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Safety of Dentistry during Pregnancy

Safety of Dentistry during Pregnancy

Few months ago, we discussed the link between gum disease and preterm labor, low birth weight and stillbirths. Dental care is safe and essential during pregnancy, yet many pregnant women forgo dental treatment entirely as a precaution. Visiting a dentist during this time can help with any pregnancy-related dental symptoms, in addition to cleanings and cavity fillings.

Pregnancy Gingivitis

Pregnancy causes hormonal changes that lead to pregnancy gingivitis or periodontitis in 40% of pregnant women. Inflammation of the gums can cause bleeding, swelling and tenderness. More frequent cleanings may be necessary to treat this condition.

Pregnancy Tumors

In some pregnant women, overgrowth of tissue called “pregnancy tumors” appear on the gums, most often during the second trimester1. It is not cancerous, but is a swelling that may be related to excess plaque.

Increased Risk of Tooth Decay

Morning sickness increases the amount of acid in the mouth, which weakens the outer layer of the tooth (enamel), making the tooth more vulnerable to demineralization and decay. It can also cause a gag reflex, preventing proper brushing. Also, pregnant women may be more prone to cavities due to consumption of more carbohydrates1.

Gestational Diabetes

Gestational diabetes also occurs in 2-5% of pregnant women2. Any inflammatory process, including acute and chronic periodontal infection, can make diabetes control more difficult. Poorly controlled diabetes is associated with adverse pregnancy outcomes such as preeclampsia, congenital anomalies, and large-for gestational age newborns2. Controlling all sources of acute or chronic inflammation helps control diabetes.

Safety of Dental Treatment

Dental treatment can be done at any time during pregnancy, though the safest time to perform elective dental treatment is during the second trimester (weeks 14 to 20). By this time, the development of the fetal organs is complete, while nausea and postural discomfort are often less of an issue.

While we postpone all non-urgent dental care until after delivery, certain cavity fillings, root canals, crowns or extractions may be necessary to reduce the chance of infection. One or two x-rays may even be needed.

A recent study in the August 2015 issue of the Journal of the American Dental Association showed that using local anesthetics—such as lidocaine—during dental treatments were safe during pregnancy3. According to the American College of Radiology, no single dental x-ray has a radiation dose significant enough to cause adverse effects in a developing embryo or fetus4.

During pregnancy, remember to limit sugary foods and drinks, brush and floss regularly and visit the dentist for routine cleanings. Pregnant women with severe vomiting (hyperemesis) or gastric reflux can help avoid damage to their teeth from stomach acid by using an antacid or by rinsing with a teaspoon of baking soda in a cup of water after vomiting5.

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