Pregnancy and Oral Health

1. Pregnancy and Oral Health [f.zare.MD]

2. Changes During Pregnancy that Affect Oral Health • Hormonal Affects • Increased tooth mobility • Saliva changes • Increased bacteria • Gum problems

3. Saliva changes • Decreased buffers • Decreased minerals • Decreasing flow first and last trimester • Increased flow second trimester • More acidic

4. Increased Bacteria • Increased acidity • Increase in decay-causing bacteria • Increased Snacking • Morning sickness/low blood sugar • Between-meal snacks • Increase in amount and frequency of starches/carbohydrates • Crackers are commonly recommended • Promotes decay-causing bacteria

5. Increased Bacteria • Increased food supply • Increased hormones • Gingival fluid and saliva contain hormones • Cause gums to swell, bleed easily, and secrete more fluid • Bacteria use hormones for energy to grow and multiply • Decreased immune response limits ability to fight bacteria

6. Gum Problems • Pregnancy Gingivitis • Red edges • Swollen or puffy • Tender • Bleed easily during brushing Courtesy of Phoenix College

7. When Trouble Strikes... periodontal disease

8. Gum Problems - Pregnancy Granuloma Courtesy of Univ. of Southern California

9. Gum Problems - Pregnancy Granuloma Courtesy of Univ. of Southern California

10. Gum Changes - Pregnancy Granuloma Courtesy of Univ. of Southern California

11. Safe Dental Treatment • Most treatments considered safe • Acceptable drugs • Dental anesthetics • Chlorhexidine rinse • Give dentist your obstetrician’s contact information • Avoid • Aspirin or ibuprofen • Tetracyclines, chloramphenicol

12. Changes During Pregnancy that Affect Oral Health • Morning sickness • Difficulty with hygiene • Gum disease • Tooth decay • Vomiting • Esophogeal Reflux (heartburn) • Acid exposure • Irritation of the gums • Weakening of tooth enamel • Dental erosion

13. Treatment for Acid Exposure • Do NOT brush immediately after vomiting • Rinse • Water with baking soda • Antacid • Plain water • Eat some cheese • Ask about fluoride

14. Oral Diseases Can Effect Pregnancy • Preterm, low birth weight (LBW) linked to periodontal disease • Thorough calculus (tartar) removal in pregnant women with periodontitis may reduce pre-term births

15. Spontaneous preterm birth in pregnant women with gum disease Spontaneous Preterm Births Jeffcoat et al. (2003) Periodontal disease and preterm birth: results of a pilot intervention study.

16. Prevention: Oral Hygiene • Reduce the amount of bacteria in your mouth • Brushing and flossing • Antibacterial mouth rinses • Xylitol gum or mints • Keep routine dental visits

17. Prevention:Nutrition for Oral Health • Eat well-balanced meals • B vitamins, especially folate (folic acid) • Vitamin C • Calcium • Snack smart • Avoid starchy or high carbohydrate snacks • Raw fruits and vegetables • Dairy products

18. Nutrition during Pregnancy • Protein is needed for the buildup of your uterus, breasts, blood supply, and baby's tissues. • Low protein intake is related to smaller-than-average babies who may have health problems. • Folate is required for protein tissue construction. Low folate levels are linked to birth defects, such as spina bifida. • Foods high in folate are the dark green veggies. • Calcium is needed by your baby for strong bones. If calcium is not supplied by the mother's diet, calcium is taken from the mother's long bones, not the teeth, for the baby.

19. Important to Remember • If nausea and vomiting is a problem, it is important to frequently brush or rinse with water. The acid could cause erosion of the teeth. • If you are craving sweets, this could cause an increase in cavities. So, just remember to snack on raw veggies and fruits.

20. What to Expect from your Hygienist • Scheduling appointments in the second trimester. Best time for routine care. • Shorter appointments and changing positions on the chair for your comfort needs.

21. x-rays • The taking of dental radiographs during pregnancy continues to be a controversial issue. • It should be noted, however, that a pregnant patient who is properly shielded can safely receive dental x-rays at any time.