Going to the Dentist While Pregnant

Is it Necessary to go to the Dentist While Pregnant?

YES! You can and should see your dentist while pregnant. Scheduling a dental checkup should be on your pregnancy “To Do List”.  As a mother of three young children, I know all about the daunting, never-ending, “To Do List”.  As a dentist, I know that scheduling a dental checkup while pregnant should be near the top of that “List”.  

Your dentist is a valuable resource during your pregnancy.  She can answer any questions or concerns you or your partner may have regarding your oral health. Visiting the dentist during pregnancy will allow your dentist to further explain how a mother’s oral health can affect the growth and development of her unborn baby.  

Your dentist can also address changes you may be experiencing, such as bleeding gums or increased tooth sensitivity. More importantly, your dentist is trained to look for changes that you may NOT be aware of, such as cavities requiring tooth fillings and the presence of gum infections or tooth abscesses.

Keeping your teeth and gums healthy is ALWAYS important to prevent health problems, but even more so while you are pregnant. Studies show that there is a link between poor oral health and premature birth, low birth weight and pre-eclampsia. This is why going to the dentist while pregnant is so important. In most cases, you can schedule a dental checkup and have routine dental procedures completed while you are pregnant, without even having to obtain a medical clearance from your OBGYN or Midwife.

Changes in Oral Health During Pregnancy

A mother’s body will undergo amazing changes during pregnancy, all in an effort to create the best environment for her baby to thrive.  Unfortunately, these changes can sometimes cause expectant mothers to develop dental complications.

Pregnant women can experience oral infections, pregnancy gingivitis, periodontitis and oral pyogenic granulomas. Chances are you have never heard of some of these conditions.  Don’t worry! You don’t need to know everything about pyogenic granulomas and periodontal disease – that is why you have a dentist.  

Just because you are pregnant does not mean you are going to experience dental problems. However, if you do have dental problems while you are pregnant do not delay going to the dentist.  Some women are fortunate to go their entire pregnancy without any changes in their dental health. That being said, there are several dental complications that do tend to be more prevalent during pregnancy.

Gingivitis During Pregnancy

Pregnancy gingivitis is a condition that causes inflammation in the gum tissue around your teeth. Moms-to-be are most susceptible to developing pregnancy gingivitis during their 1st trimester when increased levels of hormones, like progesterone and estrogen, can cause their gums to become tender, swollen and bleed easily.

Did you know? For some women, unexpected bleeding when brushing their teeth is one of the first signs their body sends them to signal pregnancy.  

Periodontitis During Pregnancy  

In some women, pregnancy gingivitis can progress into periodontitis.  The word periodontitis literally means “inflammation around the tooth”.  Pregnancy gingivitis can make brushing and flossing uncomfortable and difficult.  This allows plaque – a sticky film of bacteria – to accumulate around your teeth.

If this type of bacteria is not properly removed by a dentist or hygienist it can lead to periodontitis – a chronic infection in the gum tissue that ultimately deteriorates the bone holding your teeth in place.  An overview of 23 systemic reviews conducted through 2016, concluded that associations do exist between periodontitis and maternal and neonatal health.4

Periodontitis during pregnancy has been shown to increase the risk of:

1. Preterm birth
2. Low birthweight
3. Development of pre-eclampsia

Pyogenic Granulomas During Pregnancy 

Pyogenic granulomas (there is that word again!), sometimes referred to as pregnancy tumors, are benign growths of the tiny triangular shaped gum tissue located in between the teeth.  These benign tumors usually appear during the second trimester, but can last throughout the entire pregnancy.

A pyogenic granuloma will typically appear as an area of red, raw looking, swollen gum tissue with a bumpy, raspberry-like texture.  Though they are relatively harmless, pyogenic granulomas do tend to bleed very easily and can make brushing and flossing more challenging. While these tumors typically resolve on their own after giving birth, it is ALWAYS best to consult with your dentist should you notice any areas of swollen gum tissue during your pregnancy.  

Increased Risk of Tooth Decay During Pregnancy

Many women will experience an increase in cavities during and even after their pregnancy. It is a common misconception that as the baby develops it pulls calcium from the mothers’ teeth, causing them to weaken and decay – this is NOT true.

For many mothers, the increase in cavities is most likely related to the weakening of the tooth’s enamel. Enamel is the hard, outer layer of the tooth that can be weakened by exposure to harmful acids and sugar.  There are several things, common to most pregnancies, which can weaken the tooth’s enamel:

• Cravings and increased snacking, especially on carbohydrates
• An overactive gag reflex causing a lack of, or decrease in, brushing and flossing
• Frequent bouts of vomiting – often referred to as “morning sickness”, though some mothers will say it can strike at any point of the day

There are many dental changes and challenges that can arise during your pregnancy, BUT, you are not helpless when it comes to warding off some of these challenges.

