Protecting your pregnant patients

Pregnant patients are extremely vulnerable, and practitioners must support them in maintaining a good oral care regime. 

Many expectant mothers worry that dental treatment during pregnancy isn’t safe. As long as dentists are told that their patient is pregnant, however, they can consider all the options available to safely provide an appropriate dental care plan for the entire pregnancy and beyond.

Some procedures are best deferred. The Department of Health advises pregnant women do not get amalgam fillings replaced until after they’ve given birth – while (according to a large body of research) foetal risk from amalgam is largely theoretical, most dentists and patients decide together whether to delay placement and removal of these types of fillings. Similarly, X-rays are generally delayed unless there’s an overriding need. It’s good advice for women to visit the dentist before they start trying for a baby, so any invasive treatment can be completed before they fall pregnant. 

Increased risks

So, what are the increased risks to oral health that pregnant women may experience? Morning sickness, for example, can be damaging to the surface of the teeth, due to the presence of stomach acid. Any woman suffering from morning sickness should therefore be advised to rinse with water or a non-alcohol based mouthwash. 

Inflammation of the gingiva during pregnancy can lead to bleeding gums. Recent research suggests that gingivitis during pregnancy may be due to high levels of the hormone oestrogen (Gürsoy et al, 2013). A study found that the oestrogen found in pregnant women strongly determined their risk of developing gum disease, and in all three trimesters women with higher levels of oestrogen or plaque had more pregnancy-related gingivitis than those with lower levels. Because high oestrogen is found in healthy pregnancies, these results underline the importance of good dental health from the prenatal period.  

If gingivitis leads to periodontitis, this can set off a chain of reactions capable of damaging the body’s workings. It may result in a preterm or low birth weight baby and research has shown that women who are successfully treated for their periodontal disease have significantly lower incidence of these outcomes (the risk of preterm birth is reduced with successful periodontal treatment). Aside from being predisposed to a myriad of post-natal complications, pre-term and low birth-weight babies are also more likely to encounter heart disease, high blood pressure or diabetes later in life (March of Dimes Foundation, accessed 2014).

Numerous studies have shown that pregnant women with periodontal disease are more likely to develop gestational diabetes mellitus than those with healthy gingiva. Gestational diabetes can lead to pre-term delivery, and although the condition usually disappears after the pregnancy has ended, women who develop it have a greater risk of developing type two diabetes in later life. Research has also found a link between periodontitis and pre-eclampsia (Ruma et al, 2008). This is a rapidly progressing condition that can lead to fatal consequences for both the mother and the unborn child. 

Regular visits 

Pregnant women need to visit their dentist regularly and get advice about how to properly care for their teeth. Gingivitis can be reversed so it doesn’t proceed to periodontitis, if practitioners can encourage patients to follow good dental care routine. If access is a problem, dentists should be making sure their patient knows to take full advantage of free NHS dental care from the start of their pregnancy.

As well as daily brushing, pregnant women should invest in a good toothbrush. For example, the Curaprox Hydrosonic is suitable for people with sensitive gums. With gentle Curen filaments, it offers effective cleaning of the gum line and periodontal pockets. The Hydrosonic is part of a range of complementary products for sensitive patients, including the CS5460 manual brush and the alcohol-free Curasept Ads mouthwash – all suitable adjuncts to a pregnant patient’s oral care routine. 

In conclusion, the huge changes that a woman’s physiology goes through during pregnancy means that dental health may need closer attention at this time. Simple advice to establish a good oral care routine will help to decrease plaque and periodontal pockets, and your pregnant patient will have a lower risk of developing more serious problems that that will affect them and their unborn child. 

For a list of references contact

Following his degree in biochemistry, Howard’s early career was in the pharmaceutical industry, where he worked for a number of the large multinationals before becoming CEO of Merck for 11 years. Until recently, his principle activity was as chairman of Life Plus Europe, a successful multi-level marketing company supplying nutritional products on a personal import basis throughout Europe. Howard is focusing on developing a range of natural products for the dental market.

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