Pregnancy and Oral Health

By Aishwarya Jayadeep

When I was practicing, I had seen many pregnant ladies in their last trimester coming for emergency dental treatment, having ignored simple care of the teeth during the early stages. As with any other treatment, it is not advisable to undergo dental treatment too during the last stages of pregnancy as taking antibiotics or other medication at this stage may be bad for the baby's health. So here are some tips for a pregnant woman for better oral health.
It's a myth that calcium is lost from the mother's teeth and "one tooth is lost with every pregnant".The calcium your baby needs is provided by your diet, not by your teeth. If dietary calcium is inadequate, however, your body will provide this mineral from stores in your bones . But you may experience some changes in your oral health during pregnancy. The biggest  change is a surge in hormones  particularly an increase in estrogen and progesterone which is linked to an increase in the amount of plaque on your teeth. If the plaque isn't removed, it can cause gingivitis-red, swollen, tender gums that are more likely to bleed. Gingivitis during pregnancy is called "pregnancy gingivitis" affects most pregnant women to some degree, and generally begins to surface in the second trimester. But if you already have gingivitis, the condition is likely to worsen during pregnancy. If untreated, gingivitis can lead to periodontal disease, a more serious form of gum disease and may even lead to teeth loss.
Pregnant women are also at risk for developing pregnancy tumors,which are inflammatory, benign growths that develop when swollen gums become irritated. Normally, the tumors are left alone and will usually shrink on their own after pregnancy. But if a tumor is very uncomfortable and interferes with chewing, brushing or other oral hygiene procedures, the dentist may decide to remove it.


How  to take care of your  teeth during pregnancy to prevent the above said problems?

You can prevent gingivitis by keeping your teeth clean, especially near the gumline. You should brush with fluoride toothpaste at least twice a day and after each meal when possible. You should also floss thoroughly each day. If toothbrushing causes morning sickness, rinse your mouth with water or with anti-plaque and fluoride mouthwashes. Good nutrition-particularly plenty of vitamin C and B12-help keep the oral cavity healthy and strong. More frequent cleanings from the dentist will help control plaque and prevent gingivitis. Controlling plaque also will reduce gum irritation and decrease the likelihood of pregnancy tumors.

When and how often should I see my dentist?

If you're planning to become pregnant or suspect you're pregnant, you should see a dentist right away. Otherwise, you should schedule a check- up in your first trimester for a cleaning.  A visit to the dentist also is recommended in the second trimester for a cleaning, to monitor changes and to see how  effective your oral hygiene is. Depending on the patient, another appointment may be scheduled early in third trimester, but these appointments should be kept as brief as possible.


What are the procedures I should avoid?

Nonemergency procedures generally can be performed throughout pregnancy, but the best time for any dental treatment is the fourth through six month. Women with dental emergencies that create severe pain can be treated during any trimester, but your obstetrician should be consulted during emergencies that require anesthesia or when medication is being prescribed. Only X-rays that are needed for emergencies should be taken during pregnancy Radiation from dental X-rays is extremely low. However, every precaution is taken to minimize radiation exposure. A leaded apron minimizes exposure to the abdomen and should be used when any dental radiograph is taken. Lastly, elective procedures that can be postponed should be delayed until after the baby's birth.

Is there a connection between my diet during pregnancy and my babies oral health?

Eating a balanced diet is necessary to provide the correct amounts of nutrients to nourish both you and your child. What you eat during the nine months of pregnancy affects the development of your unborn child -- including teeth. Your baby’s teeth begin to develop between the third and sixth month of pregnancy, so it is important that you receive sufficient amounts of nutrients – especially calcium, protein, phosphorous, and vitamins A, C, and D.

Mouthwash -To use or not?

By Aishwarya Jayadeep

Whenever I take my daughter to the dentist, they suggest that she use anti-cavity mouth wash. Though we have bought it, none of us are really regular about using it. We typically use it only when we eat something with a strong odour - like garlic. or onion. But in spite of this, I am proud to say that after my little one has got her permanent set of teeth, she doesn't have a single cavity or plaque on her teeth. This I attribute to the habit of brushing and flossing regularly with a fluoride toothpaste. So from my personal experience what I realized is that if you are brushing regularly with a fluoride toothpaste, you may not need to use the mouthwash at all; but if your brushing habits are a little slack, this may help you a bit.
The most often asked question about mouth wash is whether it is as effective as advertised. The simple answer is that it depends upon your need. Studies have shown that most over-the-counter antiplaque rinses and antiseptics aren't much more effective against plaque and periodontal disease than rinsing with plain water. Most dentists are skeptical about the value of these anti plaque products, and studies point to only a 20 to 25 percent effectiveness, at best, in reducing the plaque that causes gingivitis. However anti-cavity rinses with fluoride,  have been clinically proven to fight up to 50 percent more of the bacteria that cause cavities. Nevertheless, many dentists consider the use of fluoride toothpaste alone to be adequate.
The U.S. Food and Drug Administration (FDA) has divided the entire range of mouthwashes in three broad categories:
-Cosmetic
-Therapeutic
-A combination of the two
Cosmetic
Cosmetic rinses are commercial over-the-counter (OTC) products. They are typically used after brushing to help remove oral debris. They provide a temporary solution that lasts from at least 10 minutes to maximum three hours. However, by reducing bacteria from the mouth, they suppress bad breath and leave your mouth with a pleasant taste after eating. These are mostly fluoride based mouthwashes.
Therapeutic
The therapeutic grade mouthwashes are stronger in their action; in addition to serve all the purposes of OTC mouthwashes, they are empowered with other active ingredients that fight against some oral diseases. In order to obtain the therapeutic grade, the product must obtain the FDA approval. These mouthwashes such as Peridex or PerioGard are prescribed by dental professionals to treat oral diseases causing inflammation, swelling, and bleeding of the gums.
The therapeutic mouthwashes are again divided into two types depending on their uses:
-Antiplaque/antigingivitis rinses
-Anticavity fluoride rinses
Combination
However, there is another category of mouthwash and that incorporate the features of both the cosmetic and therapeutic products. These multi-action mouthwashes came to be known as total care or combination mouthwash. These products contain a variety of anti-bacterial ingredients that work against oral bacteria responsible for producing unpleasant odors and plaque.
Now the question of the hour would be  should I use a rinse?
That depends upon your needs. Most rinses are, at the very least, effective oral antiseptics that freshen the mouth and curb bad breath for up to three hours. Their success in preventing tooth decay, gingivitis (inflammation of the gingival gum tissue) and periodontal disease is limited, however.
Rinses are not considered substitutes for regular dental examinations and proper home care. Dentists stress a regimen of brushing with a fluoride toothpaste followed by flossing, twice a day. If done consistently and properly, the brushing and flossing, along with routine trips to the dentist, should be sufficient in fighting), tooth decay and periodontal disease.