Pregnancy and teeth

About pregnancy and teeth

Pregnancy does not directly cause poor mouth health and damage to teeth. But changes in lifestyle, habits and body processes may increase your risk of dental problems during pregnancy.

Brushing your teeth twice a day with fluoride toothpaste and visiting your dentist will help keep your teeth and gums as healthy as possible during pregnancy.

Some dental problems can affect a developing baby

Research has shown there is a link between severe gum disease in pregnant women and premature birth with low birth weight. Babies who are born prematurely can have a risk of brain injury, and problems with their eyesight and hearing.

Gum disease can be treated by a dentist during pregnancy.

Looking after your teeth before pregnancy

You’re less likely to have dental problems during pregnancy if you look after your teeth and gums before you are pregnant. You can do this by:

• Brushing your teeth at least twice a day with fluoride toothpaste.
• Cleaning between your teeth with floss or interdental brushes once a day.
• Eating a healthy diet and limiting food and drinks high in added sugar.
• Avoiding tobacco products and minimising alcohol. It’s advised not to drink alcohol during pregnancy, and tobacco products should be avoided at all times.
• Visiting your dentist every 6 to 12 months.

If you’re planning on getting pregnant, see your dentist to discuss any treatments that can be done before your pregnancy. Most dental treatment is safe at any time during your pregnancy, but many women feel more comfortable during the second trimester. You may choose to defer elective or cosmetic treatment until after the baby is born.

Always tell your dentist if you are pregnant

Dentists will take extra precautions when they know you’re pregnant to ensure your care is safe for you and your baby.

Untreated decay and gum disease can lead to infections, which can be a risk to you and your baby. Common concerns about dental treatment during pregnancy include local anaesthetics, or numbing agents, and dental x-rays. These are both safe during pregnancy. However, if you have concerns, speak to your dentist so they discuss your individual needs and options.

You can see the dentist at any stage of your pregnancy. Some women find it is most comfortable during the second trimester, when morning sickness has reduced and before the increased size of the baby makes them uncomfortable. Keep in mind that you will probably be very busy with a newborn, so it may be easier to schedule dental appointments before your baby arrives.

Causes of dental health problems

Common causes of dental health problems during pregnancy can include:

• hormone changes
• vomiting
• cravings for sugary foods
• gagging whilst brushing your teeth.

Hormone changes and gum problems

Pregnancy hormones can put some women at risk of gum problems, which can include:

• Gingivitis (inflammation of the gum) – this is likely to occur during the second trimester. Symptoms include swelling of the gums and bleeding, mostly during brushing and when flossing between teeth.
• Periodontal disease – infection of the structures supporting the tooth (gums, ligament and bone). This is caused by untreated gingivitis, and in severe cases, the teeth can become loose and may need to be removed.
• Pregnancy epulis or pyogenic granuloma – a red, round growth that appears on the gum, which can bleed easily.

If you have gum problems during pregnancy, it’s important to get them checked by a dentist before you give birth. While most types of gum problems caused by pregnancy hormones resolve after birth, a small number of women may develop ongoing gum disease that will need treatment after pregnancy.

Bleeding gums are a sign that your gums are unhealthy because there is bacteria (germs, or plaque) building up near the gums. It is important to keep brushing the gums gently but thoroughly. Use an extra soft toothbrush and fluoride toothpaste to brush at least twice a day and clean between your teeth with floss or interdental brushes.

Vomiting can damage teeth

Pregnancy hormones soften the ring of muscle that keeps food inside the stomach. Gastric reflux (regurgitating food or drink) or the vomiting associated with morning sickness can cover your teeth with strong stomach acids. Repeated reflux and vomiting can damage the surface of the teeth (enamel) and increase the risk of decay.

Try these suggestions if you’re experiencing vomiting:

• Avoid brushing your teeth immediately after vomiting. While the teeth are covered in stomach acids, the actions of brushing may scratch the tooth enamel.
• Rinse your mouth thoroughly with plain tap water.
• Follow up with a mouthwash containing fluoride.
• If you don't have a fluoridated mouthwash, put a blob of toothpaste containing fluoride on your finger and smear it over your teeth. Rinse thoroughly with water.
• Wait for an hour after vomiting before you brush.

If you experience recurrent vomiting, speak to your doctor or obstetrician about other strategies to manage your symptoms.

Retching or gagging while brushing teeth

Some pregnant women find that brushing their teeth, particularly the back teeth, can cause gagging. However, it’s important to brush all of your teeth to avoid tooth decay.

Some tips to help prevent gagging include:

• Use a toothbrush with a small soft head, such as a brush made for toddlers.
• Take your time. Go slowly when you brush.
• It may help to close your eyes and concentrate on your breathing.
• Try listening to music.
• If the toothpaste's taste makes you gag, switch to another brand. Or brush your teeth with water, then use a fluoride mouthwash. Go back to brushing with a fluoride toothpaste as soon as you can.
• Toothpastes that do not contain SLS (sodium lauryl sulfate) tend not to foam up as much. This may help reduce the gag reflex.

Food cravings while pregnant

Some women have unusual food cravings while pregnant. If you have cravings for sugary snacks, it’s best to avoid them as it may increase your risk of tooth decay. Try to snack on foods low in added sugar instead.

If nothing but sweetness will satisfy your craving, try choosing healthier options sometimes, such as fresh fruit. Hard cheeses, nuts, eggs, carrots/vegetable sticks and dips are some examples.

Rinse your mouth with mouthwash containing fluoride or brush your teeth after having sugary snacks. If your cravings continue, speak to your dentist about preventive treatments and other products containing calcium or fluoride which may offer you more targeted protection.

Where to get help

• Your dental professional
• Your GP (doctor)
• Your obstetrician
• Australian Dental Association
• Oral Health Victoria – provides public dental services through the Royal Dental Hospital of Melbourne and community dental clinics for eligible people.