Pregnancy and Oral Health
Congrats!!
You’re about to become a Mama!
Read this blog to learn just how to navigate oral health during and after pregnancy
Pregnancy was one of the most amazing, yet challenging chapters of my life. It was accompanied by excitement, but also confusion and anxiety about what to expect and how to best care for my body and child. I hope that this blog can be read and shared amongst other pregnant women to help ease some of the anxieties around oral health care during pregnancy and that you gain the proper knowledge on how to best care for your oral health during this time and even after birth.
As you probably know by now, pregnancy is a time of significant change in a woman’s body, and oral health is no exception. The hormonal fluctuations during pregnancy can profoundly impact the mouth, leading to a variety of symptoms and conditions that require meticulous care by yourself and your oral health care team. Understanding these changes and maintaining good oral hygiene can help ensure a healthy pregnancy and overall well-being for both mama and baby!
Is it safe to get your teeth cleaned while pregnant?
The answer is yes and you absolutely should! I often recommend that my pregnant patients come in for an extra cleaning during pregnancy— depending on their oral health status and how soon their delivery date is. As you’ll read later in this blog post, your body goes through a lot of hormonal changes and it is highly recommended that you have a dental professional evaluate your oral health during this precious time.
You may see a dental office for a cleaning during any time of your pregnancy, although it is said that the 2nd trimester is most preferred. Radiographs (X-rays) will not be taken during this time, and some treatments may be postponed until after baby has arrived, depending on symptoms and/or infection status. If you have a hard time laying down with the pressure of the baby, you may request a pillow to prop you to one side and can ask for breaks in between your appointment, if necessary. This may be a reason to come in for your dental cleaning before the 3rd trimester, to avoid being super uncomfortable in the chair. Oh and remember- you’ll have to pee a lot more!
Feel free to use this appointment as an opportunity to ask questions and get feedback on the status of your oral health and what you can do to better care for and maintain the health of your gums— for yourself and for your baby.
After baby is here, you should get a cleaning and check up within approximately 4 months, to ensure that your oral health is in tip-top shape, or to get instructions on how to get it back to being in better condition.
Are there weird things that can happen in my mouth during pregnancy?
Yes, but this is not meant to scare you- but rather inform you. One of the most common oral health symptoms that I see in my pregnant patients is pregnancy gingivitis. This condition is characterized by swollen (puffy), red and tender gums that may bleed when brushing or flossing. The increased levels of progesterone and estrogen can enhance the blood flow to the gum tissues, making them more susceptible to irritation and inflammation from plaque and food debris. It is crucial to maintain diligent home care (brushing twice a day and properly flossing at least once a day) and is often recommended to get dental cleanings every 4 months during and sometimes after pregnancy to prevent and heal pregnancy gingivitis.
Another prevalent oral health issue during pregnancy, although I have not yet seen this with a patient personally, is the development of pregnancy tumors— clinically known as pyogenic granulomas. These benign growths typically appear on the gums and can be uncomfortable and cause difficulty in speaking or eating. Although they are non-cancerous and often resolve after birth, they can be alarming and may require professional treatment if they interfere with your daily life. Again, maintaining optimal oral hygiene routines at home can significantly reduce your risk of developing such tumors.
Nausea and Vomiting During pregnancy:
Many women experience nausea and vomiting during their pregnancies. For some, it may only last through the 1st trimester, for others unfortunately— it can be something they battle their entire pregnancy.
Regardless of how often it occurs, I’m pretty sure we can all agree that it straight up sucks.
If you find that you are experiencing these symptoms, I have a few things I would like you to know…
First off, you are not alone. I experienced this in my 1st and a little bit of my second trimesters for both kids (if I remember correctly)… it will come to an end… eventually!! Hang in there!
If you find that you are vomiting, an oral hygiene tip that we give to our patients is to avoid brushing your teeth right after. I know, I know- It’s what feels natural- but it actually just spreads the acidity around and can cause damage to the teeth. This damage is called acid erosion and for some people that deal with excessive vomiting and acid exposure to the teeth, it can be visibly noticeable by dental professionals. It can lead to weakened teeth, an increased in decay (cavities), a higher chance of breaks, chips and cracks and may be visible on the front side of the teeth as well.
Above is a photo of acid erosion on the back side of the teeth. Commonly found on patients that suffer from excessive vomiting during pregnancy and bulimia (an eating disorder that involves self induced vomiting).What you want to do instead is to swish around with water after vomiting. The main goal (for most people) after vomiting is really just to get the bad taste out of your mouth… and water rinses are effective in doing so. This also helps neutralize your mouth. After swishing with the water and rinsing a few times, if you find that you can tolerate drinking some water- then do it!
At about 30 minutes after vomiting, you can proceed with brushing your teeth. This is actually the recommendation we make to anyone after highly acidic foods or drinks- even after coffee consumption.
