You'd never miss an ob-gyn appointment when you're expecting. But what about a dental exam? Believe it or not, your mouth can affect your pregnancy: Studies suggest that moms-to-be with gum disease have a higher risk of delivering prematurely. "What begins in a person's mouth can affect her overall health, so dentists and ob-gyns should work in tandem to monitor oral and physical health during pregnancy," says Stuart Froum, D.D.S., president of the American Academy of Periodontology and director of clinical research at New York University Dental Center's department of periodontics and implant dentistry. Even so, more than half of pregnant women don't get dental exams, according to the American College of Obstetricians and Gynecologists (ACOG). That's why ACOG now recommends that all ob-gyns perform routine oral-health assessments during the first prenatal visit. If you're concerned that time in the dental chair may harm your unborn baby, let our experts answer your pressing questions.
My mouth feels fine. Do I really need another dental checkup?
Your standard twice-a-year dental cleanings may not be enough. If you have gingivitis, your doctor may recommend more frequent cleanings (say, every three months) throughout your pregnancy. Even if you've never had dental problems before, rising hormone levels during pregnancy can lead to swollen gums that trap food and increase your risk of gum irritation and infection. Roughly 40 percent of moms-to-be have some dental-health concern such as gum infection or untreated tooth decay, according to ACOG. And while these problems don't always cause symptoms or discomfort, at-home care can only do so much. "More intensive cleanings at the dentist's office remove built-up plaque and tartar that cause gum disease," says Dr. Froum. Plus, a thorough exam can pinpoint potential problem areas.
Should I change my regular dental routine?
The American Dental Association (ADA) recommends that pregnant women brush thoroughly with a fluoride toothpaste twice a day and floss daily. Your dentist may also recommend rinsing at night with an antimicrobial mouth rinse.
Is it safe to get dental work other than cleanings?
It's better to get fillings, crowns, root canals, or even tooth extractions than to develop an infection that could induce early labor. Because certain numbing drugs such as lidocaine can cross the placenta, it's best to undergo these types of dental work in the second trimester, when medications are less likely to affect fetal development. Hold off on cosmetic procedures until after you deliver.
Should I skip X-rays?
"I only recommend them for a pregnant woman if she is experiencing a dental emergency like an excruciating toothache, which may then require a root canal," says Ada Cooper, D.D.S., a New York City dentist and consumer advisor for the ADA. But don't panic if you need one. The radiation level of dental X-rays is very low and a lead apron greatly minimizes exposure.
What are those weird bumps on my gums?
About 5 percent of moms-to-be develop small red bumps between their teeth called pregnancy tumors. "They're an overgrowth of gum tissue possibly caused by excess plaque aggravated by hormonal changes," says Dr. Froum. While not cancerous, they can be painful and bleed. The bumps typically go away a month or so after childbirth, but your dentist can remove them if they're unsightly or interfere with your ability to eat or speak.
Why do some of my teeth feel loose?
"Gain a child, lose a tooth" is just an old wives' tale. Still, teeth may feel a little wiggly if the supporting bone and ligaments loosen during pregnancy. "It can be an indication that you have a severe infection called periodontitis that destroys both gums and bone," says Dr. Cooper. Treatment involves scaling the teeth to scrape tartar from above and below the gum line and smoothing root surfaces. Definitely see your dentist if your teeth feel loose.
I'm throwing up a lot. Am I damaging my teeth?
They would have to be bathed in stomach acid almost daily for a couple of years for any significant damage to occur, says Dr. Cooper. Don't rush to brush after vomiting. Instead, rinse with a teaspoon of baking soda dissolved in a cup of water (plain water is fine if you can't stomach the baking soda), use a fluoride rinse, or chew sugar-free gum that contains xylitol. All are effective at neutralizing acid in the mouth.
Originally published in Parents magazine.
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