The following information was written by Dr. Minsk and published on various internet web-sites.


Pregnancy

Pregnancy affects the woman’s whole body creating special needs. The oral cavity is also affected and the hormonal changes that occur during pregnancy can create special dental care needs. But good oral hygiene and routine professional cleanings and examinations most of these changes can be managed to ensure the health of the mother and the baby.

CAVITIES: During pregnancy there can be an increase in the amount of tooth decay (cavities). A common misconception is that this is the result of calcium being withdrawn from the mother’s teeth to supply the baby’s increasing demand. But Calcium cannot be withdrawn from the teeth because it is found in a stable crystalline form. So the increase in cavities is the result of an increase in the amount of sugar consumption and lax oral hygiene. The key in prevention of cavities during pregnancy is efficient oral hygiene that includes brushing and flossing after every meal.

TOOTH EROSION: Although rare, another dental problem that can be associated with pregnancy is acid erosion of the teeth. This can result from repeated vomiting related to morning sickness or from esophageal reflux. The stomach acids could, if there is excessive exposure, erode the protective enamel from the surfaces of the teeth. To avoid this, it is important to rinse with water after vomiting and to follow this with a fluoride rinse that will neutralize the acid and protect the surfaces of the teeth. Brushing immediately after regurgitation and before rinsing with water and fluoride may actually accelerate the tooth erosion.

PERIODONTAL DISEASE: Another oral finding during pregnancy is related to the changes in hormones. During pregnancy, the levels of progesterone and estrogen can increase 10 to 30 times from what is observed during the normal menstrual cycle. This can result in dilation of the blood vessels, inflammation and an obstruction in the normal repair mechanisms of the gums. These hormonal changes may exaggerate the body’s normal response to dental plaque, resulting in red, swollen gums that may bleed easily and become painful. 65-70% of pregnant women develop pregnancy gingivitis.

Pregnancy gingivitis is more common and severe between the second and 8th month of pregnancy. Pre-existing gum problems worsen during pregnancy and gingivitis can become quite severe. Gum problems related to pregnancy usually diminish after pregnancy but may not go away completely. Without proper treatment, they can result in gum and/or bone loss.

Up to approximately 10% of pregnant women could develop what is commonly called a pregnancy tumor (pyogenic granuloma). It is a benign growth that can develop as a response to plaque or local irritation. It is more commonly seen in the second trimester of pregnancy and usually in the front teeth. The tumor looks like a large lump on the gum with red dots on it. It is painless unless it interferes with the normal bite or it becomes traumatized. Oftentimes, the pregnancy tumor heals after giving birth and unless it is painful, it doesn’t require treatment. But if it is painful, or to prevent further complications, the tumor should be professionally removed and the gum thoroughly clean.

Pregnancy gingivitis can be prevented with regular professional cleaning and reinforcement of oral hygiene techniques (daily brushing and flossing). If it does develop, scaling and root planing with local anesthesia may be indicated.

Risks to the baby: Like all infections, periodontal disease in a pregnant woman may also affect the health of the baby. Pregnant women who have periodontal disease may be seven times more likely to have a baby that is born too early and too small.

To prevent harm to the baby, special precautions need to be taken related to dental treatment. Although elective dental treatment should be delayed until the second trimester, emergency treatment should be performed as soon as possible to prevent stress or the threat of infection to the mother or the baby. Even in light of the obvious safety of dental x-rays, x-rays should be used selectively during pregnancy, and only when necessary and appropriate to aid in diagnosis and treatment. As a final point, your dental care provider needs to know if you are pregnant, because there are certain medications that are commonly used in dental treatment that may be harmful to the baby.

If you are or are planning to become pregnant or find out that you are pregnant, visit your dental care provider right away. Your dentist will review oral hygiene techniques and assess your dental care needs for prevention or treatment of cavities and periodontal disease. If you are having problems with your pregnancy, have a high risk pregnancy, or had problems with previous pregnancies, inform your dentist who will consult with your physician prior to dental treatment.
SWARTHMORE DENTAL ASSOCIATES
Nikolaos D. Karellos, D.M.D. | prosthodontist
Laura Minsk, D.M.D. | periodontist
Nikolaos D. Karellos, D.M.D.
Laura Minsk, D.M.D.
801 Yale Ave.
Suite 619
Swarthmore, PA 19081
(610)328-4815