PregnancyPregnancy and and

Oral HealthOral Health

[f.zare.MD][f.zare.MD]

Changes During Pregnancy Changes During Pregnancy that Affect Oral Healththat Affect Oral Health

Hormonal AffectsHormonal Affects Increased tooth mobilityIncreased tooth mobility

Saliva changesSaliva changes

Increased bacteriaIncreased bacteria

Gum problemsGum problems

Saliva changesSaliva changes Decreased buffersDecreased buffers

Decreased mineralsDecreased minerals

Decreasing flow first and last trimesterDecreasing flow first and last trimester

Increased flow second trimesterIncreased flow second trimester

More acidicMore acidic

Increased BacteriaIncreased Bacteria Increased acidityIncreased acidity

Increase in decay-causing bacteriaIncrease in decay-causing bacteria Increased SnackingIncreased Snacking

Morning sickness/low blood sugarMorning sickness/low blood sugar Between-meal snacksBetween-meal snacks

Increase in amount and frequency of Increase in amount and frequency of starches/carbohydrates starches/carbohydrates Crackers are commonly recommendedCrackers are commonly recommended Promotes decay-causing bacteriaPromotes decay-causing bacteria

Increased BacteriaIncreased Bacteria Increased food supplyIncreased food supply Increased hormonesIncreased hormones

Gingival fluid and saliva contain hormonesGingival fluid and saliva contain hormones Cause gums to swell, bleed easily, and Cause gums to swell, bleed easily, and

secrete more fluidsecrete more fluid Bacteria use hormones for energy to grow Bacteria use hormones for energy to grow

and multiplyand multiply Decreased immune response limits Decreased immune response limits

ability to fight bacteria ability to fight bacteria

Gum ProblemsGum Problems

Pregnancy GingivitisPregnancy Gingivitis Red edgesRed edges

Swollen or puffySwollen or puffy

TenderTender

Bleed easily Bleed easily during brushingduring brushing

Courtesy of Phoenix CollegeCourtesy of Phoenix College

Gum Problems - Pregnancy Gum Problems - Pregnancy GranulomaGranuloma

Courtesy of Univ. of Southern CaliforniaCourtesy of Univ. of Southern California

Gum Problems - Pregnancy Gum Problems - Pregnancy GranulomaGranuloma

Courtesy of Univ. of Southern CaliforniaCourtesy of Univ. of Southern California

Gum Changes - Pregnancy Gum Changes - Pregnancy GranulomaGranuloma

Courtesy of Univ. of Southern CaliforniaCourtesy of Univ. of Southern California

Safe Dental TreatmentSafe Dental Treatment

Most treatments considered safeMost treatments considered safe Acceptable drugsAcceptable drugs

Dental anesthetics Dental anesthetics Chlorhexidine rinseChlorhexidine rinse

Give dentist your obstetrician’s contact Give dentist your obstetrician’s contact informationinformation

AvoidAvoid Aspirin or ibuprofenAspirin or ibuprofen Tetracyclines, chloramphenicolTetracyclines, chloramphenicol

Changes During Pregnancy Changes During Pregnancy that Affect Oral Healththat Affect Oral Health

Morning sicknessMorning sickness Difficulty with hygieneDifficulty with hygiene

Gum diseaseGum disease Tooth decayTooth decay

VomitingVomiting Esophogeal Reflux (heartburn)Esophogeal Reflux (heartburn) Acid exposureAcid exposure

Irritation of the gumsIrritation of the gums Weakening of tooth enamelWeakening of tooth enamel Dental erosionDental erosion

Treatment for Acid ExposureTreatment for Acid Exposure Do NOT brush immediately after Do NOT brush immediately after

vomitingvomiting Rinse Rinse

Water with baking sodaWater with baking soda AntacidAntacid Plain waterPlain water

Eat some cheeseEat some cheese Ask about fluorideAsk about fluoride

Oral Diseases Can Effect Oral Diseases Can Effect PregnancyPregnancy

Preterm, low birth weight (LBW) linked Preterm, low birth weight (LBW) linked to periodontal diseaseto periodontal disease

Thorough calculus (tartar) removal in Thorough calculus (tartar) removal in pregnant women with periodontitis pregnant women with periodontitis may reduce pre-term birthsmay reduce pre-term births

Spontaneous preterm birth in Spontaneous preterm birth in pregnant women with gum diseasepregnant women with gum disease

0.0%1.0%2.0%3.0%4.0%5.0%6.0%7.0%8.0%9.0%

10.0%

No treatment Polish Cleaning

Jeffcoat et al. (2003) Periodontal disease and preterm birth: results of a Jeffcoat et al. (2003) Periodontal disease and preterm birth: results of a pilot intervention study. pilot intervention study.

Spon

tane

ous

Pret

erm

Birt

hs

Prevention: Oral HygienePrevention: Oral Hygiene

Reduce the amount of bacteria in Reduce the amount of bacteria in your mouthyour mouth Brushing and flossingBrushing and flossing

Antibacterial mouth rinsesAntibacterial mouth rinses

Xylitol gum or mintsXylitol gum or mints

Keep routine dental visitsKeep routine dental visits

Prevention:Prevention:Nutrition for Oral HealthNutrition for Oral Health

Eat well-balanced mealsEat well-balanced meals B vitamins, especially folate (folic acid)B vitamins, especially folate (folic acid) Vitamin CVitamin C CalciumCalcium

Snack smartSnack smart Avoid starchy or high carbohydrate snacksAvoid starchy or high carbohydrate snacks Raw fruits and vegetablesRaw fruits and vegetables Dairy productsDairy products

Protein is needed for the buildup of your uterus, breasts, blood supply, and baby's tissues.

Low protein intake is related to smaller-than-average babies who may have health problems.

Folate is required for protein tissue construction. Low folate levels are linked to birth defects, such as spina bifida.

Foods high in folate are the dark green veggies.

Calcium is needed by your baby for strong bones. If calcium is not supplied by the mother's diet, calcium is taken from the mother's long bones, not the teeth, for the baby.

If nausea and vomiting is a problem, it is important to frequently brush or rinse with water. The acid could cause erosion of the teeth.

If you are craving sweets, this could cause an increase in cavities. So, just remember to snack on raw veggies and fruits.

Scheduling appointments in the second trimester. Best time for routine care.

Shorter appointments and changing positions on the chair for your comfort needs.

The taking of dental radiographs during pregnancy continues to be a controversial issue.

It should be noted, however, that a pregnant patient who is properly shielded can safely receive dental x-rays at any time.