Dental treatment during pregnancy – what you should know

A Mum-to-be should always remember this:
By taking care of her own health, she ensures the proper development of her child.

When planning a pregnancy, it’s a good idea to start with a visit to the dentist. The mouth is one of the main areas where hormonal changes occur during pregnancy. Gum inflammation usually increases during pregnancy, even if good oral-hygiene is performed. Pregnant women can also be affected by pregnancy gingivitis and periodontitis.

The dentist will interview the patient and perform an oral cavity check. After collecting full medical records, he or she will determine the treatment plan to fit into the schedule of the future mum. Oral cavity hygiene involves removing all caries and eliminating inflammation of the gums. It should be emphasized that prevention is much more pleasant than rescuing a tooth from trouble. What’s more, the presence of cariogenic bacteria in the mother’s saliva can negatively affect pregnancy, and after birth it can become a threat to the baby’s oral health. The more bacteria in the mother’s mouth, the faster the bacteria grows in the baby’s mouth.

Nine months of waiting is a very busy time, so let’s not forget to take care of our oral health.
Frequent nausea, vomiting and gastroesophageal reflux cause dissolution of tooth tissues (enamel erosion) and promote the development of caries. The hormonal changes experienced by a pregnant woman increase the susceptibility to inflammation, which can cause, among other things, swelling and hypersensitivity of the gums (pregnancy gingivitis). If left untreated, inflammation can develop into much more serious conditions, and these can be associated with a risk of low birth weight of the baby and even lead to premature birth.

The development and mineralization of teeth begins very early, from the 4th week of pregnancy, and ends around the age of 20. All nutritional deficiencies during this period, and especially during pregnancy, breastfeeding and early childhood, are irreversible. Hence, it is extremely important to have a good, healthy diet during pregnancy.

Energy requirements vary in each trimester.

The first trimester is usually no different from the time before pregnancy, if the expectant mother did not suffer from nutritional deficiencies.

The demand in the second trimester should increase by 360 kcal/day, and in the third trimester by another 475 kcal/day.

The diet should be composed taking into account the age of the future mum, her lifestyle and physical activity. It is important to provide nutrients from all food groups, like vegetables, fruits, complex carbohydrates, dairy products, fats and meat. The diet should be enriched with folic acid, iron, iodine, zinc and unsaturated fatty acids. Proper hydration is extremely important, thanks to which more saliva is secreted to cleanse the mouth.

Improper diet has major consequences such as malformations, anemia, low birth weight, hypertension and even premature birth.

A balanced diet affects not only the course of pregnancy and fetal development, but also health in childhood and healthy habits in adulthood. A deficiency of vitamins A, C and D, a deficiency of calcium, protein and an insufficient supply of calories are dangerous.

Varied meals eaten every 4 hours should become a permanent part of the future mother’s schedule. Regularity is key here. Sudden changes in eating and hygiene habits adversely affect this. There’s nothing worse than snacking between meals, and especially unplanned carbohydrate snacks. Yes, we’re mostly talking about sweets. They have devastating effects on tooth enamel, the sudden appearance of dental decay and cavities, as well as gum problems. Not to mention the accompanying accumulation of increased body fat, reduced sleep quality, stomach pain, gastroesophageal reflux disease or heartburn.
Sugar is the main factor responsible for development of tooth decay, as it is an excellent breeding ground for bacteria living in the oral cavity. When sugars are fermented, an acid is formed that lowers the pH of the mouth. This leads to demineralization of the enamel (decalcification). If this process is not stopped in time by the dentist, the bacteria will penetrate deep into the tooth, causing a cavity, and after getting into the tooth pulp, root canal treatment will be necessary.

According to the WHO, tooth decay is a contagious bacterial disease that causes decalcification and lytic breakdown of the hard tissues of the tooth. Hence, one infected tooth will “spread caries” on the next one. What’s more, tooth decay expands and increases the degree of infection, hence a woman should check the condition of her mouth at least twice during pregnancy: once in the 3rd or 4th month, and again in the 8th month of pregnancy.

