The close relationship between pregnancy and its influence on the condition of the teeth, and between dental procedures and their effect on pregnancy, is well understood. Can and should teeth be treated during pregnancy, or is it better to postpone procedures? Which dental procedures are safe for the baby? Below we clear up the most common doubts and deal with persistent myths.
Prevention above all
The two most important reasons why dental prevention matters so much are: first – avoiding the need for complicated dental procedures during pregnancy, and second – protecting the foetus from cariogenic bacteria entering the bloodstream (more on them in the article "How a tooth gets sick – tooth decay from the inside out"). It is a scientifically proven fact that bacteria causing infections in the mother's mouth can be transferred to the uterus, contributing to consequences as serious as premature births, low birth weight of the baby or intrauterine infections.
Facts and myths about the effect of pregnancy on teeth
Among the myths still lingering in some circles is the belief that pregnancy decalcifies the bones and teeth. This should, however, be filed away as a fairy tale, because pregnancy is not a pathological condition. While pregnant, it is nonetheless worth paying special attention to the teeth, because the hormones produced during it can start a chain reaction with unpleasant effects. It sometimes triggers so-called pregnancy gingivitis: the gums become more sensitive, congested and swollen, which encourages gentler brushing and – as a result – theoretically less thoroughness. Plaque that is not removed carefully is already a direct path to decay.
Another myth is the need to avoid dental anaesthesia. Modern dentistry offers a type that does not risk causing uterine contractions – the expectant mother, however, has an absolute obligation to inform the dentist of her condition. There are usually no contraindications to using anaesthesia. Much greater complications can be caused by the fear and pain of a mother who would decide on a procedure without anaesthesia.
Some of the beliefs circulating among pregnant women do indeed find confirmation in modern science. A fact is, for example, the influence of the mother's diet on the baby's teeth – as early as the 6th week of pregnancy the buds of the future teeth begin to form, and by the time of delivery this process is complete. A newborn therefore already has the buds of both milk and permanent teeth. That is why the diet of a pregnant woman must not lack products rich in calcium, fluoride, phosphorus, iron and vitamins A, C, D and K (more in the article "Diet and tooth decay").
The harmful effect of morning sickness on the condition of the teeth is also scientifically confirmed. Hydrochloric acid entering the mouth during vomiting has a destructive effect on the enamel and each time causes irreversible changes in it. The remedy is specialist rinses, with which the mouth should be rinsed immediately after vomiting. Our specialists will help select such a rinse, as well as a suitable toothpaste containing fluoride compounds and hydroxyapatite, and will clarify doubts about using sonic toothbrushes or irrigators.
It is worth thinking about having teeth treated as early as the pregnancy-planning stage. While the effect of decay on the foetus is known, researchers point out that untreated gum and periodontal diseases can delay conception – because of pro-inflammatory compounds present in the blood.
To sum up: pregnancy in itself does not cause dental diseases. It can, however, indirectly favour conditions that weaken the teeth and increase their susceptibility to decay – but these can be kept under control thanks to prevention and regular visits to the dentist.
Which procedures can be performed during pregnancy, and which are dangerous?
The first condition for performing any procedure is to inform the dentist of the pregnancy without fail. We surround pregnant patients with special care and make every effort to ensure the procedure is as stress-free as possible for mother and baby.
Most dental procedures can be safely carried out during pregnancy. The anaesthetics used today do not cause uterine contractions or the constriction of blood vessels, and the composite materials used for fillings are safe for the baby. Teeth can also be extracted during pregnancy.
Somewhat greater caution is required for root canal treatment, because during pregnancy X-rays are as a rule not taken – especially in the first trimester. When an image is an absolute necessity, we use modern digital radiovisiography, which significantly limits the radiation dose.
During pregnancy, procedures involving long-term general anaesthesia or heavy bleeding are not recommended. Procedures that are not absolutely necessary are advised to be performed after delivery – which is why it is usually advised against, among other things, placing implants, extractions in the first trimester (apart from exceptional situations), the surgical removal of wisdom teeth or whitening. There are no data on the effect of whitening on the course of pregnancy; it is known, however, that ozone treatment may show an effect harmful to the foetus.
The good news is that orthodontic treatment can be undergone without concern. What is more – as a result of hormonal changes the teeth may even move into the desired place more easily. A necessary condition while wearing braces during pregnancy is heightened care for oral hygiene. In each case the dentist decides on the indications and contraindications.
We offer comprehensive help to all expectant mothers who do not know which toothpastes, rinses, toothbrushes and other tools to use during pregnancy. We invite you for check-ups before pregnancy and once in each trimester.
Studies
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Treating periodontal disease for preventing adverse birth outcomes in pregnant women
Iheozor-Ejiofor Z., Middleton P., Esposito M., Glenny A. M. (2017) · Cochrane Database of Systematic Reviews · Cochrane systematic review
Treating periodontal disease in pregnancy improved the condition of the gums and showed no significant harm. There is, however, no convincing evidence that treatment alone prevents preterm birth or low birth weight.
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Pregnancy outcome after in utero exposure to local anesthetics as part of dental treatment
Hagai A., Diav-Citrin O., Shechtman S., Ornoy A. (2015) · The Journal of the American Dental Association · prospective cohort study
Exposure to local anaesthetics during dental procedures in pregnancy was not associated with more frequent major birth defects or other adverse outcomes in this cohort. Standard assessment of the indication and of the patient's condition is still needed.
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Physiology of pregnancy and oral local anesthesia considerations
Zhou X., Zhong Y., Pan Z., Zhang J., Pan J. (2023) · PeerJ · narrative review
The available data support using appropriately chosen local anaesthetics in pregnancy when treatment is needed. Untreated pain and infection are a burden as well, so urgent care should not be postponed only because of pregnancy.