• Pregnancy can lead to dental problems in some women.
• Caring for teeth during pregnancy is important for the mother and baby’s health.
• Visit the dentist during pregnancy for a check-up.
• It’s safe to visit the dentist during pregnancy.

About pregnancy and teeth

Pregnancy can lead to dental problems in some women, including gum disease and tooth decay. During pregnancy, hormones affect gums and teeth.

Brushing teeth twice a day with fluoride toothpaste and visiting your dentist will help keep your teeth and gums as healthy as possible during pregnancy.

Some dental problems can affect a developing baby

Research has found a link between severe gum disease in pregnant women and premature birth with low birth weight. Babies who are born prematurely can have a risk of brain injury, and problems with their eyesight and hearing.

It’s been suggested that up to 18 out of every 100 premature births could be linked to severe gum infection (periodontal disease). Gum disease can be treated by a dentist during pregnancy.

You’re less likely to have dental problems during pregnancy if you look after your teeth and gums before you are pregnant. You can do this by:

• Brushing your teeth at least twice a day with fluoride toothpaste.
• Flossing between your teeth once a day.
• Eating a healthy diet and limiting food and drinks high in added sugar.
• Avoiding tobacco products and minimising alcohol (it’s advised not to drink alcohol during pregnancy, and tobacco products should be avoided at all times).
• Visiting your dentist every 6 to 12 months.

If you’re planning on getting pregnant, see your dentist to discuss any treatments that can be done before your pregnancy. If you need dental treatment during pregnancy, non-urgent procedures can often be performed after the first trimester.

Always tell your dentist if you are pregnant

Dentists will take extra precautions when they know you’re pregnant to ensure your care is safe for you and your baby.

Common causes of dental health problems during pregnancy can include:

• gum problems
• vomiting
• cravings for sugary foods
• gagging while brushing teeth.

Gum problems

Pregnancy hormones can make some women be at risk of gum problems including:

• gingivitis (infection of the gum) – this is likely to occur during the second trimester. Symptoms include swelling of the gums and bleeding, mostly during brushing and when flossing between teeth
• periodontal disease – infection of the structures supporting the tooth (gums, ligament and bone). It’s caused by untreated gingivitis, which and can lead to tooth loss
• pregnancy epulis or pyogenic granuloma – a red, round growth that appears on the gum, which can bleed easily.

If you have gum problems during pregnancy, it’s important to get them checked by a dentist before you give birth. While most types of gum problems caused by pregnancy hormones resolve after birth, a small number of women may develop a deeper level of gum disease that will need treatment after pregnancy.

If your gums bleed, don’t stop brushing your teeth. Use a soft-headed toothbrush and fluoride toothpaste, and brush at least twice a day.

Vomiting can damage teeth

Pregnancy hormones soften the ring of muscle that keeps food inside the stomach. Gastric reflux (regurgitating food or drink) or the vomiting associated with morning sickness can cover your teeth with strong stomach acids. Repeated reflux and vomiting can damage the surface of the tooth (the enamel) and increase the risk of decay.

Try these suggestions if you’re experiencing vomiting:

• Avoid brushing your teeth immediately after vomiting. While the teeth are covered in stomach acids, the actions of brushing may scratch the tooth enamel.
• Rinse your mouth thoroughly with plain tap water.
• Follow up with a mouthwash containing fluoride.
• If you don't have a fluoridated mouthwash, put a blob of toothpaste containing fluoride on your finger and smear it over your teeth. Rinse thoroughly with water.
• Wait for an hour after vomiting before you brush.

Retching or gagging while brushing teeth

Some pregnant women find that brushing their teeth, particularly the back teeth, can cause gagging. However, it’s important to brush all of your teeth to avoid tooth decay.

Some tips to help prevent gagging include:

• Use a toothbrush with a small soft head, such as a brush made for toddlers.
• Take your time. Go slowly when you brush.
• It may help to close your eyes and concentrate on your breathing.
• Try listening to music.
• If the taste of the toothpaste causes you to gag, switch to another brand. Or brush your teeth with water and then use a mouthwash containing fluoride. Go back to brushing with toothpaste containing fluoride as soon as you can.

Some women have unusual food cravings while pregnant. If you have cravings for sugary snacks, it’s best to avoid them as it may increase your risk of tooth decay. Try to snack on foods low in added sugar instead.

If nothing but sweetness will satisfy your craving, try to sometimes choose healthier options, such as fresh fruit. Rinse your mouth with mouthwash containing fluoride or brush your teeth after having sugary snacks.

During pregnancy, you will need to increase the amount of calcium you eat or drink to protect your bones and the needs of your developing baby.

Good sources of calcium include:

• milk, cheese and plain yoghurt or sugar-free fruit yoghurt
• calcium-fortified soy, almond or other types of milk, cheese and yoghurt if you can’t have dairy (choose products low in added sugar)
• some types of nuts such as almonds.

Vitamin D helps the body to utilise calcium. Small amounts of sun exposure can help to support vitamin D levels. Take care not to get sunburnt.

Good food sources of vitamin D include:

• fatty fish, such as salmon, herring and mackerel (discuss with your doctor how much of the types of fish you can safely have during pregnancy)
• eggs
• margarine
• vitamin D fortified milk (and alternatives)
• breads and cereals.

If you’re not getting enough vitamin D from your diet, you can take supplements – ask your doctor or obstetrician if you need to take a vitamin D supplement.