As I child, my mom told me that the reason she has to wear dentures is because she loose all her teeth during her pregnancy. I have always felt very guilty about costing her teeth. The old wives’ tale which says ‘a tooth lost for every child’ has been ingrained in my mind since my childhood days. In fact, I was surprised to find out that this was not entirely true after I joined the medical profession. Although this saying seems a bit far-fetched, it is actually based loosely in fact. Due to the hormonal changes in pregnancy, the gums and teeth are affected to a certain extent.

Due to the hormonal changes in pregnancy, gum bleeding becomes more common during pregnancy. Inflammation of the gum or gingivitis is common in pregnancy and can be uncomfortable and cause swelling, bleeding, redness or tenderness in the gum tissue. Although it is uncomfortable, it rarely causes any problems. However, a more advanced oral health condition called periodontal disease (a gum infection which destroys the attachment fibres and bones that support and hold teeth in the mouth) may pose a risk to your pregnancy.

Some women crave for sweet food during pregnancy and this can lead to increase risk of tooth cavities. Therefore, it is important to brush and floss your teeth regularly in pregnancy. Visit your dentist regularly before and during pregnancy is important to ensure good dental care and to prevent complications associated with dental diseases.

Studies had shown that periodontal disease can be associated with premature birth and low birth weight babies. One of the possible explanations is that the oral bacteria which caused inflammation of the gum may trigger the release of a hormone called prostaglandin, which in turn may trigger early labour. Other studies have shown that periodontal disease can be associated with low birth weight babies, gestational diabetes mellitus & preeclampsia. Therefore if you have periodontal disease, it is important that you treat the problem before you embark on your pregnancy. If you suffer from periodontal disease during pregnancy, it is important that you see your dentist as quickly as possible. Certain dental procedures such as scaling and root planing may be able to reduce the risk of premature birth. Ask your dentist about it

Certain medication such as paracetamol and acetaminophen is safe throughout pregnancy but the used of non-steroidal anti-inflammatory drugs may not be safe.

If antibiotics are required to treat your toothache, you must indicate to your dentist that you are pregnant. The antibiotics in the Penicillin and Cephalosporin groups are generally safe in pregnancy. The use of Tetracycline should be avoided because it can affect the bones and teeth of a developing baby.

Most dental procedures are safe during pregnancy. The use of local anaesthesia for pain relief during a dental procedure is safe. Some major dental procedure may require the use of general anaesthesia (to render you unconscious during the procedure). Studies had shown that the use of general anaesthesia will not harm your baby. Some practitioners may want to delay the procedure until you are in the second trimester because of the concerns of the effect of general anaesthesia onto the development of the baby’s organs and the risk of miscarriage. However, there is no strong evidence to suggest that general anaesthesia during the first trimester can cause harm or impaired the development of your baby. During the third trimester, due to water retention and swelling of your airway, general anaesthesia may pose difficulties and there is a higher risk of stomach content aspiration due to the enlarging womb which compresses onto your stomach. Therefore, your practitioner may delay the procedure after your delivery.

Routine dental X-rays are usually postponed until after your delivery because of the concern of radiation. However, the actual risk of radiation during a dental X-ray is usually very small. Dental X-ray is targeted to your mouth and is far away from your womb and hence the risk of exposing radiation to your baby is small. Therefore, if you required an X-ray for dental procedures, the benefit may outweigh the risk in some circumstance.

There are a few ways you could further minimized the risk of exposing radiation to your baby during a dental X-ray. Always inform your practitioner that you are pregnant so that he/she could take extra-precaution during an X-ray. A lead apron (abdominal shield) should be used to protect your womb and a collar shield should be used to protect your thyroid.

It is important to brush and floss your teeth regularly in pregnancy. Brushing your tongue at the same time can help to combat bacteria and keep your breath fresh. Brush your teeth after every meal can help to take away the funny taste in your mouth especially during the first trimester. Visit your dentist regularly before and during pregnancy is important to ensure good dental care and to prevent complications associated with dental diseases. You may want to ask your dentist to recommend a mouth rinse to reduce the bacteria and plague.

Although fluoride protects teeth from cavities, there have been some studies to suggest that high concentrate of fluoride in water may cause harm to the developing baby. In 2006, American Dental Association issued an Interim Guidance on Reconstituted Infant Formula and warns that fluoride intake above the recommended level for a child’s age creates a risk of enamel fluorosis in teeth during their development before eruption through the gums. The amount of fluoride recommended for babies under a year old is less than that for older children and adults. In 2006, the Lancet, a reputable medical journal published a review paper which found that high concentration of fluoride may be associated with skeletal abnormalities and IQ deficits. As a general rule, it is best not to take fluoride beyond the small amount added to city water supplies.