By Dr Ola Hassan – BChD (University of Leeds), MJDF RCS (Eng)
Pregnancy and the lead up to planning for one can be a mixture of emotions, and a rollercoaster of biological changes. As women we take it on the chin, we manage to adapt, and week by week we somehow succeed to get over the hurdles of whatever our body throws at us : The nausea, the bloating, the insomnia, the general soreness our body feels as it stretches and changes in size and shape, except we just cannot shake off…toothache. No matter what remedies we try there is just no avoiding a trip to the dentist if you are unfortunate enough to experience the agony that comes from a poorly tooth.
As a dentist, it really does hurt the toothy loving part of my heart when expectant mothers come in to my clinic in tears because of gum or tooth pain. It hurts because – she need not go through it at all! I promise you almost every tooth and gum ailment is preventable. I hope to be able to address this all for you in my humble attempt to instil in you a little more love towards your own oral health.
Considering the amount of public health awareness surrounding what foods and lifestyle habits are important for a healthy pregnancy, it is quite disappointing to see that not much emphasis is placed on where it all begins- the mouth! The entryway to the rest of your body and to your baby. I always wondered why I often saw pregnant ladies on an emergency clinic. Were these ladies just neglecting themselves? Did they really not know about the effects of pregnancy on their oral health? As a first-time expectant mother now halfway through my own pregnancy, I finally get to see what sort of advice and guidance there is for mothers-to-be and was quite shocked to see, at least in my experience- there is none, just a quick mention by my midwife that I would now be eligible for free prescriptions and free NHS dentistry if I filled out a form.
Hormonal changes are very substantial during pregnancy, and our gums get to experience some changes as this happens- they tend to get more sore and bleed. The slightest bit of plaque build-up would result in an exaggerated amount of inflammation and swelling- thank you Oestrogen and Progesterone- your presence is well and truly known every time we spit out blood after brushing!
We would never ignore a bleeding eye, nor a bleeding nose – yet because it is often painless, bleeding gums are just shrugged off and ignored. When gums bleed, see it as a sign that they are crying for some TLC. If ignored the inflammation that initially affects just the gums will eventually travel down to the jaw bone that holds your teeth in place and cause the bone to slowly dissolve away leading to the feeling of loose teeth, and in some severe cases to the loss of teeth. Believe me, I have seen many tears in my dental chair over the loss of teeth. It really is heart-breaking to end up with gaps in your smile.
Research has also found that if you are pregnant and have poor gum health there may be an increased risk of giving birth prematurely, giving birth to an underweight child and also pre-eclampsia. If you still choose to smoke during your pregnancy your gum problem will be exacerbated even further alongside the risks passed onto your baby.
Brush more and floss daily.
It is a bore we know, but investing 2-3 minutes of your time twice a day will save you hours of spending time with your local friendly dentist. (We are nice human beings but we appreciate why you might not like to come in to see us for treatments)
There is a technique to brushing – make sure you always angle the brush towards your gums (45 degrees) and give them a good massage as you brush each tooth in circles- no brushing vigorously back and forth! If you notice your gums bleed, do not panic and do NOT stop brushing, keep going, if your inflammation is in the early stages you will notice the gums firm up, and the bleeding stops after about 7-10 days. This indicates your gums going back to health.
See your dentist or hygienist regularly for your professional clean- it is perfectly safe to do so during your pregnancy. They will help you maintain your gums and pick up any issues early before they progress.
“My baby sucked out the calcium from my teeth.”
Sorry to break it to you, but although your tiny one is wreaking havoc in so many ways as it grows inside you, it just does not quite have this power over your pearly whites. What tends to happen is your mouth takes quite a battering during your pregnancy, from the acids from all the vomiting and nausea, to all the sweets and sugary snacks you consume to help you keep the food down, and not to mention- the regular snacking. I get it, the hunger strikes pretty often for me at the moment.
When an expectant mother attends with toothache and it turns out her tooth is infected and needs either an extraction or a root canal treatment (a procedure which removes the infected nerve from within the tooth to save the tooth from extraction) it usually means that cavity has been there for a very long time, sometimes even preceding pregnancy and it has just progressed and got worse over time eventually leading to a tooth infection. No healthcare professional enjoys putting anyone pregnant on antibiotics or undergo extensive treatment on them, although they would only do so if it is safe. Generally it is better to prevent any issues in the first place.
Lessen the snack attacks
Try to replace any processed sugary snacks with healthier options. This way every time you snack, the attack on the teeth is less powerful ensuring you do not end up with cavities leading to tooth pain.
Fluoridated toothpaste/ mouthwash
Ensure you use a fluoridated toothpaste. Read the label it should mention a number ranging from 1,350 to 1,500 ppm Fluoride. These tend to be the most effective over the counter toothpastes you can get.
After vomiting, the acids from your stomach can really wear your teeth down- ensure you rinse out right away with water or a fluoridated mouthwash to reduce the effects of acid erosion.
Say hi to your local Dentist at least once- twice a year
Probably the most important tip of all- if you are planning to get pregnant, see your dentist ahead of time, allow them to assess the health of your teeth and gums, tailor the advice to suit you and get you to a healthy standard before your pregnancy rather than pick up issues during your pregnancy that may be more challenging to treat. The less we expose you to x-ray radiation and treatment during your pregnancy the better!
In the UK we are lucky to have the NHS to support most pregnant women to access free dental care. Logging on to https://www.nhs.uk/service-search/find-a-dentist will help you locate a dentist near you that may be taking on new NHS patients. Alternatively, you can seek a dentist privately and I promise you it will be worth investing in.
For any further questions or concerns about your own oral health I am available to personally address them on my social media pages:
Ola Hassan is a UK registered dentist with nearly a decade of experience of maintaining healthy teeth and mouths in adults and children based in and around London. She has also provided teaching to undergraduate dental students and attends regular courses to update and continue her professional development. She has a special interest in treating anxious patients and in providing restorative dentistry especially minimally invasive dentistry to provide aesthetic yet functional solutions where she has won national and international awards for her cases.