Teeth During Pregnancy – What Problems Do Expectant Mothers Face

Teeth during pregnancy are perhaps more subjected to various tests than all other organs and systems of a woman’s body. However, the ‘extent of distress’ will largely be determined by their condition before conception. As is known, pregnancy acts as a catalyst for various negative processes occurring in the oral cavity. 

Thus, if a woman has poor dental hygiene, for example, if she brushes incorrectly or irregularly, this situation itself can trigger the onset of various oral cavity diseases. Pregnancy will only accelerate these pathological changes. A similar situation arises if, for instance, before pregnancy, the woman suffered from periodontitis, had mild cavities, or other oral issues – pregnancy will make these negative processes much more active. 

Impact of Pregnancy on Dental Health

To understand how to maintain dental health during pregnancy, it’s important to grasp the changes occurring in a woman’s body after conception and the reasons for adverse outcomes in the absence of adequate care. First and foremost, these are hormonal shifts. The levels of hormones like progesterone and estrogen, which have immunosuppressive properties, undergo significant changes. This leads to an increase in plaque on the gums and teeth. 

The mucous membrane of the oral cavity becomes easily irritated, bleeding at the slightest touch. Any injury increases the risk of inflammation after infection. There is a rise in ‘aggressive’ microorganisms within the oral microflora. The quantity and composition of saliva also change, contributing to tooth decay. The protective function of saliva decreases due to changes in its pH level, with increased acidity from 6.7 to 6.2.

Dental Care During Pregnancy, Cavity Prevention

To prevent negative effects of the body’s restructuring for the future mother, so she doesn’t have to treat her teeth during pregnancy, certain rules must be followed:

• Undergo a full oral cavity sanitation during the pregnancy planning stage.
• Brush teeth thoroughly with sweeping motions twice a day, using medium-hard brushes unless otherwise recommended by a doctor.
• Use dental floss 1-2 times a day to clean interdental spaces after brushing with a toothbrush.
• To improve oral hygiene, use toothpaste with fluoride concentration of 1000-1500ppm, and consider using an irrigator.
• Eat 5-6 times a day with snacks, and reduce carbohydrate intake.
• Use mouth rinses during vomiting when brushing teeth.
• Regularly undergo preventive check-ups to allow the doctor to see problems at an early stage and assist in resolving them.

Is Treatment Possible During Pregnancy

When answering the frequently asked question by pregnant women about whether it is possible to treat teeth during pregnancy, dentists authoritatively state that they see no obstacles to such procedures during pregnancy. Certainly, this is true if there is an urgent need and a professional approach to solving dental problems during pregnancy. Specialists recommend that women planning to become pregnant should address this issue even before conception occurs and visit a dental office. 

However, if the need arises during pregnancy, it must not be ignored under any circumstances. By postponing treatment indefinitely, a pregnant woman may face serious consequences, ranging from tooth loss to pathologies of the teeth, jawbones, and complex infections. 

What Procedures Are Permissible

Experts believe that it is not only possible but also necessary to treat teeth during pregnancy. Among the dental diseases that should be addressed in this “delicate” condition are ailments such as gum inflammation, cavities, periodontitis, pulpitis, stomatitis, gingivitis, and periodontitis. You should also not delay visiting the dentist and should immediately seek help in case of injury. For example, if there is a chip, root fracture, cracks, or urgent surgical intervention is needed due to a developing abscess, with periostitis, or in other similar cases.

You can also fill teeth without delaying the procedure until after the baby is born. During the filling process, the doctor can use any materials as indicated. The curing lamps used are harmless to the fetus. The dentist numbs all procedures with high-quality medications approved for use during this period.

What procedures need to be postponed 

The threat of miscarriage is the main contraindication for dental treatment during pregnancy. However, there are a number of dental procedures that must be postponed until after the baby is born. Orthodontic treatment is contraindicated. The installation of braces should be delayed, and if they are already installed, treatment continues with increased attention to enamel condition and hygiene. Teeth whitening is prohibited — the contraindication is due to the procedure potentially being aggressive for tooth enamel, which is weakened by pregnancy.

During this period, a large portion of nutrients is used by the female body for the formation and development of the baby. Because of this, many expectant mothers experience a calcium deficiency, leading to reduced strength of the hard dental tissues. Whitening teeth in such enamel conditions means seriously harming their health.

What other taboos exist

It is advisable to avoid tooth extraction during pregnancy unless it is an emergency. This refers to the third molar, impacted or unerupted teeth, if there are no complications or discomfort. The decision to extract a tooth during pregnancy is made in exceptional cases – in the presence of acute pain, inflammatory process, when restoration and adequate treatment are impossible. This happens when preserving the tooth could cause more harm to the health of the mother and child than its removal. 

Computed tomography is also not performed during pregnancy, as ionizing radiation is dangerous for the fetus. You will also have to postpone getting teeth implants. The contraindication is related to the need for CT scans during implantation, extensive surgical intervention with the use of strong anesthetics. A number of local anesthetic drugs and general anesthesia are also excluded.

Dental issues arising during pregnancy

One of the dental problems pregnant women face is toothache, often caused by cavities. In the initial stages, teeth may decay almost painlessly, or the process may be accompanied by mild pain. It is usually noticeable when consuming hot or cold foods or drinks, sweet or sour products, or during tooth brushing. Another cause of pain is increased tooth sensitivity due to the appearance of cracks in the tooth enamel or its thinning. 

