It is very important to maintain routine dental care and the treatment of oral health problems during pregnancy.
Improving oral health when pregnant can have a positive effect on overall health, prenatal outcomes and the baby’s future oral health.
Concerns are understandable but careful measures are in place to ensure the safety and health of mother and baby.
Dental Care During Pregnancy
Good oral health and control of oral disease is of utmost importance during pregnancy as it can help to reduce the transmission of pathogenic bacteria from mother to child. Regular dental visits assist in monitoring pregnant patients for any oral health issues plus receive advice on preventive care.
Common Concerns of Pregnant Women
Radiographs & Anaesthesia - Dental care including radiographs and local anaesthesia can be safely administered during pregnancy.
Periodontal (Gum Disease) Treatment - The best available evidence to date shows that treatment or gum disease is safe for both mother and fetus. It reduces periodontal pathogens, and does not alter rates of preterm birth or result in lower birth weight.
Spontaneous Miscarriage - No evidence has been round linking early spontaneous miscarriage to first trimester oral health care or dental procedures.
Pre-eclampsia - is not a contraindication to dental care.
Prompt treatment of dental caries and periodontal conditions is highly recommended. The health benefits of required dental care outweigh all perceived fetal and maternal risks related to prevention, diagnosis and treatment of oral diseases.
Your dentist should take a detailed health history and review all related health and oral conditions. They may also wish to consult with your obstetric care provider regarding any medical conditions prior to commencing dental treatment.
Clinical Procedures During Pregnancy
Emergency care should always be provided if needed during pregnancy. Elective treatment can be deferred until after pregnancy. However the following can safely be provided during pregnancy:
- Required treatment can occur throughout pregnancy - the second trimester is ideal
- Scaling and root planing to control periodontal (gum) disease
- Root canals and tooth extractions
- Diagnostic procedures, including dental X-rays with use of thyroid collar and abdominal apron
Some medications are best avoided during pregnancy. Your dentist will discuss with you and may also consult with your obstetric care provider.
Pregnant Patient Additional Care
- Avoid early morning appointments if morning sickness is occurring.
- Schedule appointments to minimise possible waiting time
- Allow time for bathroom breaks.
- Be conscious of possible exaggerated gag reflex.
- Ensure head higher than feet and legs are uncrossed
- Use of a pillow, if needed, under the right side of the body.
Self-Care when Pregnant
- Brush teeth and floss twice daily
- Limit foods containing sugar to mealtimes only
- Select water or low-fat milk over other beverages
- Eat fruit rather than drink fruit juice.
- Try a baking soda rinse for morning sickness or acid reflux.
- Try a low foaming toothpaste and a toothbrush with a smaller head if experiencing an exaggerated gag reflex
The Canadian and British Columbia Dental Associations have not developed specific guidelines for treating pregnant women. However, there is already a broad consensus in the US on best practices for improving the health and quality of life for pregnant women.
References
New York State Department of Health. 2006. Oral Health Care during Pregnancy and Early Childhood Practice Guidelines.
California Dental Association Foundation. 2010. Oral Health During Pregnancy and Early Childhood.
Northwest Center to Reduce Oral Health Disparities. 2009. Guidelines for Oral Health Care in Pregnancy. Seattle, WA.
Maryland Department of Health and Mental Hygiene - Office of Oral Health. 2012. Oral Health Care during Pregnancy: At-a-Glance Reference Guide.
American Academy of Pediatric Dentistry - Council on Clinical Affairs. 2011. Guideline on Perinatal Oral Health Care. Clinical Guidelines. Reference Manual. V 33 no 6, pp.118-123.
Silk, H., A.B. Douglass, J.M. Douglass, L. Silk. 2008. Oral health during pregnancy. American Family Physician. v. 77 no. 8, pp.139-1144.
