Protecting your pregnant patients

Pregnant patients are extremely vulnerable, and practitioners must support them in maintaining a good oral care regime. Huge physical changes, irregular eating habits and fluctuating hormones all make pregnant women susceptible to a host of things, which are detrimental to their dental health, and can have a significant impact on the health of their unborn baby too.

But many expectant mothers worry that dental treatment during pregnancy isn’t safe. As long as dentists are told that their patient is pregnant, however, they can consider all the options available to safely provide an appropriate dental care plan for the entire pregnancy and beyond.

Some procedures are indeed best deferred. The Department of Health still advises pregnant women do not get amalgam fillings replaced until after they have given birth – while (according to a large body of research) foetal risk from amalgam is largely theoretical, most dentists and patients will usually decide together to delay placement and removal of these types of fillings. Similarly, dental X-rays are generally delayed unless there is an overriding clinical need. It is good advice, then, for woman to be advised to visit the dentist before they start trying for a baby, in order that any invasive treatment they need can be completed before they fall pregnant.

So what are the increased risks to oral health that pregnant women may experience? Morning sickness, for example, can be damaging to the surface of the teeth, due to the presence of stomach acid. Any woman suffering from morning sickness should therefore be advised to rinse with water or a non-alcohol based mouthwash.

Inflammation of the gingiva during pregnancy can lead to bleeding gums. Recent pioneering research suggests that gingivitis during pregnancy may be due to high levels of the hormone oestrogen.[1] A study found that the oestrogen found in pregnant women strongly determined their risk of developing gum disease, and in all three trimesters women with higher levels of oestrogen or plaque had more pregnancy-related gingivitis than those with lower levels. Because high oestrogen is found in healthy pregnancies, these results underline the importance of good dental health starting from the prenatal period. 

If gingivitis leads to periodontitis, this can set off a chain of reactions capable of damaging the body’s workings. It may result in a preterm or low birth weight baby and research has shown that women who are successfully treated for their peridontal disease have significantly lower incidence of these outcomes.[2] Aside from being predisposed to a myriad of post-natal complications, pre-term and low birth weight babies are also more likely to encounter heart disease, high blood pressure or diabetes later in life^.[3]

Numerous studies have shown that pregnant women with peridontal disease are more likely to develop gestational diabetes mellitus than those with healthy gingiva. Gestational diabetes can also lead to pre-term delivery, and although the condition usually disappears after the pregnancy has ended, women who develop it have a greater risk of developing type-2 diabetes in later life. Research has also found a link between periodontitis and pre-eclampsia.[4]  This is a rapidly progressing condition that can lead to fatal consequences for both the mother and the unborn child.

Interestingly, at the other end of the scale, peridontal disease has also been linked with poor fertility and it could even delay conception by up to two months.[5] This really does underline the common sense advice for women to add a trip to a dentist to their pre-conception checklist.

Once pregnant, women need to visit their dentist regularly and get advice about how to properly care for their teeth. Gingivitis can be reversed so that it does not proceed to periodontitis if practitioners can encourage their patients to follow good dental care routine, twice daily. If access is a problem, dentists should be making sure their patient knows to take full advantage of free NHS dental care from the start of their pregnancy.

As well as daily brushing, pregnant women should invest in a good toothbrush. For example, the Curaprox Hydrosonic is suitable for people with sensitive gums. With gentle CUREN^® filaments, it offers effective cleaning of the gum line and periodontal pockets. The Hydrosonic is part of a range of complementary products for sensitive patients, including the CS5460 manual brush and the alcohol-free CURASEPT ADS^® mouthwash – all suitable adjuncts to a pregnant patient’s oral care routine.

In conclusion, the huge changes that a woman’s physiology goes through during pregnancy means that dental health may need closer attention at this time. Simple advice to establish a good oral care routine will help to decrease plaque and periodontal pockets, and your pregnant patient will have a lower risk of developing more serious problems that that will affect them and their unborn child.

For more information please call 01480 862084, email This email address is being protected from spambots. You need JavaScript enabled to view it. or visit www.curaprox.co.uk