Don’t Forget About Oral Health in Pregnancy (and You Know, Always!)

I feel like are mouths are (sadly) often a part of us that is overlooked. I hope most people brush their teeth, but I know a lot of people probably don’t do it enough. I know that a lot of people either don’t floss or don’t floss enough, or don’t floss “well” or “properly” according to your dental hygienist.

No matter your situation, we can all probably do better when it comes to our mouth health!

*Disclaimer: This blog is intended for informational purposes only. The information on this blog should not be used as a substitute to medical advice or medical treatment. As always, your Primary Care Provider, a doctor, or another health professional is your best resource for specific questions and medical advice. If you believe you or a loved one are experiencing a medical emergency, please contact 911.*

But did you know it is *especially* important to take care of our oral health when expecting?

Those dang hormones. They make so many things in pregnancy “off” or “weird” (or some other things “glow” maybe if you’re lucky!) and unfortunately our mouths are one of those things that are impacted. If we let our oral health get out of control during pregnancy though, we may actually be at risk for complications like preterm labor.

How do I manage my oral health during pregnancy?

  • Brush your teeth twice a day and after meals;
  • Floss daily;
  • Rinse your mouth after any vomiting (more below);
  • and see your dentist!

Fluoride products are safe to use during pregnancy, so continue to use your fluoridated toothpaste and you can use alcohol-free fluoridated mouthwash as well.

Another factor that plays a role in good oral health is eating a healthy diet and avoiding extra sugar-y or sticky foods (which can be hard with those pregnancy cravings). If you’re not sure what constitutes a healthy diet, you can speak to your physician or a Registered Dietitian (or if you’re a healthy person, even a nutritionist – I recently broke down the difference between an R.D. and different types of nutritionists in this post).

How do you maintain your oral health when you have morning sickness and nausea though?

This is something I struggled with in the first trimester. Around 7 weeks of pregnancy, I started to dry heave daily. Sometimes multiple times a day. My biggest trigger was our brand new Nespresso machine (the smell just set me off) but another one was brushing my teeth.

To cope with the sensation of nausea that brushing my teeth brought, I definitely did not always brush for the recommended 2 minutes per twice daily session. Luckily ,this was not a trigger at night for me, so I’d make sure to brush extra long then. Flossing was also difficult in the AM, so I just allotted it as a night time task in those early weeks. Probably gross, but honestly for me – necessary. I’d rather floss my teeth only at night for a few weeks then try every morning and end up vomiting, but that’s just me. I hate vomiting.

Good thing to know: the recommendation is just to floss daily, however you should make an effort to brush your teeth for at least 2 minutes twice a day.

If you are vomiting as a result of morning sickness, oral care is of course very important. Rinse your mouth after being sick with water and baking soda (1 tsp), per the College of Dental Hygienists of Ontario. Using a toothpaste that is “bland” or has no strong scent/flavouring may also be helpful in reducing nausea when brushing your teeth. Using a small-headed tooth brush can also help avoid triggering the gag reflex.

After rinsing your mouth, it is recommended you wait 60 min to brush your teeth.

The issue with vomiting and your teeth is of course the impact that stomach acid has on the enamel, the hard covering of the teeth. Enamel is dead cells so it is not repaired, which is why rinsing your mouth and caring for your teeth during pregnancy (with morning sickness) or when you are sick to your stomach is so important. Dental cavities is one of the risks related to this.

Other tips to decrease your risk of dental cavities include chewing sugar-free, xylitol gum; continuing to use your regular fluoridated toothpaste; and consuming small yet nutritious snacks throughout the day (this also helps with nausea, which tends to be worsened when you’re extremely hungry).

Beyond cavities, why else is oral health important during pregnancy?

I mentioned before that poor oral health in pregnancy can be a risk factor for pregnancy-related complications.

Issues such as gingivitis (inflammation of the gums); and periodontitis (the progression of gingivitis to permanent damage of the gums and jaw bone; aka gum disease) can occur to anyone when oral health is not cared for. When pregnant, these issues can lead to pregnancy-related complications such as preterm labour, because severe periodontitis is associated with increased prostaglandin levels (prostaglandins are involved with helping cervical dilation and contractions to occur during pregnancy, among other roles in day-to-day life).

Bacteria can also be passed from mom to baby after birth, so maintaining oral health in postpartum is important too. Actually – oral health is always important, but you know this!

When gingivitis occurs in pregnancy (as a result of… you guessed it, hormones), it may be called Pregnancy-Associated Gingivitis and is very common. You may notice bleeding or red gums, or tooth sensitivity, even if you are really great at taking care of your teeth. The risk of PAG is increased when oral health is poor, so again – it is very important to keep up with your teeth brushing and flossing to decrease risks. Usually the symptoms related to this will go away when in postpartum but if they don’t, you might want to see your dentist.

Periodonitits is not specifically associated with hormones and pregnancy, but can occur when gingivitis worsens and oral health is poor. One condition of pregnancy is related to periodontal disease – Gestational Diabetes. Additional counselling should be sought via your PCP and dentist if you have gestational diabetes re: oral care.

Can I see my dentist while pregnant?

Yes you sure can!

Routine dental care is generally considered safe for a healthy pregnant woman. The Canadian Dental Association states that polishing, scaling, and root planing can be done at any time if needed, however second and third trimester are recommended as the optimal time to perform routine dental care.

The second trimester (I found) is usually a perfect-time to have a dental cleaning done – that is when I personally went and I found I had reduced nausea and was not yet physically uncomfortable. It made me happy to know my oral health was good too; brought me a sense of ease (one less thing to worry about, right?).

The Canadian Dental Association recommends that any dental procedures that are not immediately necessary to maintain a patient’s oral health should be scheduled for postpartum.

What about dental x-rays?

*Not to be confused with X-rays of other parts of the body, for which the response is quite different*

The Canadian Dental Association states that dental radiography is safe, as long as the radiographs are taken using the correct protective equipment (which they should always be done with!). However, the use of them should be minimized (so only done if necessary) especially for patients in their first trimester.

Personally, I had x-rays done just prior to pregnancy so I delayed mine until I was postpartum. Talk to your hygienist or dentist if you have questions or concerns.

Patients with any pregnancy related complications/conditions or chronic conditions should speak to their dentist as well as potentially their doctor and/or specialist prior to any treatments, procedures, etc as guidelines/regulations may differ.

What can I do to make my dentist experience comfortable while I am pregnant?

Talk to your dentist and hygienist! Let them know that you are pregnant and what you are/are not comfortable with. It is always best to be upfront about what you want/need out of your experience. As I am always pushing my readers to do – ask questions and advocate for yourself. I am sure that your dental team will be more than willing to accommodate you, delay anything that is not necessary, or just listen to you and discuss your concerns.

Note: Dental chair positions should be adjusted to accommodate any hypotension (or nausea and reflux). This also makes the experience much more comfortable.

If you have questions about your oral health during pregnancy, talk to your dentist! As always, thanks for reading.