Seeing the Dentist in Pregnancy – FAQ’s

A healthy body is a privilege and certainly important for a successful pregnancy. Healthy teeth and gums are no exception and a lack of health in this area may lead to problems for you and your baby. Even healthy teeth can develop problems over time. Regular brushing and flossing is a good start, but for a complete picture, regular dental check ups are important.

Q. I Have No Pain, There Is No Bleeding and I Can See No Problems, So Do I Really Need To See The Dentist?

A. Many problems with teeth and gums do not hurt until the problem is more complicated and costly to fix. The best money spent at a dental clinic is with regular check ups, regular digital x-ray (see later) and prophylactic cleaning sessions. Self diagnosis is very unreliable with teeth and gums.

Q. I Haven’t Got A Regular Dentist – How Do I Find One?

A. The best way to find a dentist is by asking friends and family for a recommendation, otherwise to call the local branch of the Australian Dental Association ADA for suggestions is also ok.

Q. At What Stage Of Pregnancy Should I See My Dentist?

A. At the planning stage so that you can focus on your pregnancy rather that worry about uncertainties, however if that is not the case then late is better than never. A preventative check up should comprise of a thorough visual examination, two small x-rays (one on either side) and a scale and clean. An OPG x-ray may be appropriate to check for wisdom teeth, sinuses etc. Your Dentist can refer you for this. An OPG is usually bulk billed.

Q. How Can I Tell If I Have A Good Dentist?

A. You should be comfortable with him/her as a person, they should take time to listen to and explain your questions. If your mouth does need attention, you should be advised of what needs to be done now, what work should be deferred and the effect anything you may have done may have on you or your baby. Don’t be scared to ask for estimates of cost. If it is substantial, it’s okay to seek a second opinion. You may want to prepare a list of questions beforehand so you remember to ask all your questions.

Q. Can I Have Dental X-rays During Pregnancy?

A. This is considered safe, the baby is well protected in the womb, together with a lead apron and the focused nature of the x-ray beam the risk is considered negligible, however there is a natural reluctance to do so on the mothers as well as the dentist’s side. So this is generally reserved for emergencies when the advantage to the mother’s health is outweighed by any risk to your baby.

Q. What Is A Digital X-ray And Is It Better Than A Normal X-ray?

A. It is a way of taking x-rays of teeth with up to 90% reduction in radiation. It may not always be appropriate. Ask if your dentist uses it.

Q. My Gums Are Bleeding, Is It Normal?

A. This is most prominent between the 2nd and 8th month of pregnancy, and 30-100 % of women will experience some gum bleeding. It can largely be prevented by regular home care, scaling & cleaning by the dentist, periodontist or a dental hygienist. It is attributed to increased levels of estrogens and progesterone, making gums more sensitive to existing gingivitis, i.e. plaque bacteria present causing gums to become inflamed and thus bleed on brushing/flossing etc. Some women will experience sinus trouble, causing mouth breathing at night. This causes a drying of the mucous membranes, which in turn causes inflammation especially around the front top teeth.

Q. What Can I Do At Home To Help With Bleeding Gums?

A. Your dentist may need more than one visit to treat any gum problems, and this should alleviate most signs of bleeding. It is however important to follow a strict oral hygiene regimen of brushing (consider electric toothbrushes), flossing, interdental brushes if appropriate and varying mouth rinses. The dentist can advise you on what is appropriate for you. The gum most affected by pregnancy gingivitis is between teeth so flossing is the most effective way of dealing with the problem. There are a variety of ways to make flossing easier especially with an already sensitized retch reflex (your pharmacy will have a range of floss aids available). A healthy balanced diet will eliminate any possible nutritional deficiencies.

Q. Why Do I Have Bad Breath (Halitosis)?

A. This can have many causes both benign and more serious. As a starting point brush and floss, use a mouth rinse as well as giving tongue, gums, cheeks and palate a good scrub with a large soft bristle brush (retch reflex allowing). Sinus problems can also cause bad breath. If it becomes more of a problem, contact your dentist to see what the likely cause may be.

Q. What Is This Small Growth On My Gum?

A. There are many causes for this, some more serious than others, pregnancy granuloma occurs in 0-5% of pregnant women, a special manifestation of the gum overreacting to existing plaque and tartar build up, they can resolve spontaneously with removal of plaque/tartar, but sufficiently advanced growths may need removal via a minor surgical procedure. All swelling inside your mouth must to be checked by a dentist ASAP!!

