing at least once daily. There are studies which link more advanced gum disease, periodontitis, with pre-term low birth weight infants. Some of the plaque bacteria present in the mouth have been found to travel in the blood stream to the baby. Again early prevention prior to pregnancy can help, but treatment is also possible during pregnancy.
Morning sickness, or more correctly all day sickness, can lead to increased acidity in the mouth. This can cause dental erosion and sensitivity. For some people, nausea can mean they have difficulty brushing as it can cause vomiting. Using a toothpaste with a remineralising agent, or other products with remineralising agents can help to prevent problems. You should avoid brushing your teeth after any vomiting. Instead rinse well with water or a mouthwash to get rid of the taste and then brush 30-60 minutes later. Just after the acid, the teeth are in a weaker state, so are more likely to be damaged by brushing. Waiting before brushing, allows your saliva to restrengthen the teeth. Dental erosion can occur even without vomiting, as even with nausea, you can have more acidic breath.
Tooth decay can be increased as appetite and diet can change drastically. Tooth decay is linked to frequency of sugar intake, so the additional food and, particularly, snacks between meals can increase tooth decay risk. This increased intake is important during pregnancy, but it should be managed to ensure it is healthy. Keeping a healthy diet and trying to avoid sugary, processed food will help as fresh fruit and vegetables will not cause decay. This can be especially problematic if you are not getting enough calcium in your diet. The body will prioritise calcium for the growing foetus for bone development. This means there is less in the saliva to help remineralise the teeth after meals, which our saliva is supposed to do to prevent decay. Pregnancy vitamins/minerals and healthy balanced diet help to control this. Untreated decay is likely to spread, so this is another reason to make sure everything is healthy prior to pregnancy.
For adults, some of the biggest triggers for teeth grinding, or bruxism, is stress and poor sleep. Both of these are common in pregnancy and for months afterwards. Those with an existing habit of clenching or grinding will often get worse. Other mums-to-be may start grinding for the first time. If you notice a tight jaw, tension headaches, difficulty opening, closing, or chewing, or, even a partner notices you grinding, it is important to get an occlusal splint to prevent chips and cracks to your teeth.
Dental x-rays are low dosage. In the past, they were avoided while pregnant, to protect the baby. However, nowadays, the risk to the baby should the mum need unexpected major dental work or get future problems due to undiagnosed dental disease, means that screening x-rays are still recommended. Getting them done prior to pregnancy ensures less radiation to the growing foetus, while still making sure mum is protected and nothing is missed.
Your dentist should be able to give you specific advice for your risk level and you can discuss options and treatments with them. If you have difficulty brushing or are getting any of the problems here, they can advise what is best to do and when. Generally, the second trimester is best for treatment. The first trimester is when a lot of brain development happens and during the third trimester, it can be uncomfortable to have treatment, especially as lying down flat is not possible.
This article was provided by the friendly dentists at Darlinghurst Dental a dental clinic in Darlinghurst, NSW.
Find out more about Darlinghurst Dental on their doctors.com.au Darlinghurst dental.