Here are Some Simple Tips to Help Minimize the Risk of Dental Complications While Pregnant

1. Go to the dentist while pregnant. Maintain your normal dental visits for checkups and cleanings. Some dentists, like myself, will even recommend that pregnant women have a dental cleaning every three months.
2. Brush twice a day for two minutes using a SOFT bristled brush. Never use a medium or hard bristled brush. Soft bristles are gentle on swollen gum tissue, while still effectively removing harmful plaque and bacteria. Hold the brush at a 450 degree angle to your gum line and slowly work your way around your mouth using small circular motions.
3. Floss gently at least once a day but preferably twice.
4. Brush with a small drop (about the size of a pencil eraser) of fluoridated toothpaste. This will help strengthen your tooth’s enamel, making it less susceptible to tooth decay.
5. Change your toothbrush every 2-3 months. Once the bristles of a toothbrush start to bend outward they are no longer effectively removing plaque that accumulates at the gum-line.
6. Rinse your mouth with water as often as possible. Water is a fantastic neutralizer of harmful acids that can weaken your teeth. Due to frequent snacking and uncontrollable bouts of vomiting, pregnant women tend to have increased exposure to these harmful acids.
7. Maintain a healthy diet. Limit the amount of sugar. Try to consume at least a 1000mg of calcium a day. Good sources of calcium include milk, cheese and yogurt.

Did you know? Your baby’s pearly whites start to form before he/she is even born! That means consuming healthy foods, particularly those that contain calcium and vitamins A, C and D, while you are pregnant help form the foundation for your baby’s beautiful smile.  

If you have tooth pain go to the dentist. It is safe to go to the dentist while you are pregnant, and tooth pain can indicate the start of a dental infection that could place the health of you and your  developing baby at risk.

The Answers to the Following Questions Should Further Ease any Fears You Still Have About Going to the Dentist While Pregnant

Is It Safe to Go to The Dentist While Pregnant?

YES!  Not only is it SAFE, it is RECOMMENDED that you go to the dentist while you are pregnant. The American Dental Association, the American Congress of Obstetricians and Gynecologists, and the American College of Nurse Midwives ALL agree that treatments such as tooth extractions, root canals and cavity fillings can be safely performed during pregnancy.  

It is important to note that elective procedures, such as tooth whitening and veneers should be postponed until after pregnancy. However, delaying necessary procedures or dental emergencies until after baby is born could potentially result in more complex problems.

Can I Have Local Anesthetics While Pregnant?  

YES! A study released in 2015 by the Journal of the American Dental Association “showed no indication that exposure to dental care and local anesthetics during pregnancy is associated with increased risk for major abnormalities”. The researchers concluded “that women should not be deprived of dental care with anesthetics during pregnancy”.

Can I Have Dental X-rays Taken While Pregnant?  

Yes! According to the US Council of Radiation Protection and Measurements, the risk for birth anomalies after exposure of up to 50 millisieverts of radiation or less is negligible.

To put this into perspective, a typical dental x-ray only produces about 0.005 millisieverts of radiation. Even though radiation from dental x-rays is extremely low, your dentist should still use discretion and only take x-rays that are necessary to address the specific dental issue being treated. To further reduce exposure to radiation, your dentist should always use a leaded apron to cover your throat and abdomen.

Can I Have Dental Work Done During Any Trimester of Pregnancy?   

According to research, the second trimester of your pregnancy – weeks 13 through 26 – is the best period of time to have your dental work completed.  For most pregnant moms the second trimester may also be the most comfortable. The gagging and nausea of the first trimester has hopefully subsided and your baby hasn’t yet grown to the point of causing back pain or making it difficult to lay flat on your back.

In most cases, you can schedule a dental checkup and even have routine work completed without even having to obtain a medical clearance from your OBGYN or midwife.

Your dentist may ask to have a medical clearance if you have pregnancy induced hypertension, gestational diabetes or a history of preterm labor.  If your dentist requests medical clearance prior to dental treatment, there is no need to worry; opening the lines of communication between dental and medical health care providers benefits EVERYONE.

The more informed you are about seeing the dentist while you are pregnant, the less stressful your appointment will be. Stress in not good for you or your growing baby; so be informed and have peace of mind that dentistry is safe during pregnancy and you are doing the right thing. Remember, you are not medically, physically or mentally compromised – YOU ARE PREGNANT!

Disclaimer: Pregnancy by Design’s information is not a substitute for professional medical advice or treatment. Always ask your healthcare provider about any health concerns you may have.

Cited Research

Vernes JN, Sixou M. Preterm low birth weight and Maternal periodontal status: a meta-analysis. Am J Obstet Gynecol 2007.

New York State Department of Oral Health.  Oral Health Care During Pregnancy and Early Childhood:  Practice Guidelines.  New York City: New York State Department of Health; 2006.

JADA 146(8) http://jada.ada.org August 2015. Pregnancy Outcome after in utero exposure to local anesthetics as par of dental treatment.

Daalderop LA, Wieland BV, Tomsin K, et al. Periodontal Disease and Pregnancy Outcomes: overview of systemic reviews. JDR Clinical and Translational Research 2017.