Healthy Teeth Make for a Healthier Pregnancy

There are a lot of things a woman must endure when she is pregnant, but a toothache shouldn’t be one of them.

Many expectant moms avoid seeing a dentist out of fear that dental treatment could be harmful to their pregnancy or their baby. That’s not true, says Tonya Fuqua, D.D.S., director of Child Oral Health at the Center for Children’s Health, led by Cook Children’s Health Care System.

“It is 100% safe to treat a pregnant female during the whole nine-month time frame of her pregnancy,” Dr. Fuqua said. “The second trimester is ideal because that can be the safest and most comfortable time for mom, but if you need treatment during the first or third trimester, you should absolutely get it.”

The American Congress of Obstetricians and Gynecologists (ACOG) agrees, saying that women should and can safely maintain their oral health during pregnancy, be it through prevention, diagnosis or treatment with procedures such as fillings, extractions and even root canals.

Not only is it safe, but it’s crucial that women see the dentist during pregnancy for their health, the health of the pregnancy and the future health of their baby.

“Women still need regular dental care when they’re pregnant,” said Shanna Combs, M.D., an obstetrician and gynecologist at Cook Children’s who has experience treating both adults and adolescents. “It’s okay to go see a dentist when you are pregnant. It’s safe and it’s actually good for you and your baby to get good dental care.”

Myths that pregnant women should not get X-rays or have numbing medication for treatments have scared many away from getting help for painful oral issues. In 2007-2009, 56% of women in the United States reported that they did not visit a dentist during pregnancy, according to ACOG.

On top of their concern for safety, lots of pregnant women struggle with a sensitive gag reflex, nausea and sensitivity to tastes and smells, turning a simple teeth cleaning visit into an uncomfortable ordeal.

“Most of the things that dentists use, like antibiotics and topical anesthetics are all things that are fine and safe to use in pregnancy,” Dr. Combs said. “More than anything, as pregnant women get bigger, just being in the dental chair and laying back might make them dizzy, weak and lightheaded, so definitely take that into consideration and ask your dentist to tilt you to the side. 

"Bring a pillow to your appointment if you need to put it behind your back, under your knees or between your legs when you’re in the dental chair. But, please, don’t run from the dentist when you are pregnant. You need good dental care.”

Cost can be a barrier, too. Dental treatment is expensive, but financial resources are available, especially during pregnancy.

“For young uninsured women in Texas, pregnancy gets them insurance coverage through Medicaid that will pay for their dental care,” said Andrea Palmer, M.D., an obstetrician and gynecologist in Fort Worth.

Healthy Teeth Help Mom and Baby

Taking care of your oral health contributes to your overall good health, and a healthy momma has a much better chance at a healthy pregnancy. Ignoring issues could be dangerous for both mom and baby.

“If an expectant mom is in pain of any kind and may be hurting every time she eats or drinks then she might not be eating and drinking enough because of it, and that’s a big problem for mom and baby,” Dr. Fuqua said. “If mom is not getting the nutrition she needs to care for that baby, then the baby isn’t getting the nutrition it needs to grow and develop properly.”

A toothache could be the result of a cavity. If left untreated, that cavity can turn into an abscess, which is an infection-filled pocket at the base of the tooth. That infection can get into the bloodstream and spread to other parts of the body resulting in a life-threatening condition called sepsis. Tooth pain can also lead to increased inflammation and blood pressure, which can be especially dangerous during pregnancy.

All of these issues create risk factors that could cause a baby to be born before their due date. Some studies show a link between diseased teeth and gums and preterm labor, according to Dr. Combs. Babies born prematurely may require admission to the neonatal intensive care unit (NICU) and are at risk of having underdeveloped lungs and neurological complications.

“We don’t want to let things fester and a cavity is not going to naturally fill itself without intervention,” Dr. Palmer said. “I’ve had patients who were admitted to the hospital with an abscess and were on sepsis watch, and that’s definitely not good for baby. So doing all that we can for outpatient preventative dental treatment is the best idea for mom and baby always.”

Pregnancy Impacts Oral Health

As much as poor oral health can impact pregnancy, being pregnant can wreak havoc on a woman’s teeth and gums. Increased levels of hormones during pregnancy can cause gingivitis, or gum disease, and can fan the flames of cavity growth. 

Some women who have never had cavities before could potentially be at risk for the development of multiple cavities during pregnancy, according to Dr. Fuqua.

Hormones aren’t the only culprit. Sugary cravings and changes in appetite and eating habits give bacteria ample feeding grounds. Acid reflux and vomiting due to morning sickness increase the acidity within the mouth, and acid to teeth is like rust to metal. Sensitivity to certain tastes and smells and an overactive gag reflex are also common during pregnancy and can deter moms from brushing thoroughly.

“These things create a domino effect,” Dr. Fuqua said. “So it’s much safer to do prevention, meaning dental checkups, cleanings, exams and even X-rays when necessary, than to ignore an issue or try to wait it out until after birth. Prevention is key and your oral health is a part of your overall health.”

Prevention Is The Best Medicine

Women should make dental care a part of their regular health checkups, especially if they are pregnant or thinking about getting pregnant. Dr. Fuqua says to think of a cleaning as no different in terms of risk to you or your baby than brushing your teeth in your own bathroom. 

Some women may need to increase their cleaning visits during pregnancy from every six months to every three or four months to help prevent pregnancy-induced gingivitis or other dental issues.

Moms who take good care of their teeth set their babies up for good oral health after birth, too. A mom with a healthy mouth reduces the number of bacteria transmitted to baby through common mom activities. 

What mother doesn’t shower her baby with kisses, or taste baby's food to make sure it isn’t too hot before feeding, or “clean” the pacifier that fell on the ground by sticking it in her mouth first? If done with a mouth full of cavities, these activities can transmit disease-causing bacteria to baby that will target their oral health as they grow.

Beyond regular check-ups and cleaning, pregnant women should see their dentist at the first sign something has changed in their mouth or something feels different. Bleeding gums, bad breath, a dark spot on a tooth, and discomfort when eating or drinking something hot, cold or sweet are all indications that something may be wrong.

Dr. Fuqua encourages pregnant women to communicate with their hygienist and dentist about their needs prior to and during their appointments. Don’t be afraid to tell them you need to elevate your head a little or take breaks during treatment. 

If certain smells bother you, let them know and they can help minimize any discomfort. If you’re really nervous or have a significant gag reflex, nitrous oxide will help you relax and is safe for use during pregnancy, according to Dr. Fuqua.

Don’t neglect those pearly whites when you have a little one on the way. Taking care of your teeth before, during and after pregnancy is not only safe for you and your baby, but good for your overall health and the health of your child. Healthy moms make healthy babies.