Dental conditions during pregnancy
Pregnancy can trigger a number of physical changes in oral health, including pregnancy gingivitis (inflammation of the gums) and pregnancy epulis (a growth on the gum).
Gingivitis, a form of periodontal (gum) disease, is common in pregnancy. The hormonal changes that occur at this time lead to increased blood flow to the gum tissue and increased inflammation of this tissue in response to the presence of plaque.
If you have pregnancy gingivitis, your gums will appear swollen and bleed easily. The severity of the gingivitis can be minimised by greater attention to oral hygiene. Brushing your teeth thoroughly twice a day with fluoride toothpaste will help reduce plaque, as will flossing after each meal.
Recently, a body of evidence has emerged linking more severe gum disease (periodontal disease) in pregnancy to an increased risk of premature birth. However this remains controversial. Meta-analyses (in which researchers combine results of several relevant studies) have not shown that treating gum disease (such as through scaling and root planing) during pregnancy reduces the risk of preterm delivery.
Occasionally, some pregnant women will develop a localised swelling on the gum, known as a pregnancy epulis or pregnancy granuloma. Typically this will occur in the second or third trimester, sometimes even appearing for the first time in the final month of the pregnancy.
A pregnancy epulis will often bleed easily, and can appear red and inflamed, however they are generally not painful. A pregnancy epulis is a benign (harmless) tumour and does not have the potential to become malignant (cancerous).
Some women who have an epulis will have it removed during pregnancy, usually because of bleeding, for cosmetic reasons, or because the diagnosis is uncertain. However, if left alone, the epulis will usually become smaller or disappear after childbirth.
Special considerations regarding oral health during pregnancy include:
You should eat a balanced diet including sufficient quantities of calcium, protein, phosphorus, and vitamins A, C, and D during pregnancy. This is important for your baby's dental health as well as your own.
Hormonal changes during pregnancy and the acid from vomiting if morning sickness is present can all contribute to an increased risk of dental caries (tooth decay) during pregnancy.
In general, any elective dental procedure should be postponed until after delivery, especially if it involves X-rays and anaesthesia.
However, a toothache should be considered a dental emergency. It is particularly important for your dentist to treat infections that can cause toothache, because these infections can potentially spread throughout the body and affect your pregnancy.
If you need to have a filling, it is important to note there is no evidence that amalgam (silver-coloured) fillings are linked to mercury toxicity. Nevertheless, if you are concerned about having amalgam fillings, there are viable alternatives.
It is safe to treat gum disease during pregnancy and this may reduce the risk of adverse pregnancy outcomes, such as preterm birth, as discussed above.
Some antibiotics, including tetracyclines, are not suitable during pregnancy as they can cause discolouration of your baby's developing teeth.
Therefore it is important that your doctor or dentist is always aware if you are either pregnant or possibly pregnant. There are many antibiotic options available that have been proven to be safe in pregnancy.
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