Dental advice during pregnancy

When you are pregnant, your body undergoes a series of temporary changes throughout your entire system, including in your mouth.

And because these changes can lead to dental conditions such as gingivitis during pregnancy or periodontal disease, it is important to pay particular attention to dental hygiene, as well as to visiting the dentist, which should not be avoided during this period. 

In this article, we offer a series of dental tips for pregnant women to help maintain good oral health during pregnancy and after childbirth.

Contrary to the myths circulating online, visiting the dentist is extremely important during pregnancy.

The hormonal changes that occur over the course of the nine months of pregnancy can also affect dental health. Close monitoring and proper care are essential for several reasons.

The impact of increased hormone levels

“Rising levels of progesterone and oestrogen, combined with circulating bacteria and local irritants, can lead to the development of pregnancy granuloma or pregnancy epulis in around 5% of pregnant women. Pregnancy epulis is a small, soft, reddish or purplish growth that usually appears on the gum between the teeth. “It is not cancerous and is not dangerous, but it may bleed slightly when brushed or when chewing,” explains Dr Marina Băjinaru, Specialist in Oral and Maxillofacial Surgery at DENT ESTET clinics.

Furthermore, hormonal changes can exacerbate the gums’ inflammatory response to bacterial plaque, promoting the development of pregnancy gingivitis, characterised by gum bleeding and inflammation. Additionally, the periodontal ligament apparatus may be temporarily affected, which can lead to mild, temporary tooth mobility. In most cases, these changes are reversible after childbirth, provided there are no pre-existing, untreated gum or periodontal conditions.

The importance of scaling and regular check-ups

During pregnancy, regular dental check-ups and professional scaling are essential for maintaining oral health. Removing bacterial plaque and tartar reduces gum inflammation and prevents existing problems from worsening.

Contrary to common fears, scaling is a safe procedure during pregnancy and helps maintain a healthy oral environment for both the mother and the foetus. Regular monitoring allows for the early identification of any problems and minimally invasive intervention before they progress.

Preventing oral problems can reduce the risk of obstetric complications

Studies show that there is a link between untreated oral infections, particularly periodontal disease, and an increased risk of obstetric complications, such as preterm birth or low birth weight.

Chronic inflammation and bacteria in the oral cavity can have a systemic effect on the body, which is why the prevention and timely treatment of gum disease are important not only for dental health but also for the normal progression of pregnancy.

Ideally, a comprehensive oral health assessment should be carried out before pregnancy, so that any dental problems can be treated in good time. In practice, however, this does not always happen, which is why it is essential for expectant mothers to know which dental procedures can be safely carried out during pregnancy.

Specialists emphasise that dental treatments can be carried out in any trimester, when necessary. However, the period considered optimal for planned procedures is the second trimester, particularly between weeks 14 and 20, when risks are minimal and the patient’s comfort is greater.

There are no medical recommendations requiring simple dental treatments to be postponed until after childbirth. On the contrary, timely treatment of oral problems is important, as conditions such as periodontal disease have been associated, in some studies, with an increased risk of obstetric complications, including preterm birth or pre-eclampsia.

Ideally, any non-urgent dental procedure should be postponed until after the birth or scheduled for the second trimester, when organogenesis is complete and the risks are lower.

“Oral surgery performed in the third trimester is generally avoided, as the stress associated with a complex procedure may increase the risk of premature labour. Furthermore, during the last two months of pregnancy, prolonged horizontal positioning in the dental chair is not recommended, as it may compress the vena cava and cause a drop in blood pressure (hypotension), leading to dizziness or feeling unwell,” explains Dr. Marina Băjinaru.

For this reason, any treatment is carefully planned, taking into account both the patient’s dental needs and the safety of the pregnancy.

One of the most common concerns among pregnant women relates to the use of local anaesthesia during dental treatment. According to the classification established by the FDA (Food and Drug Administration), local anaesthetics are generally considered safe during pregnancy, provided they are administered at the minimum effective dose.

Lidocaine, the most commonly used local anaesthetic in dentistry, is classified as Category B, meaning that no adverse effects on the foetus have been observed in available studies. 

Other anaesthetic substances fall into Class C and are used with greater caution, as there is a potential risk, including that of foetal bradycardia.

Adrenaline is not associated with foetal abnormalities and is considered safe when used in low concentrations (maximum 1:200,000), whilst noradrenaline should be administered with caution, using the lowest effective dose.

Pregnancy gingivitis

Inflammatory changes in the gums occur in response to the build-up of bacterial plaque, compounded by hormonal imbalances and vascular changes specific to pregnancy. The gums become more sensitive, inflame more easily and may bleed when brushed.
The good news is that severe inflammation can be prevented: if the patient had good periodontal health before pregnancy and maintains rigorous control of bacterial plaque throughout pregnancy, the risk of complications is significantly reduced.

Pregnancy granuloma (epulis gravidarum)

This refers to an increase in the volume of the interdental papilla, the gum tissue between the teeth. It is a benign inflammatory lesion, painless in most cases, which usually appears in the second trimester and tends to resolve spontaneously after childbirth. It does not require emergency treatment, but should be monitored regularly by a dentist.

Dental erosions

These occur as a result of frequent morning sickness in the first trimester, when gastric acid repeatedly comes into contact with the surface of the teeth. Erosion particularly affects the oral surface of the teeth, which is exposed to contact with gastric acid.

“An important detail that many pregnant women are unaware of: after an episode of vomiting, brushing immediately does more harm than good. Stomach acid temporarily softens the enamel, and if we use a toothbrush at this point, we are effectively rubbing the acid into the already weakened layer, accelerating wear and increasing tooth sensitivity. The recommendation is to rinse your mouth with water or a bicarbonate of soda solution and wait at least an hour before brushing. This limits enamel damage caused by the combination of chemical and mechanical trauma,” explains Dr. Marina Băjinaru, Specialist in Oral and Maxillofacial Surgery at DENT ESTET clinics.
 

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