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Dental Health in Pregnancy
Oral health is very important throughout your life, and pregnancy is no exception. Common pregnancy problems include gingivitis (red, puffy or tender gums that bleed during brushing), tooth decay and periodontal disease (chronic bacterial infection that affects the gums and structures that support tooth attachment).

Tooth decay begins with a build up of plaque, a sticky layer of bacteria that accumulates on your teeth after eating. The bacteria in plaque are harmless if they are promptly removed. However, when plaque builds up, the bacteria convert the sugar and starch that you eat into acid that attacks tooth enamel.

Pregnancy heightens the risk for cavities for several reasons. First, frequent snacking feeds bacteria. Second, hormonal changes in pregnancy increase the susceptibility of your gums to oral bacteria. Third, morning sickness exposes teeth to stomach acid, which can damage teeth. Finally, pregnant women are often tired and may neglect to practice good dental hygiene. The risk of dental problems is increased by smoking and poor nutrition.

What constitutes good dental hygiene during pregnancy?

1) Brush your teeth twice a day with fluoride toothpaste. Keep a toothbrush handy during the day to clean your teeth after eating sugary or sticky foods.

2) Floss between your teeth at least once a day.

3) Eat nutritious foods to ensure you receive adequate amounts of vitamins A, C and D, calcium, magnesium and phosphorus.

4) Drink water or low-fat milk rather than juices and sodas. Avoid carbonated beverages while you're pregnant.

5) Avoid sticky foods and those containing lots of sugar, especially between meals. Healthy snacks include fresh fruits, vegetables and dairy products, such as milk, yogurt and cheese.

6) If you suffer from nausea and vomiting, rinse with a cup of water containing a teaspoon of baking soda to neutralize the acids in your mouth.

7) Schedule a dental exam if you haven't been seen by a dentist in the last six months. If you have bleeding gums, a toothache, cavities or loose teeth, schedule your appointment right away. Medicaid recipients are often eligible for dental insurance during pregnancy.

Many of my patients worry about treating dental problems during pregnancy. They are concerned that local anesthesia or dental X-rays might not be safe. I reassure them that it is important to treat dental problems during pregnancy, and it can be harmful to postpone treatment.

Some studies have found a link between poor oral health and preterm delivery. It's thought that oral bacteria can travel through the blood stream and trigger the production of chemicals that provoke uterine contractions. Furthermore, good oral hygiene in mothers may reduce the incidence of cavities in children. Mothers without active cavities who practice good oral hygiene are less likely to transmit harmful oral bacteria to their children.

If you have the option, it's best to be treated between 14 and 21 weeks gestation, when your pregnancy is well established and it's still comfortable to recline for your appointment. A lead shield should be worn when receiving X-rays. Local anesthesia and most antibiotics are safe to use in pregnancy. Still, your dentist will likely appreciate a note from your prenatal care provider stating that it's fine for you to receive treatment.

Laura E. Stachel M.D. Obstetrician & Gynecologist