Teeth during pregnancy

Two things coincide during this time: the body goes through a hormonal change, and many women are particularly reluctant about treatments. Together, this means that something is overlooked more often during pregnancy than otherwise.

What the hormones do to the gums

The raised level of oestrogen and progesterone makes the gums more permeable and better supplied with blood. They react more strongly to the same amount of plaque than before: they swell, redden and bleed more easily. Professionally this is called pregnancy gingivitis, and depending on the study it affects a considerable proportion of pregnant women.

Occasionally a soft, heavily bleeding growth forms at a single site, usually between two teeth — a pregnancy epulis. It is benign and as a rule recedes after the birth. It is only removed if it causes trouble.

What matters is this: the hormones do not create the inflammation, they intensify the reaction to the plaque. Anyone who cleans particularly carefully during this time — above all the interdental spaces — usually has few problems. A softer toothbrush makes it more bearable.

Vomiting and erosion

Stomach acid is considerably more aggressive than anything you eat. With frequent vomiting in the first months it can attack the enamel, especially on the inner surfaces of the upper front teeth.

What to do afterwards — and what not:

• Do not brush straight away. The enamel is softened by acid; the brush then removes it as well.
• Rinse the mouth with water, better with a fluoride solution or a bicarbonate solution, which neutralises the acid.
• Wait about half an hour, then brush.
• With frequent vomiting, inform the practice — a fluoride varnish protects the surfaces at risk.

What may be treated during pregnancy

More than many people assume. An untreated inflammation or a painful tooth is more of a burden than a treatment.

• The best period is the second trimester. In the first trimester the development of the organs is particularly sensitive; in the third, lying down for a long time is uncomfortable and can strain the circulation.
• A local anaesthetic is possible. There are preparations that are well studied in pregnancy — the practice chooses accordingly.
• X-rays are limited to what is necessary. Necessary images are defensible with an apron and modern digital equipment; the radiation dose of a single image at the tooth is very low and practically does not reach the abdomen.
• Professional tooth cleaning is entirely sensible, now in particular.
• What can wait are bleaching and larger procedures that can be planned.

In every case, say that you are pregnant — including in early pregnancy and including for a routine cleaning.

The saying about the tooth each child costs

It is wrong. The child's need for calcium is not met from the teeth; enamel is not a store from which the body can take minerals. With bone that is different, with teeth it is not.

That teeth nevertheless come to harm more often during this time has other reasons: more frequent small meals, cravings for sweet and sour things, vomiting, more sensitive gums and the tendency to postpone appointments. All four can be influenced.

And for the child

Caries bacteria are transmitted, usually by the closest carers. Licked dummies and shared spoons are the classic routes. Anyone who gets their own oral health in order before the birth lowers the number of germs passed on later. That is the best time for the child's prevention — before it even has teeth.

A treated periodontitis before a planned pregnancy makes sense for the same reason: the connection with premature birth has been described, and treatment during pregnancy probably comes too late for that.