How does pregnancy affect my oral health?
It's a myth that calcium is lost from the mother's teeth and "one tooth is lost with every pregnancy." But you may experience some changes in your oral health during pregnancy. The primary 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. Also, there are physiological vascular and inflammatory changes which can cause your gums to be prone to bleeding. Also, if you are experiencing increased occurrences of vomiting, the stomach acid can erode teeth and increase your risk for cavities.

How does a build-up of plaque affect me?
If the plaque isn't removed, it can cause gingivitis--red, swollen, tender gums that are more likely to bleed. So-called "pregnancy gingivitis" affects most pregnant women to some degree, and generally begins to surface in the second trimester. 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. Pregnant women are also at risk for developing pregnancy tumours, inflammatory, benign growths that develop when swollen gums become irritated. Normally, the tumours are left alone and will usually shrink on their own. But if a tumour is very uncomfortable and interferes with chewing, brushing or other oral hygiene procedures, the dentist may decide to remove it.

Are there any conditions that will affect my baby?
Studies show that periodontal (gum) disease may be a risk factor for preterm birth and low birthweight babies. Dental infections can cause adverse pregnancy outcomes.

How can I prevent these problems?
You can prevent gingivitis by keeping your teeth clean, especially near the gum-line. Your 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 tumours.

When should I see my dentist?
If you're planning to become pregnant or suspect you're pregnant, you should see a dentist right away. Your dentist will assess your oral condition and map out a dental plan for the rest of your pregnancy. A visit to the dentist is recommended in the second trimester for a cleaning, to monitor changes and to gauge the effectiveness of your oral hygiene. Depending on the patient, another appointment may be scheduled early in the third trimester, but these appointments should be kept as brief as possible.

What about x-rays?
Approximate fetal radiation dose from dental radiographs is extremely low. According to the American College of Radiology, no single diagnostic x-ray has a radiation dose significant enough to cause adverse effects in a developing embryo or fetus. The maximum safe exposure to your baby is 50 mSv (a unit used to describe radiation doses). Four bitewing radiographs is approximately 0.005 mSv (and this is not directed at your baby but at your mouth). To put this into perspective, the average annual natural background radiation for a person in the United States is 2.5 mSv. At our office we use protective aprons which will cover the chest and abdomen to ensure that virtually no dose will be given to your baby.

Are there any procedures I should avoid?
Non-emergency procedures generally can be performed throughout pregnancy, but the best time for any dental treatment is during the second trimester. 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. Lastly, elective procedures that can be postponed should be delayed until after the baby's birth.