Q. Are Silver Fillings Safe For Me And My Baby?

A. Silver fillings are considered safe by the ADA as well as the World Health Organisation (WHO), and there are no reliable scientific studies to prove otherwise. This is however an emotional and possibly contentious issue, so if for whatever reason you are unhappy to have silver amalgam fillings placed discuss this with your dentist and explore other options such as tooth coloured resins or porcelain or gold. These may be costlier options. Discuss the appropriate options with your dentist.

Q. I Have Food Cravings, Is It Bad For My Teeth?

A. Cravings imply foods not eaten in moderation, therefore anything sugary acidic or syrupy in nature are worth raising with your dentist to see what can be done to minimise damage. If you are not sure if you are damaging your teeth, ask your dentist.

Q. I Have Morning Sickness And Have Been Vomiting. Is This Bad For My Teeth?

A. The acid from your stomach can severely damage your teeth; even acid reflux common in pregnancies can cause erosion of your teeth’s enamel, leaving them sensitive and vulnerable to excessive wear and decay.

Q. What Can I Do To Prevent Tooth Damage From Vomiting?

A. Do not brush your teeth immediately after vomiting as the enamel is vulnerable and soft and easily worn by vigorous brushing, so a fluoride rinse will help to remineralise any acid damaged enamel. A recently released ‘tooth mousse’ containing bioactive calcium and phosphate in the form of casein phosphopeptide derived from cows milk helps not only with patients at high risk from decay but also the repair/remineralisation of damaged enamel. Note that this product is lactose free and your dentist should know of this product (it was developed in Melbourne!).

Q. My Dentist Has Prescribed Antibiotics. Are They Safe?

A. If you or your dentist is unsure about the safety of any drugs administered then this should be double checked with your attending obstetrician. Again the benefits need to be weighed against the risks .Penicillin is considered safe generally (except in cases of allergy), so is codeine and paracetamol. Note that aspirin containing drugs are not safe.

Q. Is Fluoride Safe During Pregnancy?

A. The best source of fluoride is from water, however some areas in Melbourne are non-fluoridated, so check with your dentist or local council. Should you not feel comfortable with fluoridation, the it is the more important to check your child’s teeth for cavities later as fluoride does make enamel more resistant to caries/decay.Topical fluoride gels are available at pharmacies, these are topical and not systemic.

Q. Is Local Anaesthetic Safe During Pregnancy and Breastfeeding?

A. Yes it is, and even though it is secreted in breast milk, it does not seem to cause any adverse effect on the baby, neither short nor long term. Some suggest it may affect taste adversely, but the author has found this not to be the case whenever he has administered local anaesthetic for lactating mothers and followed up on the subsequent feeding pattern of the baby.

Q. What Do I Need To Know About Drugs and Breastmilk?

A. Local anaesthetic, filling materials and other drugs used during routine dental work is considered safe, even though most drugs administered will show up in breastmilk, some non dental drugs are in fact concentrated in breast milk (i.e. meprobromate). Should it be necessary to administer drugs undesirable or even detrimental in breast milk then previously expressed milk can be stored in a refrigerator and used 24-48 hours after. Some drugs to stay clear of are di-gesic, atropine containing drugs, diazepam (sedative/sleeping pills) steroid creams, i.e. for skin conditions or mouth ulcers (i.e. triamcinolone in Orabase).

Q. What Should I Do About My Problematic Wisdom Teeth?

A. Wisdom teeth are a major source of potential infection in the mouth and can have serious consequences when infected. It’s often difficult to predict if they will in fact get infected or when this may happen. As this makes them a liability often removal is the best form of preventing serious infection. There are risks involved with the removal of some wisdom teeth, this needs to be weighed up case by case.

Are These Old Wives Tale True? “Loosing a Tooth Per Child / Growing Long In The Tooth!”

No. These are common misconceptions and not an inevitability of pregnancy or old age. With good home care and advice/treatment from your dentist these are entirely avoidable conditions.

This article was written by BellyBelly’s Dental Surgeon, Dr. Axel Ecke.

Disclaimer: Please note that the above advice should always be backed up by your attending GP, obstetrician and/or dentist ,the list of drugs is a guide only and by no means comprehensive.

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