Article On Dental Care During Pregnancy

The Author Dr. Bhavna Malik Gothi (M.D.S.-Oral and Maxillofacial Surgery) is Associate Professor and Head in the Department of Dentistry, Shri Guru Ram Rai Institute of Medical & Health Sciences. She has 17 years of experience in the discipline of Dentistry

IS ORAL CARE AND ORAL HEALTH IMPORTANT IN PREGNANCY ?

Definitely YES! Oral health is an equally important part of overall health and should be nurtured during pregnancy as well.

Lots of Oral changes that has been reported to occur during pregnancy are :

• Large amount of steroid hormones are produced which exacerbate gingival inflammation (gum swelling) that is initiated by soft deposits called plaque.
• Selective growth of certain microbes increases in the mouth that are harmful for the bone support of the teeth causing tooth loosening. This has led to the false adage “one tooth for every pregnancy.”
• Pregnancy granuloma usually in the upper front  teeth is the result of progesterone-induced vascular response seen only in diseased gingiva. Bleeding from the gums on even slight trauma from toothbrush bristles is also exaggerated in pregnant females.
• Dental Erosion may be intensified due to increased exposure to gastric acid from vomiting or gastric reflux.
• Dental caries (Tooth decay)- as a result of raised acidity in the mouth and greater intake of sugary snacks and drinks secondary to pregnancy cravings along with reduced attention to prenatal oral health maintenance.

Therefore,  to deal with all  the above changes  following measures should be practiced:

• Full oral examination must be done before/during and after pregnancy to achieve and maintain optimal oral hygiene.
• Informing women in the antenatal period that routine dental treatment (restoration/cleaning of teeth/ root canal treatment/extractions/ dental xray ,if required, can be done after appropriate consultation) of affected teeth can be managed during pregnancy. But the safest period is considered to be during the 4th,5th and 6th months of pregnancy i.e.(second trimester) according to the literature.  However if any emergency treatment, for example, drainage of (pus) dental abscess ,is required, it can be done in the first as well as third trimester also.
• Pregnancy granuloma , bleeding like conditions resolve on their own post delivery mostly, only if, adequate oral health is achieved.
• Rinsing with a baking soda solution may help neutralize acid. Swishing with warm salt water relaxes gums and reduces gum sensitivity.
• Timely done fillings for affected teeth stops the further progression of decay which may otherwise, cause tooth loss.
• Dental counseling for limiting sugary foods and drinks, brushing twice a day with fluoridated toothpaste, and dental visits twice a year should be strictly followed by the would-be mothers. Prenatal as well as perinatal diet as well dental counselling goes a long way in maintaining both mother and infant oral health alongside general health.
• Pregnant females must avoid smoking and alcohol consumption as smoking negatively affects oral health. The possibility of abortion or stillbirth increases among smokers as per literature. Tobacco chewing has been established as one of the factors for oral cancer.

Mothers can protect their oral health by taking the necessary precautions as above and play critical role in child’s upbringing and teaching them a healthy lifestyle as oral health equals overall health.

Though education and socioeconomic status , family support to a pregnant woman are  some of the factors that are pivotal in practicing uniform oral routine. Oral checkup should be made  a part of mandatory antenatal protocol. By consistent obstetricians dental referrals and dental counselling one can hope to improve the oral health even for the poor and the underprivileged as WHO in their world health report in 2005 stated that the healthy future of society depends on the health of the children of today and their mothers , who are guardians of that future.