Parent Tips for when Baby is here:
As hard as it is- TRY YOUR BEST to not kiss your baby on the lips. They even recommend avoiding the face when possible, but even I had a hard time with that. THEY ARE JUST SO SQUISHY AND KISSABLE!! The goal is to reduce the bacteria that is transferred from you to your baby. Yes, they will receive the bacteria from your mouth when you kiss them. This includes the bacteria that causes cavities.
Ehh, this is also a good time time mention that although we see this on TV and probably see it out and about among other families- USING YOUR MOUTH to clean your baby bottle and/or pacifier after it has dropped on the ground or even just to hold it, is NOT A GOOD IDEA. (I had to really train my husband to stop this behavior!!) I know it does not seem like a big deal, but your bacteria is very different than the bacteria your baby has and their immune system is nothing compared to yours. So trust me- just don’t do it!
Proper Oral Hygiene (during AND not during pregnancy):
What do I mean by “proper oral hygiene”? Well, most would say “brushing twice a day and flossing daily”, but it’s not just how often you clean your mouth, but what you are doing and how you are doing it each time. Don’t feel bad if you don’t know how to do any of these steps. I truthfully did not know a lot of this before dental hygiene school. And I’m too embarrassed to admit some of the things that I thought were okay to do before I knew better. So with that said- let’s break down the ideal oral hygiene routine (In just 3 easy steps!)
Mouthwash: OK… truth be told- this is really not necessary for most people. The exception is if it has been recommended or prescribed to you by a health care or dental professional for a specific reason. Some people just like the way it makes their mouth taste or feel, but in all reality, there are some mouthwashes that can actually end up causing stain or even acid damage and decay if used excessively. If you choose to use a mouthwash during your oral health care routine, I would suggest using an antiseptic mouthwash and using it before brushing and flossing. To be clear, I would not consider mouthwash to be one of the steps in your daily hygiene routine.
The 3 steps are as follows:
Brushing, Flossing and Tongue Scraping
Step 1 or 2: Brushing
For those of you that choose not to use mouthwash to start, you may want to proceed with brushing. The standard is to brush twice a day for two minutes at a time. Now, I get asked a lot if you should brush or floss first. The answer is: IT DOES NOT MATTER. Some dental professionals will suggest brushing first, some will suggest flossing first. This is usually just a preference that often varies from person to person. There has been research that proves the benefits of each variation, so I personally don’t mind which one you start with- I just care that you do both. I will talk more about flossing in the “Flossing” bullet point below .
Let’s talk Toothbrushes:
Before I chat about electric vs manual toothbrushes, I will say that each have been considered effective in the removal of plaque. However, it truly has everything to do with how you use them and how often you use them.
Electric toothbrushes: Most people can benefit from an electric toothbrush. If you haven’t tried one or don’t know where to start when selecting one, I do have a few products linked here that I or my fellow colleagues and friends do recommend. There are truly so many options out there (My personal favorite is this Oral B Electric Toothbrush). I honestly don’t feel that everyone needs the very top of the line model, but I often receive negative feedback about cheaper options that did not last long or that I feel are less effective at helping the patient maintain optimal oral health. So the products that I have linked are what I believe to be pretty good “middle of the line” products that I don’t feel are waaaaaay too expensive, but rather a good investment.
Some benefits of using an electric toothbrush:
Easier to use (once you get the hang of it).
Less motions required by you (which is great for people with poor dexterity or injuries that result in making toothbrushing difficult)
Most electric toothbrushes have a timer built in so that you know when your two minutes is up. They usually beep or pause motions every 30 seconds so that you know when to swap to a new area. (You have 4 sections of your mouth. You should spend 30 seconds on each of those 4 sections, which equals the 2 minutes).
Less waste: when it’s time for a new toothbrush head, you just have to replace the top portion, rather than the entire toothbrush handle.
Most electric toothbrushes will either stop or light up when you are brushing too hard, which will help you learn the proper pressure to use when brushing your teeth. This is important, since brushing too hard results in gum recession and increased tooth sensitivity over time.
Manual Toothbrush: If you prefer a manual toothbrush, be sure that it is labeled as a “soft” or “ultra soft” brush. They make “medium” and “firm” bristles too, but I am convinced that those are only intended to be used for scrubbing the grout of your tile at home. These bristles are far too harsh for your gums and can lead to the break down and recession of your healthy gum tissue that surrounds the teeth. This will eventually lead to increased sensitivity and quite possibly the need for gum surgery down the line. So trust me when I stress the importance of using a soft or ultra soft toothbrush.
Step 1 or 2: Flossing
What to use: I highly recommend string floss for my patients (video demonstration coming soon). I know floss picks are much easier for most people to use, but these typically only reach down to the top of the gumline. The bacteria travels down underneath the gumline, which is why string floss should be used to properly reach it. The floss picks are not a bad idea to use if your main goal is trying to get a piece of food out from between your teeth. Even I use them from time to time, but the little tiny, tight piece of floss does not allow you to wrap it around the tooth to reach far down enough to properly disrupt the bacteria and clean what’s called the “pocket” (between your gums and your teeth), so they are not a great option for everyday use, nor should it be the only thing you are using to clean between your teeth.
