HEALTH WATCH
Teething troubles
Dr. V. RANGARAJAN
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Pregnancy can cause dental problems. A look at how to take care of your teeth during this time.
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Time to look at your teeth: Dental health is a crucial factor during pregnancy. PHOTO: SHAJU JOHN
PREGNANCY is a time of anticipation but it is also a time when, apart from other things, a lot of changes occur within the mouth and oral cavity. These are temporary all right, but it is important to take care of dental health during pregnancy to prevent permanent damage to teeth and gums.
Pregnancy causes an increase in the level of hormones — oestrogen and progesterone. Starting around the second month and continuing for the rest of the pregnancy, these hormone changes affect the gums or gingival. The gingival is much more susceptible to irritation from plaque (soft) or calculus (hard) deposits on the teeth. The exaggerated inflammatory response can vary from a mild redness to swelling of the gums between the teeth. This swelling is painless, but it could bleed easily.
Dental hygiene
Most pregnant women experience some form of inflamed gums even with good dental hygiene. Additionally, looseness of teeth may be noticed, especially in the third trimester. Usually, with proper oral care, these changes are reversed after the baby is born. But neglecting them may lead to gum disease. New research suggests a link between pre-term, low birth weight babies and gum infection during pregnancy. The bacteria, which cause gingivitis, can enter the bloodstream through the mouth and can travel to the uterus, triggering the production of chemicals called prostaglandins, which are suspected to induce premature labour.
Oral care: Brush teeth at least twice a day with toothpaste that contains fluoride, taking extra care to clean carefully along the gum lines. Floss daily. Get routine dental examination and teeth cleaning done.
Cavities
Cavities or decay can increase during or after pregnancy due to factors related to pregnancy, not the pregnancy itself. Due to gum inflammation and tenderness, some women may at times avoid proper brushing and flossing resulting in plaque accumulation. As the foetus grows, the stomach capacity decreases and so, women may indulge in frequent small meals and sugary snacks. With more plaque present and more available sugars, there is an increase in decay caused by bacteria in the mouth. This is passed from mother to child through saliva, making the child susceptible to tooth decay at a later date.
Oral care: Eat a variety of healthy foods with plenty of vitamin C and B12. Avoid sweet and sticky food.
Erosion of enamel
Nausea and vomiting are common during pregnancy. Frequent vomiting can cause retention of stomach acids in the mouth in turn leading to erosion of the tooth enamel.
Oral care: Do not brush teeth for 30 minutes after vomiting. By brushing immediately, the toothpaste combines with the acid leading to further erosion of the enamel. Rinse mouth with water or a fluoride mouth rinse to freshen mouth and protect teeth.
Treatment during pregnancy
Dental treatment should be restricted to routine examinations, teeth cleaning & elimination of infection.
The safest period to administer treatment is the 2nd trimester (4th to 6th month of pregnancy).
Oral infection should be treated immediately because it can rapidly spread throughout the body and adversely affect the foetus.
In case of pain, emergency treatment should be completed immediately.
Cavities have to be filled to prevent them from worsening further.
All elective treatments including cosmetic ones and tooth replacement can be postponed until after childbirth.
X-rays may be necessary to perform certain emergency procedures. They should be kept to a minimum.
A lead apron should be used for protection. It is safer to have them done during the 2nd trimester. Digital x-rays are safer as they offer even less exposure to radiation.
Although dental local anaesthetic injections such as lignocaine can enter the placenta, which filters out most drugs, the doses used in most dental procedures are considered safe.
To control oral infections, acceptable antibiotics such as pencillin, amoxicillin, and clindamycin could be used.
Tetracycline, which can cause discoloration of the child's temporary and permanent teeth, has to be avoided.
To control pain, paracetamol is considered safe. No drug should be taken without the concurrence of the consulting gynaecologist and dentist.
By having a dental examination completed before planning pregnancy, the risk of a dental emergency during pregnancy can be reduced.
E-mail the writer at: drvranga@yahoo.com
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