DISCLOSURE: Noelle Copeland RDH is the oral care specialist and dental consultant to the Brilliant and Baby Buddy oral care lines through Compac Industries. See terms below.
Pregnancy is beautiful, challenging, and sometimes it can be downright difficult. Oral care during pregnancy is an often “overlooked” necessity, as some have been led to believe that professional oral care is a luxury rather than a need. Lack of access to care ranks high as a barrier to oral health, especially during pregnancy. Oral health and systemic health are intricately connected, they directly and indirectly affect one another and pregnancy can exacerbate this significantly in some women. So if you are pregnant or thinking about becoming pregnant, oral care should be added to your list of professional visits to address.
When to Visit the Dentist during pregnancy
Visiting the dentist regularly should be a part of everyone’s routine, with professional cleanings at least twice a year. However, it’s a common situation for professional oral care to be reserved for emergencies or as a temporary symptom reliever. What does that mean? It means that 40% of adults will only visit the dentist when they have a problem or they are in pain, and by that time, whatever the culprit is, it’s likely more invasive and more expensive to treat, than it would have been if regular dental visits had been a regular part of a health routine.
When a woman is pregnant there are many hormonal changes that happen that can drastically affect the oral health of the mother. Not only should you see the dentist regularly before getting pregnant, but it is also recommended and safe to see the dentist while pregnant. This includes hygiene cleanings, restorative dental treatment if necessary, x-rays, and even periodontal therapy if needed.
When there are pathogenic bacteria in the mouth that has been left undisturbed in the gum tissue, the teeth, and the tooth’s supportive structures, like the bone and ligaments, it causes an array of issues from mild to severe gingivitis, active periodontal disease, to decay and cavities. For pregnant women, that bacteria travel in the bloodstream throughout the body, with the ability to transmit and colonize the placenta. In fact, preterm low birth weight babies are a risk factor to mothers who have chronic periodontal disease that goes untreated before and during their pregnancy.
If you are pregnant or thinking about becoming pregnant be sure to visit your dentist and schedule a cleaning with your dental hygienist. Always discuss your concerns with your physician and your dentist. Make your appointment early in gestation. Scheduling your visits in the first half of your pregnancy will help alleviate some of the discomforts you may experience later on in your pregnancy when you are less comfortable laying back in the dental chair. However, the first and second trimesters can be plagued with the most challenging morning sickness episodes, nausea, and fatigue. If you cannot make it early, still go later on, and talk to your professional about ways to make you more comfortable while receiving treatment.
Pregnancy symptoms that can affect oral health
Some of the less pleasant side effects of pregnancy have a direct link to side effects that will manifest orally, like dry mouth, bleeding gums, sensitive teeth and gums, and increased plaque accumulation.
- Morning Sickness
- Regurgitation (vomiting)
- Heightened senses… taste, smell, sound, and sight
Morning sickness that lasts well beyond the morning plagues many mothers. Along with a heightened increase in the senses. This includes a sense of smell, sense of taste, and even sensitivity to light and sound.
Vomiting or Reflux
When you are having regurgitation (vomiting or reflux) episodes, you don’t feel like eating anything truly healthy, if I’m being totally honest. My first two trimesters consisted of ginger ale, saltine crackers, and a bag of lemons I would carry around and sniff when I started to feel queasy ( that works really well by the way). Not the best choices for my teeth or yours, but sometimes, “ It is, just what it is” we have to do our best and move on.
When you regurgitate or if you just experience acid reflux regularly this situation allows stomach acids to coat the teeth and gums causing dry mouth and removing the protective tooth pellicle that is needed to protect the teeth all day. Then add carbonated acidic liquids (ginger ale) and starchy foods like crackers (Saltines) to the mix and a mother’s oral health can decline rapidly, especially if she had struggles with oral health before getting pregnant.
Dizziness and Headaches
Other triggers during pregnancy include things like bright fluorescent lights that can cause you to have a dizzy headache that leads to even more nausea. It’s a strange phenomenon but I can speak first hand of its realness. Fluorescent lights flicker but you can’t actually see it flicker, but your brain transmits the flickering and it can cause a neurological response, like dizzy headaches.
Good ole’ fatigue can also just wipe out the most intentioned pregnant mom.
