One way to prevent cavities in young children is to improve pregnant women’s oral health. Pregnancy may make women more prone to periodontal (gum) disease and cavities. Oral health may be considered an important part of prenatal care, given that poor oral health during pregnancy can lead to poor health outcomes for the mother and baby.

Pregnancy and Periodontal Disease

Nearly 60 to 75% of pregnant women have gingivitis, an early stage of periodontal disease that occurs when the gums become red and swollen from inflammation that may be aggravated by changing hormones during pregnancy. If gingivitis is not treated, the bone that supports the teeth can be lost, and the gums can become infected. Teeth with little bone support can become loose and may eventually have to be extracted. Periodontitis has also been associated with poor pregnancy outcomes, including preterm birth and low birth weight. However, how periodontitis may lead to adverse pregnancy outcomes is not yet fully understood.

Pregnancy and Dental Cavities

Pregnant women may also be at risk for cavities due to changes in behaviors, such as eating habits. Women who have a lot of cavity-causing bacteria during pregnancy and after delivery could transmit these bacteria from their mouth to the mouth of their baby. Early contact with these bacteria and to other sugars, such as from frequent snacking or taking a bottle to bed, can lead to early childhood cavities and the need for extensive dental care at a young age.

• 1 in 4 women of childbearing age have untreated cavities.
• Children of mothers who have high levels of untreated cavities or tooth loss are more than 3 times more likely to have cavities as a child.
• Children with poor oral health status are nearly 3 times more likely to miss school because of dental pain.

Pregnancy can make brushing difficult. Some women experience nausea from strongly flavored toothpastes. Switching to a neutral-flavored toothpaste may help.

During pregnancy, your hormone levels also go up and down. This raises your risk for several oral health problems:

• Severe gum disease (periodontitis). Changing hormone levels during pregnancy can make gum disease worse or lead to severe gum disease in as many as 2 in 5 pregnant women. Periodontitis is an infection of the tissues that hold your teeth in place. It's usually caused by not brushing and flossing, or brushing and flossing in a way that allows plaque — a sticky film of bacteria — to build up on the teeth and harden. Periodontitis can cause sore, bleeding gums, painful chewing, and tooth loss. Women who do not get regular dental care and women who smoke are more likely to have periodontitis.
• Loose teeth. The tissue supporting your teeth may loosen during pregnancy since many of your joints and tissues loosen in preparation for childbirth. Taking good care of your mouth can help prevent tooth loss.
• Wearing down of your tooth enamel. If you have morning sickness that causes vomiting, the stomach acid that comes up during vomiting can erode tooth enamel (the hard, protective coating on the outside of your teeth). Heartburn, another common pregnancy discomfort, can also wear down your tooth enamel over time if stomach acid is coming up into your throat and mouth. To prevent this erosion, the American Dental Association recommends rinsing your mouth with 1 teaspoon of baking soda mixed in a cup of water 30 minutes before brushing your teeth.

Yes. You need to continue your regular dentist visits to help protect your teeth during pregnancy.

• Tell your doctor you are pregnant. Because you are pregnant, your dentist might not take routine x-rays. But the health risk to your unborn baby is very small. If you need emergency treatment or specific dental x-rays to treat a serious problem, your doctor can take extra care to protect your baby.
• Schedule your dental exam early in your pregnancy. After your 20th week of pregnancy, you may be uncomfortable sitting in a dental chair.
• Have all needed dental treatments. If you avoid treatment, you may risk your own health and your baby's health.

Taking care of your mouth while you are pregnant is important for you and your baby. Getting oral health care, including cleanings, X-rays, fillings, and pain medication, is safe when you are pregnant.

Also, brushing twice a day with fluoride toothpaste, drinking water throughout the day, and eating nutritious foods will help keep you and your baby healthy.

