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Dental Work During Pregnancy

Taking care of your teeth and gums is important during pregnancy. When conception occurs, the body begins producing high levels of the pregnancy hormones estrogen and progesterone. These hormones, especially progesterone, can cause dental problems for expectant mothers. For example, progesterone can cause your gums to swell and become spongy, allowing bacteria to grow more easily between the teeth and gums, causing a condition known as pregnancy gingivitis (see below). During pregnancy, some women experience noticeably swollen gums, while others do not have any oral health problems at all. In most cases, dental problems disappear after the delivery of your baby.

Many women are unsure whether they should have dental work during pregnancy because they worry that it might harm their baby. Dentists recommend getting regular checkups while you are pregnant because of issues that can arise from the hormone changes. If you are planning to get pregnant, you should take care of all major restorative procedures before conception so you can start your gestation cycle with a healthy mouth. Preventive dental care is critical if you want to avoid oral infections that can lead to periodontal disease (which has been linked to preterm birth).

Visiting the Dentist

It’s important to inform your dentist if you are either pregnant or planning to become pregnant. This will allow him or her to prioritize the dental work you need done. There are many procedures and treatments that can be done during pregnancy that will not harm your baby, but not all types of dental work can be done safely. The safest course of action is postponing all dental work until after childbirth, but some dental emergencies require treatment during pregnancy. Root canal therapy, dental fillings, crowns, and tooth extractions are all procedures that can be done if necessary while you are pregnant. However, your dentist may postpone certain dental procedures, especially if they involve the use of general anesthesia.

There are several conflicting studies on the possible negative effects on a baby that can result from the medication used for some dental procedures. Lidocaine (Category B) is commonly used for dental work, but it crosses the placenta once it’s administered. Drugs labeled category B are safe for use during pregnancy. Antibiotics like penicillin, amoxicillin, and/or clindamycin are all category B drugs.

Elective procedures like teeth whitening should be avoided altogether during pregnancy. Many people wonder about taking x-rays while they are pregnant. Most routine x-rays are postponed until after birth, but dental x-rays are considered safe if a lead apron is used to cover the abdomen area. According to the American College of Radiology, diagnostic x-rays have not been known to have adverse effects on a developing baby.

Medical professionals believe that it’s best to avoid all risks during the first trimester, since this is when fetal organ development occurs. If non-emergency dental treatment is needed during the third trimester, it is typically postponed until after birth. Lying on your back for extended periods of time may be difficult during your third trimester and could pose a risk of premature labor. The second trimester is the best time to receive dental work during pregnancy.

Pregnancy Gingivitis

Pregnancy gingivitis is a common form of gum disease among expectant mothers. It typically develops between the second and eighth month of gestation. Approximately half of all pregnant women develop pregnancy gingivitis due to fluctuating hormones that cause swollen, red, tender gums that bleed. It is recommended you visit your dentist regularly and use proper oral hygiene techniques, especially if you have been diagnosed with gingivitis. If left untreated or if pregnancy gingivitis gets out of control, it can develop into periodontal (gum) disease. Periodontal disease has been linked to premature labor and low birth weights. According to the American Dental Association, pregnant women with periodontal disease are seven times more likely to have a baby born too early and/or too small. This is due to very high levels of prostaglandin found in severe cases of periodontal disease. Prostaglandin is a labor-inducing chemical found in oral bacteria.

Pregnant women who need treatment for periodontal disease receive treatments such as root planing and scaling. Both treatments are non-surgical and involve removing bacteria and plaque located on the surface of the teeth (scaling), or in a tooth’s root or gingival pocket (root planing). This kind of dental work during pregnancy is perfectly safe.

Pregnancy Tumors

Occasionally, pregnancy tumors develop on the gum tissue, near the upper gum line. These tumors appear as large lumps with dark red pinpoint markings. Although they are called tumors, there is nothing cancerous about them. They do not spread and only occur in about 10 percent of women with pregnancy gingivitis. Pregnancy tumors can bleed and scab, which can affect your speech and eating habits. They occur at various times in pregnancy, but are most common during the second trimester. You may hear them called by several names, including pregnancy epulides, lobular capillary hemangioma, granuloma of pregnancy, and pyogenic granuloma.

In most cases, pregnancy tumors disappear after giving birth. Dentists can remove them with a simple procedure, using a limited amount of local anesthesia, but the recurrence rate for removed tumors is 50 percent. The other treatment option is to leave the lump alone and eliminate the cause of it instead, by having your dentist remove built-up plaque near the tumor. Good oral hygiene can often prevent pregnancy tumors from developing.

Dental Tips during Pregnancy

Here are some tips to help you maintain good oral health while you are pregnant:

  • Brush and floss your teeth twice a day or after each meal with a fluoride toothpaste.
  • Use over-the-counter alcohol-free fluoride mouth rinse.
  • Rinse your mouth out with water or brush your teeth after episodes of morning sickness. If the toothpaste is causing the morning sickness, talk with your dentist about recommended brands.
  • Visit your dentist on a regular basis. Do not skip a dental appointment because you are pregnant. Hormonal changes can put you at an increased risk for disease.
  • Inform your doctor about your dental health and treatment.
  • Receive regular dental cleanings.
  • Postpone elective procedures until after giving birth.
  • Eat a well-balanced diet.
  • Avoid overindulging in sugary treats.
  • Talk with your dentist about the risks and benefits involved with any treatment you may need.
  • Pay attention to changes that may occur in your teeth and gums.

    [Page updated June 2017]