Can I use anything else other than floss?
I often recommend a Waterpik water flosser to my patients. However, I DO NOT believe it replaces the need for flossing entirely. I think that this is a great tool for people to add to their home care routine. The only times that I recommend that this be used instead of floss is if I just know there’s no chance my patient will floss with regular floss, if dexterity is an issue (often from injury or in my elderly patients) or if flossing an area is just not possible (usually from a bridge or wires placed in the mouth for orthodontic purposes or post ortho retainer wires). If you feel you need something more than floss, there are some added tools you can use. I typically recommend things like proxabrushes or soft picks to patients that have spaces in between their teeth that seem to collect excess food and debris. These are also great options for people that have bridges, crowns or braces.
How often?: It is ideal to floss every day, just before bed. At the end of the day, your mouth has been exposed to so much. There is food debris that’s wedged between your teeth and gums and it needs to be removed to avoid irritation in your gums and cavities in your teeth. When you go to sleep, your saliva also goes to sleep. The saliva is what helps fight off the bacteria and helps to keep your mouth clean. When your saliva is at rest, there is no defense against the bacteria and acids in the mouth. Which is why it is so important to reduce the amount of bacteria in the mouth before you go to sleep each night.
For my patients that just won’t floss daily, I always suggest that they start out with a minimum of 3 times a week. Please note that this is still less that ideal, but it’s a start. I often tell them to look at their weekly routine and select three days that they can commit to flossing before bed. For example, if a college student has evening classes on Tuesday and Thursdays and they are too tired by the time they get home, I will suggest that they choose Monday, Wednesday and Friday for their complete oral hygiene routine (which includes flossing). If they missed on Wednesday for whatever reason, make up for it that following day. Sometimes little post it notes on the mirror can help remind and motivate you to spend the extra few minutes before bed. Trust me- it will pay off in the long run!
Should I floss before or after brushing? This is up to you! Research shows benefits of each. All that I really care about is that you perform both! I personally floss after brushing, but that’s me. You do you!
Step 3: Tongue Scraping
I personally think that everyone should at least own a tongue scraper. You may not feel the need to use it every single day, but the amount of bacteria that sits on your tongue every day is a lot. Some patients come in with a thick, white coating on their tongue. I for sure would recommend that this type of patient use one daily at the end of their oral hygiene routine. For those of you that don’t seem to struggle with this, I would say a few times a week would be good.
What do I use to scrape my tongue?
There are several products out there that you can use. I have linked some below:
Breath Rx Tongue Scraper: My personal favorite. Easy to clean, easy to use!
How do I scrape my tongue?
Believe it or not, there is a right way to scrape your tongue. First off, make sure you do this step last. You will want to lean forward over the sink, and allow the water to run slightly so that you can rinse your tongue scraper between scrapes.
Start by sticking your tongue out as far as it will go and then place the tongue scraper as far back as your gag reflex will allow. Press lightly against the tongue with the tongue scraper and scrape toward the tip of your tongue. The yucky stuff will fall into the sink and also stick to your tongue scraper. Lift the tongue scraper and rinse under water. If you have a strong gag reflex and this is not possible, I suggest pouring some flavored mouth rinse on your tongue scraper to help distract your tongue from what is going on. The key is to make sure that you are scraping in a downward motion, allowing the gross layer of bacteria to fall out of your mouth and not just brushing your tongue back and forth- which is just spreading the bacteria.
In conclusion:
Although this was a lot of information, I hope that you found it somewhat useful! If you have any questions or concerns about anything going on inside your own mouth while pregnant, feel free to reach out to me on my social media page @mamacleansteeth .
I am so excited for you to embark on this journey- hang in there mama and congratulations!
NOT dental related but a recommendation for expecting parents:
Photo of mentioned website logo for reference. Click on logo above to access the direct website.
When I was pregnant with my first daughter, it was during the start of the 2020 pandemic. As you may remember, everything that used to be done in person, quickly turned to online. This included our parenting classes that we had planned to attend. However, my hospital did not seem to have a ton of material available online, since they instructed us to go in person and was not prepared for this sudden change. This caused so much stress and anxiety for me, feeling like I was about to be thrown to the wolves— I was not equipped to parent a newborn! Sure, I’m great with kids, but having a newborn is a different beast!! And I wanted to feel prepared! So I started asking around and doing my own research. We ended up using what I believe to be an amazing online course and I recommend this over and over again.
We purchased two courses, the newborn-5 months and the next one through to 24 months, but if I’m being honest, we were too busy to watch the second portion when our child reached that age, and by then— we felt like we got the hang of it. Feel free to check it out, do your own research and purchase whichever classes you feel are right for you!
I also just learned that she offers other courses, such as toddler sleep training and more!! (which I am for sure in need of right about now)
Cara is a pediatric nurse and mother, and she just does an amazing job teaching newbies the ropes of parenting in the beginning stages of life.
Here is her website (click photo below to access direct link): www.takingcarababies.com