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1. Pregnancy and Oral Health

Contributed by:

Dr. Wong Foot Meow


Changes in Pregnancy

Having a baby is a happy event. However every part of a women's body is affected by pregnancy including the teeth and gums. Changes in a women's body especially hormonal changes may affect her oral health as the altered level of hormones ( oestrogens and progesterones ) may make it easier for bacteria to grow which can lead to gum problems. Many women and their dentists have reported this connection for years. More research is needed to explain what exactly is going on but there is little dispute that some women's oral health suffers during menstruations, in pregnancy, menopause and oral contraceptive use. The old wives tale of "losing a tooth per pregnancy" does not hold because with proper care and attention, a women can maintain a healthy dentition for a lifetime.

Dental Health and Pregnancy

Apart from other bodily changes directly related to pregnancy, 60 to 75% of pregnant women will experience increased gingivitis, beginning in the second or third month of pregnancy, which increases in severity through the eight months and begins to decrease in the ninth month. This condition known as pregnancy gingivitis is characterized by swelling, bleeding and redness in the gum in response to only small amounts of plaque or calculus. In addition the pyogenic granuloma ( pregnancy epulis or pregnancy tumour ) of pregnancy is well recognised. There are growths at the gum margins which sometimes enlarge to substantial size and bleeds easily on trauma necessitating surgical removal.

Morning sickness, food cravings and general malaise during the first Trimester can result in poor oral health resulting in fresh caries in certain susceptible teeth.

Pregnancy - related oral care problems can be prevented or controlled by good oral hygiene habits. Notify your dentist when you find out that you are pregnant because the dentist may schedule more frequent cleanings, reinforce brushing and flossing habits or recommend products like oral irrigation or mouth rinses that will help ensure you are getting a good cleaning at home.

It is advisable to reschedule any elective medical or dental treatment during the first trimester of pregnancy where the body systems and organs of the foetus is starting to form. To protect you and the foetus from unnecessary drugs or x-rays, your dentist can schedule elective procedures during the second trimester where the foetus is less vulnerable ( and you are likely to be more comfortable ) than in the late stages of pregnancy. Should there be a history of miscarriage it may be advisable to delay treatment ( within reason ) until after you deliver.

If there's an emergency, dental X-rays are permissible because of the low doses of radiation used. Wearing a lead apron will further insulate the baby from exposure. Request your dentist to use ass little local anaesthetic as possible to limit the foetus exposure to chemical and to substitute safer alternative drugs known to be detrimental to the developing foetus.

Studies have shown that a mother-to-be's nutrition is important to the baby's oral and facial development. A pregnant women's diet should include sufficient amounts of nutrients especially Vitamin A, C and D with Calcium, Phosphorus and the recommended amount of protein. This is taken over and above a normal balanced diet with plenty of fruits, vegetables and fibre.

A recent study indicated that gum infections in a pregnant woman may lead to a seven fold increase in the risk of delivering a premature low birth weight baby. There is a suggestion that untreated periodontal disease may account for a large number of unexplained premature deliveries.

Tip Top Tooth Care

Most patient with neglected mouths including some pregnant women blame their poor oral condition with the following common excuses.

  1. I don't have time for the whole brush-and-floss routine.
  2. My mouth hurts when I brush.
  3. I am too embarrassed to brush in publish rest room after lunch. Flossing hurts and is too awkward for me.
  4. The taste of toothpaste turns my stomach.
  5. I don't feel well and I have jaw pain that prevents me from opening wide enough to floss and brush my back teeth. Please see your dentist who will resolve all these issues in no time at all.

Food for Healthy Teeth

Some food can boost your dental health and help prevent tooth decay, gum disease and other problems. Eating more of the following foods cannot substitute for daily brushing and flossing plus your annual visit to the dentist but they can certainly help to keep your mouth healthy.

  1. Crisp juicy apple or other raw crunchy fruits and vegetables.
  2. Spicy edibles that make your mouth water e.g.. chillies.
  3. Carrots which are rich in beta carotene.
  4. Plain non fat yoghurt - rich in calcium for healthy bones and teeth.
  5. Low fat cheese after a sugary snack. These products can neutralize cavity causing acids.

Food for Healthy Teeth

Over and above the recommendations made earlier, remember the following for an uneventful pregnancy.

  • Balanced diet with plenty of fibre, low calories and low fat regime.
  • Brush your teeth twice a day.
  • Floss after every meal.
  • Visit your dentist annually.


Malaysian Dental Association shall ensure that the collection, use and disclosure of your personal data is consistent with the Malaysian Personal Data Protection Act 2010 ( 'PDPA' ). It is acknowledged that personal data collected and processed is obtained voluntarily and with your consent.

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