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Dental Care for a Healthy Pregnancy

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Behold your expanding belly. Unpredictable skin. Swollen breasts. With all the crazy changes that occur in pregnancy, it would be nice to focus on something about your body that stays constant, like, hmm... the inside of your mouth?

If only you were so lucky. Like it or not, even your gums are hijacked by pregnancy hormones. "Changes in progesterone and estrogen affect the way gum tissue reacts to plaque," says Patricia Meredith, D.D.S., a spokeswoman for the Academy of General Dentistry. Low levels of plaque that might have been inconsequential before you conceived can cause worrisome problems now. In fact, most pregnant women experience some degree of gingivitis, which is marked by red, swollen gums that bleed easily, even with gentle brushing. Untreated, gingivitis can escalate to gum disease -- a big deal because women with this condition are significantly more likely to have a preterm baby, according to many studies, including one published last year in the Journal of Periodontology.

But wonky hormones aren't the only challenge to healthy teeth. The carbs you may rely on to quell nausea (crackers, anyone?) also bathe your teeth in sugars. Morning sickness in the first trimester and heartburn, which often strikes later, increase acids in your mouth, hosting a cocktail party for cavity-causing bacteria.

That's the bad news. But you still have reason to grin. You can keep your teeth and gums in tip-top condition during pregnancy -- if you show them a little extra love.

Make a Date with Your Dentist

No one loves going, but preventive care is more important than ever now. "We don't want any surprises, especially if they require undergoing an emergency treatment during pregnancy," says Sally Cram, D.D.S., a periodontist in Washington, D.C. If it's been six months since your last cleaning, arrange a visit ASAP.

Stick to Your Cleaning Schedule
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Less than a third of women go to the dentist while they're expecting -- not good, considering that a pregnancy lasts nine months and most people need a cleaning every six. Your dentist may want to see you every three or four months if you're prone to gingivitis. Check with your insurance company, suggests Amy Bevan, a mom of two in Sudbury, Massachusetts, and manager of a dental practice: "Some are starting to cover more frequent cleanings for pregnant women."

Get a Handle on Brushing

Just as you did in your pre-pregnancy days, you should brush your teeth two to three times daily with fluoride toothpaste and a soft-bristled brush. Dentists recommend soft-headed toothbrushes over hard or medium ones because their pliable bristles can reach under the gumline to sweep away plaque and bacteria. Brush for at least two minutes, hitting all areas of your mouth; don't forget your tongue. "If toothpaste makes you queasy, it's okay to brush without it," says Season Rose, D.M.D., a dentist in Allentown, Pennsylvania. "The act of brushing is better than nothing." (Psst, Dr. Rose told us even she skipped the paste when she was preggo.)

Don't Forget to Floss

Even good brushers sometimes slack off when it comes to flossing, but you need to do it every day, particularly when you're pregnant, says Casey Cook, D.M.D., a dentist in Somerville, Massachusetts. If your gums are sensitive and bleeding, try a waxed floss, which is generally easier to use, Dr. Cook says. Flossing will help reduce the inflammation that's causing sensitivity and bleeding. What merits a call to the dentist? If a tooth feels loose, the bleeding doesn't stop after a few rinses, or your gums are still very tender after flossing religiously for three weeks, check in with her.

Give Your Teeth a Good Rinse!

Because bacteria pose a greater threat during pregnancy, gargling with an antimicrobial mouthwash is a smart idea (especially if you cut your brushing sessions short because they make you gag). If your mouth tends to be dry (which sometimes happens in pregnancy for reasons that aren't clear), pick a product that doesn't contain alcohol. It makes dry mouth worse, Dr. Rose says.

Manage Your Morning Sickness

Vomiting and gastric reflux bring acids from the stomach up into the mouth. These acids can erode tooth enamel, making your teeth more susceptible to cavities and chips as well as more sensitive to extreme temperatures, particularly cold (ice cream, ouch!). After a gastric episode, neutralize the acids by rinsing your mouth thoroughly with water mixed with a teaspoon of baking soda; then brush with a toothpaste that has fluoride. "If you're suffering from frequent bouts of morning sickness you may be a candidate for a prescription toothpaste with extra fluoride," Dr. Cook says. Talk with your dentist to see if you should consider trying a new formula.

Keep Your Toothbrush Handy

If you're eating more frequently to stave off nausea or because your increasingly squashed stomach gets full fast, it makes sense to brush more too. Try to do so after every meal or snack, especially if you consume carbs. Carbohydrates -- even healthy ones such as fruit and nonfat milk -- break down into sugars that sit on your teeth. If you can't brush, rinse your mouth with H20. In general, "make sure you're drinking plenty of water," Dr. Rose says. Think of it as a tide rolling in and sweeping the bacteria away.

Chew Gum

Sugarless packs that contain xylitol, a compound extracted from birch trees, have been shown to reduce cavities. Pop a piece four or five times a day, after meals and snacks, to get the benefit. Artificial sweeteners in moderate amounts, like those in these gums, are safe for moms-to-be, says Sheila Chhutani, M.D., an OB in Dallas.

Originally published in the July 2011 issue of American Baby magazine.

All content on this Web site, including medical opinion and any other health-related information, is for informational purposes only and should not be considered to be a specific diagnosis or treatment plan for any individual situation. Use of this site and the information contained herein does not create a doctor-patient relationship. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.