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Necessary dental care

Pregnancy is a time of anticipation and change.  There are many obvious changes throughout a woman’s body and some not so obvious, that occur within the mouth, or oral cavity.  While temporary, pregnancy does affect how and when dental care is provided.

There is a long standing myth that a woman loses a tooth for every child she has.  Of course this is not the case, but circumstances and changes in the mouth may make it appear so.  The myth goes on to claim that the fetus draws calcium directly from the mothers teeth and results in weakened teeth that decay and may be lost.  In fact the mothers diet (and nutritional supplements) give the developing fetus all the calcium he or she needs to develop.  Increased cavities are the result of many factors such as an increase in snacking and  poor oral hygiene.

Starting about the second month of and continuing for the rest of the pregnancy, hormone changes affect the gums or gingiva.  The gingiva is much more susceptible to
irritation from plaque (soft) or calculus (hard) deposits on the teeth.  An  exaggerated inflammatory response can result in mild redness or gingivitis, to swelling of the gingiva between the teeth.  These swellings are painless, but do bleed easily.  Most pregnant women experience some form of inflamed gums even with good dental hygiene.  Additionally, looseness of the teeth may be noticed, especially in the third trimester.  These gingival changes usually reverse after the baby is born.

Cavities or decay, as noted above, can increase during or after pregnancy.   Factors related to the pregnancy, not the pregnancy itself, can lead to this increase.  The inflamed gums that many women experience can be tender so she may avoid brushing and flossing.  Plaque accumulates.  As the fetus increases in size, the stomach capacity decreases and to compensate, frequent small meals and sugary snacks are common.  With more plaque present and more available sugars, there is an increase in decay.

Dental care  during pregnancy
Dental care during pregnancy is important.  While many treatments are elective and usually postponed until after pregnancy, there is care that a pregnant woman needs and sometimes treatment cannot wait, but can be done with minimal risk.  Consultation with a woman’s physician also helps minimize risks.

First trimester 
A dental exam and routine hygiene care (cleaning) is important so that the irritants (plaque and calculus) that lead to gingival inflammation and cavities, can be removed.  Instructions in home care can help the pregnant woman maintain her oral health.  Other dental treatment is usually postponed until after the pregnancy, and more pressing treatment is delayed until the second trimester, if possible.

Second trimester
Routine hygiene care again is advisable.  Necessary dental treatment is relatively safe and comfortable for the woman at this stage.

Third trimester
If needed, due to inflammation or swelling of the gums, another hygiene appointment may be appropriate, but early  in this trimester is the best time.  Appointments are kept short as the woman is usually uncomfortable reclining in the dental chair.

Necessary dental care
It is important to treat pain and infections anytime, but during a pregnancy as they can cause stress for the mother and can endanger the fetus. If your cavities are minor, you may want to wait to have them filled. However, if you have a substantially sizable cavity, the risks of getting a filling placed are offset by the risks of bacteria from your cavity in your system! Another potential risk you would face is that of the anesthetic in your blood stream during treatment, so if you can complete the filling without anesthetic you are also better off. Sometimes, we can also place a less invasive temporary filling until you are out of any risk. Your dentist will be able to assess the risks vs. needs for you.  

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