Today I will exercise ✔
Today I will brush and floss 3 times ✔
Today I will eat lots of vegetables and drink lots of water ✔
Today I will take a 5-hour nap and eat crackers and drink ginger ale. ✔
You’re just going about your day and then all of a sudden it feels like little fairies are slowly pulling your eyelids closed and you swear you could sleep for hours…and sometimes you do, and that is exactly what you should do. Don’t fight it!
Hormone Changes During Pregnancy
So what does all that have to do with your mouth and oral health? Well for starters, blame it all on your hormones. The increase in hormones changes how our bodies respond to things. So whenever you have a drastic change in how you eat, how you sleep, or your level of daily activity, that can have an effect on your oral health, either directly, because you are so exhausted or sick that you have literally stopped brushing and doing regular oral care, or indirectly because the increase in hormones is causing your body to overly respond to the typical bacteria and plaque in your mouth, in retrospect causing inflammatory pregnancy gingivitis.
Gingivitis/Periodontal disease in Pregnancy
The prevalence and severity of gingival inflammation in pregnancy can be mild and not related to plaque accumulation, meaning the teeth are clean and the gums are just swollen because of the hormonal changes that are taking place. These changes increase blood flow to the gums and also change how the body responds to oral bacteria, causing sensitive, irritated, and swollen gums.
However, gingival inflammation can also be caused by plaque and bacteria in the mouth, making the gingivitis more severe. In fact, if you have gingivitis before getting pregnant, you are at risk that pregnancy will increase the severity of it.
How to Avoid Periodontal Disease in Pregnancy
Periodontal disease, in retrospect, is an active infection in the mouth, having a direct effect on the teeth and the supporting structures they sit in, the bone, ligaments, and gum tissues. Periodontal disease is NOT reversible, It can be treated and health can be restored, but the damage it does to the teeth, gums, and bone is permanent. Once the pathogenic bacteria starts to erode away the bone that teeth are securely fit into, the body does not regenerate that bone.
- Pregnancy Gingivitis: Reversible, often exaggerated during pregnancy because of hormonal changes or plaque in the mouth.
- Pregnancy Periodontal Disease: Not reversible. Was present and progressing before pregnancy occurred and then pregnancy accelerates it. Treatable professionally and health can be restored.
Oral Care at home
- Brush 2-3 times a day: At least 2 minutes of brushing, rinsing with an alcohol-free mouth rinse, and flossing every night, and even using interproximal cleaners for any spaces or areas between the teeth that need a little extra attention.
- Don’t brush after an episode of vomiting/reflux. It takes thirty minutes for your saliva to rebuild the protective tooth pellicle that is stripped off your teeth after ANY sort of oral acidic event, like vomiting or reflux. In the meantime, your teeth and tissues are at risk, especially to abrasion and erosion from a toothbrush.
- Rinse your mouth with plain water after an episode. Then follow that up with a Ph stabilizing mouth rinse or gel with Xylitol. Drink lots of water.
Products I LOVE for homecare
Oral sensitivities during pregnancy can be challenging. Finding the right brush doesn’t have to be. Brilliant® has a specially formulated toothbrush just for pregnant moms, with over 18,000 extra sensitive, microfine bristles. In my opinion, it’s the best toothbrush for sensitive teeth and gums. No other specialty toothbrush can match the Brilliant® design. Multidirectional bristles reach all around while brushing, polishing away plaque while gently massaging the gums, cheeks, and tongue simultaneously.
I also love xylitol. Xylitol is a mouth gel that can help prevent cavities by reducing the number of pathogenic bacteria in the mouth and their ability to “Stick” to teeth, gums, and other oral tissues. Xylitol also helps to remineralize teeth by increasing saliva production and lowering oral acidity.
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8/12/2020 This article is intended to provide an understanding of and knowledge about “oral health topics” as expressed through the perspective and experience of the author. It is not intended to be a substitute for professional advice or counsel, including the diagnosis or treatment of any condition. Always seek the advice of your dentist or other qualified healthcare providers with any questions you may have regarding a medical condition, an oral condition, illness, or treatment of any listed or non-listed situation above. By using this site, you signify your assent to our Terms and Conditions. If you do not agree to all of these Terms and Conditions, do not use this site.
Noelle Copeland RDH is an Oral Care Specialist and Dental Consultant who provides content for Brilliant Oral Care and Baby Buddy.