The optimal period for dental procedures is the second trimester: week 14 to 20th.

It is not recommended to undertake any invasive procedures in the first trimester. In the third trimester it is necessary to remember about the proper positioning of the patient in the chair and all procedures should be performed with special care. For pregnant women, a semi-recumbent position is not recommended. In this position, the enlarged uterus compresses the vein supplying blood from the lower part of the body and makes it difficult for it to return to the heart and thus reducing the volume of blood pumped out of the heart. Lying down on your back for too long can cause the so-called inferior vena cava compression syndrome, which is manifested by weakness, paleness and increased heart rate. To prevent this problem, pregnant women should keep their right hip slightly raised (10-12cm) while seated in a dental chair, or keep them inclined to the left.

Pregnant women often do not go to the dentist because they are afraid of excessive stress, which is why it is so important to choose the right clinic that we trust.

High doses of X-rays are carcinogenic (causing cancer) and teratogenic (causing abnormal fetal development). A high dose of radiation, especially during the crucial period of organogenesis, can disrupt the development of many organs in the baby, especially the central nervous system.

The radiation dose harmful to the fetus is about 100 mGy. For comparison, a single tooth X-ray during pregnancy is far from what is considered harmful (about 0.1 mGy). Nevertheless, all precautions must be taken when taking the photo, such as the use of a lead apron or collar. X-ray examination in pregnancy can only be performed in situations where the correct diagnosis can only be made based on an X-ray. If the clinical situation does not require it, all X-rays should be postponed.

It is important to remember that we are constantly exposed to radiation from everyday objects such as tv, computers and mobile phones. It is estimated that the fetus is exposed to ambient radiation at an average dose of 5 mGy per day.

Myths vs facts

• There are many myths saying that “pregnancy causes teeth to fall out”, “the baby sucks calcium out of the mother”, and “each child costs mum a tooth”, when the truth is, it all depends on prevention and proper oral hygiene.

• “You don’t have to take care of the baby teeth, as they will fall out anyway”. This is absolutely not true. The condition of baby teeth has an impact on the health of our child’s entire body. Tooth decay in baby teeth should be detected at the earliest possible stage and treated immediately. Ignoring dental check-ups in a child only leads to later treatment of caries at an advanced stage, which can be unnecessarily painful and traumatic for our child and costly.

• “Stop brushing my teeth when my gums start to bleed.” Most often, neglect of hygiene procedures is caused by the gag reflex when brushing the back teeth, or the “toothbrush turning pink” – inflammation of the gums with bleeding during brushing. Don’t let negligence lead to deterioration in oral hygiene, as this vicious cycle will only worsen inflammation. If your toothbrush turns pink during brushing, it means that you have an active periodontal disease that requires immediate treatment. Basic hygiene routines should include daily flossing between your teeth, brushing at least 2 times a day, using a water flosser and cleaning your tongue. If any disturbing symptoms persist for longer, be sure to see a dentist.

• “The saliva will kill all the bacteria.” Remember that there is a close relationship between the condition of the parents’ mouth and the child’s health. Tooth decay is a contagious disease, so you should never kiss the baby on the lips or lick dummies or your baby’s spoons, as this way we can “share” the caries with your baby..

• Breastfeeding vs. formula milk. Breastfeeding is extremely important for the proper development and growth of the baby. The sucking reflex stimulates the growth of the maxillofacial system, leading to the stimulation of the muscles responsible for lifting and extending the mandible forward. Artificial feeding (from a bottle) does not require much effort, what is worse, it leads to the consolidation of the physiological mandibular body, which in the future may cause problems with controlling the chewing activity. Natural breastfeeding is always best for the baby, of course not all women can do it. In such a situation, it is worth remembering about the proper selection of teats (choose the ones that mimic a nipple), bottles and feeding position to stimulate the jaw muscles to work, and thus prevent the development of malocclusion.