Tips for getting oral health care:

• If your last dental visit was more than six months ago or if you have an oral health problem or concern, make an appointment as soon as possible.
• Getting oral health care during the second trimester is best. During the first trimester, you might have morning sickness. And during the third trimester it can be uncomfortable to lie on your back in the dental chair.
• Tell the dental clinic staff that you are pregnant and your due date. This information will help them provide the best care and keep you comfortable.
• Tell the staff about any changes in your teeth or gums. Also tell them about all medications, including vitamin and mineral supplements, that you are taking.
• Talk with the staff about any concerns or worries you have about getting oral health care.
• Talk to your doctor or your Head Start program staff if you need help getting oral health care or making an appointment.

Taking good care of your oral health is important for you and your baby. It is safe and important to get oral health care when you are pregnant. Practicing good oral hygiene, eating healthy foods, and getting oral health care will help keep you and your baby healthy.

Tips for keeping your mouth and teeth healthy when you are pregnant:

• Eat healthy foods, like whole-grain products; fruits; vegetables; and lowfat milk, cheese, cottage cheese, and unsweetened yogurt. Meats, fish, chicken, eggs, beans, and nuts are also good choices.
• Drink water, especially between meals and snacks. Drink tap water that has fluoride.
• Eat healthy snacks, like fruits; vegetables; and low-fat milk, cheese, cottage cheese, and unsweetened yogurt.
• Eat fewer sweets like candy, cookies, cake, and dried fruits. Drink fewer sugary drinks like fruit-flavored drinks, pop (soda), and fruit juice. If you eat sweets or drink sugary drinks, have them only at mealtimes.
• Brush your teeth with a soft toothbrush and fluoride toothpaste twice a day, after breakfast and before bed. Do not rinse after brushing. The small amount of toothpaste that stays in your mouth is good for the teeth.
• Floss once a day before bed.
• Rinse every night with an over-the-counter alcohol-free mouthrinse with fluoride.
• If you vomit, rinse your mouth with a teaspoon of baking soda in a cup of water. This helps prevent damage to your teeth.
• Get oral health care. If your last dental visit took place more than 6 months ago or if you have any oral health problems or concerns, schedule a dental appointment as soon as possible.
• Tell the dental clinic that you are pregnant and your due date. This information will help staff provide the best care for you.

There are many myths about dental health and pregnancy. Although you have a lot to think about during this time, oral health is important during pregnancy and should not be neglected.

The following facts are true and will help to improve your dental health during your pregnancy!

• Nutrition is very important during pregnancy because your baby gets nutrients from your system. By eating right, you can start caring for your baby’s teeth as soon as you find out you are pregnant. Be sure to include foods with calcium and vitamin D in your diet. Your doctor can give you information to help you eat well during pregnancy.
• Some women have dental problems during pregnancy. Hormonal changes can make your gums sore, swollen and bleeding. This can be prevented by brushing and flossing your teeth daily. If you did not have your teeth cleaned before you found out that you were pregnant, having your teeth cleaned by a dental hygienist or dentist early in your pregnancy may help prevent most gum problems.
• Some women develop a “pregnancy tumor” on their gums. This is a painless bump on your gums that can be pink, red or purple. It will usually not cause any problems, but care should be taken to keep the area around the tumor clean. See your dentist if you think you may be having this problem.
• Dental problems also can be caused by snacking more often. When the snacks are sweet, tooth decay or cavities occur. It is important to snack less often, or eat sweets at the end of a meal instead of between meals.
• It is important to see your dentist and dental hygienist during your pregnancy to prevent dental problems. Be sure to make a dental appointment before your baby is born. After birth, it may be several months before you will be able to find the time for an appointment.
• If you need to have emergency dental care during your pregnancy, you may need to have some X-rays taken of your teeth. Always be sure to remind your dental care professional of your pregnancy. Care should be taken to limit or avoid nitrous oxide, some prescribed antibiotics and some pain medications. Your dentist can contact your obstetrician with any questions.