True or false? It’s perfectly safe to visit your dentist while pregnant.
If you answered false, you’re wrong — but you’re not alone. According to a recent US survey, most women received no routine dental care during their pregnancies, and half of moms-to-be with obvious dental problems, like pain, didn’t seek care because they believed that having oral health problems during pregnancy is normal, or that dental treatment could harm the baby.
That’s something Jan a patient can understand. “My midwife told me that healthy gums lead to a healthy baby, and that gum disease and not caring for your teeth can lead to prematurity,” she says. Still, the first-time mom-to-be was reluctant to use freezing when a checkup during her second trimester revealed she needed a filling. “My fear was it might harm the baby’s brain development,” she says. “There are some conditions, like autism, where the causes are unclear. I wanted to stay away from any unknowns,” she says. Jan was also concerned that her anxiety during dental procedures might trigger a different problem:preterm labour.
But routine dental care — including brushing, flossing and professional cleaning — actually protects against preterm labour by helping prevent periodontal (gum) disease, which is linked to an increased risk of low birth weight and premature birth. One theory is that the low-grade infection and inflammation of the tissues surrounding the teeth set off an immune response that can hinder your baby’s growth and ultimately convince your body that the baby would be better off being born. Even if you have healthy gums, pregnancy can set the stage for periodontal disease and cavity formation. Hormonal changes and increased blood volume soften gum tissue, giving bacteria easier access. Morning sickness can compound the problem, eroding enamel and hastening decay. (Swish with water after vomiting to rinse away stomach acids.)
What’s less clear is whether treating established gum disease during pregnancy can reduce these risks, though a preliminary study found that rinsing for thirty seconds twice a day with an alcohol-free mouthwash seemed to reduce the chances of giving birth before 35 weeks from one in five to one in 20. Harinder Sandhu, director of the Schulich School of Medicine & Dentistry at Western University in London, Ont., emphasizes that treatment for gum disease is vital, even if there’s no hard proof it minimizes the risks. “If care isn’t instituted, progression is much quicker and more severe,” he says.
While it’s probably best to put off elective procedures, such as teeth whitening, until after your baby’s arrival, “If a woman needs treatment, including X-rays, freezing and filling, it’s safe to carry that out any time during pregnancy,” stresses Euan Swan, manager of dental programs at the Canadian Dental Association. Local anaesthetic, for example, usually doesn’t even reach the baby, according to Douglas M. Black, past president of the Society of Obstetricians and Gynaecologists of Canada. For comfort’s sake, you may want to schedule any non-emergency procedures between 14 to 20 weeks — after morning sickness has passed for most, and before the baby is big enough to make it uncomfortable to lie on your back.
That’s when Jan had her tooth repaired. And thanks to a shallow cavity and an understanding dentist, she was still able to forego the freezing, which gave her peace of mind. It wasn’t easy — Jan has a bit of dentist-phobia to begin with — but she knew about the link between oral health and her baby’s well-being, and let that guide her decision.
TIP: Oral health is now considered so important to a healthy pregnancy that the American College of Obstetricians and Gynecologists recommends an oral exam be included in the first prenatal visit and that caregivers advise expectant moms to see a dentist.
Toothaches and pain can occur for a number of reasons. When tooth pain is accompanied by sensitivity to hot or cold food or drink, intense or persistent pain, discomfort when applying pressure, an abscess and/or fever you may need a root canal. An endodontist or dentist can properly diagnose you and recommend treatment. However, tooth pain can occur for reasons other than the need for a root canal. Some of the more common causes of toothaches include:
1. Cavities and Tooth Decay
Tooth decay is caused when foods containing sugars (or carbohydrates, which are also sugars) are left on the tooth. Bacteria in the mouth turn these sugars into acid which erode the teeth and ultimately cause a cavity to be formed. If the cavity is not treated in a timely manner it can decay to the point of requiring a root canal.
Symptoms of cavities/tooth decay include: tooth pain and/or sensitivity, mild to severe pain when eating or drinking things that are sweet, hot or cold, pain when biting down, visible holes in your teeth and/or pus around the tooth in pain.
2. Cracked or Fractured Tooth
A tooth fracture can occur with varying levels of severity. A tooth can be fractured only on the outer layer, it can be fractured on the outer and inner layers, or it can be fractured on the outer layer, inner layer and the pulp, also known as the nerve of the tooth. The latter is considered the most severe and could require a root canal.
Symptoms of a cracked or fractured tooth include: pain when chewing or when applying pressure and sensitivity/pain when eating or drinking hot or cold things. With a cracked or fractured tooth the pain may be intermittent, and at times it is even difficult to properly identify them on x-rays.\
3. Grinding Teeth
Many people occasionally grind or clench their teeth. At times people do this as a result of stress, but sometimes it is a result of poor teeth alignment or missing teeth. If teeth grinding occurs too frequently it can damage teeth and cause other health problems.
Most frequently, teeth grinding occurs while people sleep, so it can be difficult to diagnose. However, common symptoms include: a constant headache or a sore jaw, especially in the morning.
4. Gum Disease
Gum disease is an infection of tissues around the tooth. There are two types of gum disease. Gingivitis is an infection which only impacts the gums around the tooth. Periodontitis is a more severe form of gum disease as it spreads and impacts the tissues and bone below the gums.
Symptoms of gum disease include: Gums that bleed easily when brushed or without clear reason, swollen gums, gums that pull away from teeth, pus coming from the gums, a change in your bite, bad breath and/or loose teeth.
Dr. James L. Johnson