True or false? It’s perfectly safe to visit your dentist while pregnant.
If you answered false, you’re wrong—but you’re not alone. According to a recent US survey, most women received no routine dental care during their pregnancies, and half of moms-to-be with obvious dental problems, like pain, didn’t seek care because they believed that having oral health problems during pregnancy is normal, or that dental treatment could harm the baby.
Read more: Dental health in pregnancy>
That’s something Alison Lee-Pitman, of Guelph, Ont., can understand. “My midwife told me that healthy gums lead to a healthy baby, and that gum disease and not caring for your teeth can lead to prematurity,” she says. Still, the first-time mom-to-be was reluctant to use freezing when a checkup during her second trimester revealed she needed a filling. “My fear was it might harm the baby’s brain development,” she says. “There are some conditions, like autism, where the causes are unclear. I wanted to stay away from any unknowns,” she says. Lee-Pitman was also concerned that her anxiety during dental procedures might trigger a different problem: preterm labour.
But routine dental care—including brushing, flossing and professional cleaning—actually protects against preterm labour by helping prevent periodontal (gum) disease, which is linked to an increased risk of low birth weight and premature birth. One theory is that the low-grade infection and inflammation of the tissues surrounding the teeth set off an immune response that can hinder your baby’s growth and ultimately convince your body that the baby would be better off being born. Even if you have healthy gums, pregnancy can set the stage for periodontal disease and cavity formation. Hormonal changes and increased blood volume soften gum tissue, giving bacteria easier access. Morning sickness can compound the problem, eroding enamel and hastening decay. (Swish with water after vomiting to rinse away stomach acids.)
Read more: Your guide to pregnancy hormones>
What’s less clear is whether treating established gum disease during pregnancy can reduce these risks, though a preliminary study found that rinsing for thirty seconds twice a day with an alcohol-free mouthwash seemed to reduce the chances of giving birth before 35 weeks from one in five to one in 20. Harinder Sandhu, director of the Schulich School of Medicine & Dentistry at Western University in London, Ont., emphasizes that treatment for gum disease is vital, even if there’s no hard proof it minimizes the risks. “If care isn’t instituted, progression is much quicker and more severe,” he says.
While it’s probably best to put off elective procedures, such as teeth whitening, until after your baby’s arrival, “If a woman needs treatment, including X-rays, freezing and filling, it’s safe to carry that out any time during pregnancy,” stresses Euan Swan, manager of dental programs at the Canadian Dental Association. Local anaesthetic, for example, usually doesn’t even reach the baby, according to Douglas M. Black, past president of the Society of Obstetricians and Gynaecologists of Canada. For comfort’s sake, you may want to schedule any non-emergency procedures between 14 to 20 weeks—after morning sickness has passed for most, and before the baby is big enough to make it uncomfortable to lie on your back.
That’s when Lee-Pitman had her tooth repaired. And thanks to a shallow cavity and an understanding dentist, she was still able to forego the freezing, which gave her peace of mind. It wasn’t easy—Lee-Pitman has a bit of dentist-phobia to begin with—but she knew about the link between oral health and her baby’s well-being, and let that guide her decision.
TIP: Oral health is now considered so important to a healthy pregnancy that the American College of Obstetricians and Gynecologists recommends an oral exam be included in the first prenatal visit and that caregivers advise expectant moms to see a dentist.
A version of this article appeared in our January 2014 issue with the headline "Brush up," p. 45.
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