Wisdom teeth may cause discomfort due to pulpitis. This issue leads to inflammation of the soft dental tissue where the nerve is located. Pain sensations with wisdom tooth pulpitis occur unexpectedly, radiating pain to the ear or temple. Teeth can also hurt during pregnancy due to periodontitis, when tissue behind the root tip becomes inflamed, causing fistula formation, pain when biting, lip and cheek swelling, and pus discharge.

Tooth Chipping – Causes and Prevention

In addition to experiencing toothache during pregnancy, women may also face another unpleasant problem – teeth starting to chip. 

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This situation may occur due to a deficiency of calcium in the future mother’s body. The fetus is continuously developing, and the mother’s body directs this microelement in large quantities to form the fetus. 

The deficiency is particularly acute during the formation of the future baby’s skeleton. Undoubtedly, a pregnant woman’s teeth also deteriorate because hormonal changes in her body can affect the condition of her teeth. Therefore, to replenish the “reserves” of this important mineral during pregnancy, it is essential to include cheese, cottage cheese, yogurt, and other dairy products in the diet.

Features of Dental Treatment in the 1st Trimester

The choice of treatment methods and how to manage pain relief during dental procedures, if necessary, is largely determined by the timing of these procedures. In the 1st trimester, which lasts up to and including the 12th week, all vital systems of the baby’s body are being developed. The placenta is not fully formed at this stage, so it cannot reliably protect the fetus from external influences. 

The woman’s body is also undergoing significant changes. Any stress, intervention, or medication can negatively affect both the progression of the pregnancy and the child’s health. Therefore, in the 1st trimester, teeth are primarily treated using non-invasive therapeutic methods.

What is allowed and what is not during treatment in the 1st trimester

If a pregnant woman seeks dental care, the dentist, when choosing how to address the issue, focuses not only on the urgency or danger of the situation but also on the first trimester being a special time in pregnancy development. Therefore, the doctor aims to avoid the use of medications, surgical operations, and anesthesia. If procedures are unavoidable, the most gentle treatment methods are used. 

Cavities at an early stage are treated using the ICON technology, with small cavities being filled without anesthesia. Prophylactic measures (professional hygiene) are recommended regardless of the term. Taking into account the patient’s condition, the dentist selects the safest tools and medications for her.

2nd Trimester: Indications, Contraindications

As is known, the 2nd trimester spans from the 13th to the 24th week of pregnancy. It is the safest and most calm period for both the mother and the baby. Development occurs gradually and smoothly. Therefore, patients who need cavity treatment, professional hygiene procedures, or other dental treatments are scheduled for this time. 

This is because a reliable protection for the fetus in the form of a formed placenta has already been created. The pregnant patient’s well-being allows the necessary time to be spent in the dental chair, and the periods of high risk for pregnancy termination are already behind. During this period, all planned procedures are carried out – wisdom teeth are treated, as well as ailments threatening near-future exacerbation, and professional cleaning is performed.

Third Trimester

If a woman experiences toothache during late pregnancy, it is a serious problem because most dental procedures are contraindicated during this period. The period from the 25th week until childbirth, like the first trimester of pregnancy, is a challenging time for the expecting mother. The difficulties are related to the increased sensitivity of the placenta to external influences and the significant stress on the female body. 

The indication for dental treatment during the third trimester is only acute conditions that could significantly harm the health of the baby and the expecting mother. Anesthesia for procedures is not allowed, and enduring pain is contraindicated for pregnant women. Therefore, therapeutic treatments, routine procedures, and operations will need to be postponed until after childbirth. Even if a tooth falls out, restoring the integrity of the dental row will have to wait, and dental implants should be considered after the baby is born.

Home Remedies for Pain Relief

During pregnancy, women often experience tooth decay due to well-known reasons, leading to various levels of pain symptoms. It is important for expectant mothers to care for the safety of the fetus, so it makes sense to use home remedies for toothache, for example:

• “Dental drops” – contain natural substances like peppermint oil, valerian, and camphor. The pain will gradually subside if you apply a cotton ball soaked in this solution to the aching tooth. The product is an excellent sedative and antiseptic.
• Clove powder – if sprinkled on the inflamed gum area, the pain sensations will start to diminish.
• Herbal infusions and decoctions – for preparing rinses, use St. John’s wort, chamomile, calendula, plantain, sage. You can use a simple saline solution. Before use, it’s advisable to slightly warm a small amount of the solution or decoction. It’s necessary to rinse as often as possible.

Non-medication remedies for toothache relief

Moreover, if a pregnant woman has crumbling teeth and experiences periodic pain, the following may help in managing them:

• Houseplants such as pelargonium, aloe, kalanchoe. A piece of the leaf from any of these plants is pressed to the affected area after being peeled to release the juice.
• Garlic – can be used in 2 ways. For the first method, it is recommended to crush a clove of garlic to achieve a mushy consistency, then apply a small amount of this substance to the wrist where the veins are prominent. If the toothache is on the right, the mush is applied to the left wrist; when the pain manifests on the left, apply it to the right. The second method involves applying a piece of garlic directly to the aching gum.

Medications used to relieve toothache

If home remedies have proven ineffective, the bothersome area can be numbed with relatively safe medications. However, it’s still worth getting a doctor’s approval for their use: 

• Children’s gels for toothache – Kamistad, Calgel, Dentol Baby, which dull pain, fight inflammation, and cool the painful area.
• No-shpa – effective in relieving intestinal and stomach spasms, headaches, and toothaches.
• Grippostad – a remedy intended for combating colds, but also works well for toothaches. Contraindicated in the first trimester of pregnancy.
• Paracetamol – you will need to take one whole tablet.
• Pentalgin, Tempalgin – the analgesic effect is achieved by taking half a tablet of either of these remedies.

For very severe toothache, one tablet of Ketanov is permitted.