From tweaking your wardrobe to altering your diet, there’s a lot to get to grips with when you’re expecting. However, it’s often less well known that at the same time as your body is hard at work growing a baby, your dental health might also need some extra TLC.
Indeed, the natural hormonal changes experienced by women who are expecting risk having a knock-in impact on the state of your smile. While things like bad breath and tooth sensitivity are very common oral health problems at this time, there is also a greater risk of gum disease and teeth moving. This is why it’s important to attend regular check-ups with your dentist throughout the trimesters - with the NHS offering free check-ups and treatment during pregnancy and for 12 months after you give birth.
We’ve enlisted dentists Dr Tom Crawford-Clarke and Dr Smita Mehra, and dental therapist Miranda Pascucci to share their expert insight. Additionally, we discuss NHS treatment you are entitled to while you’re expecting and the common myths that dentists are desperate to bust…
11 things dentists want pregnant women to know
1. Your risk of gum disease increases
“Pregnancy can cause both direct and indirect effects on teeth,” explains Dr Crawford-Clarke, , founder and principal dentist of LUCEO Dental. “Due to hormonal changes - particularly with respect to increased oestrogen and progesterone - there can be an increase in gum inflammation and bleeding, called gingivitis.” Symptoms of which can also include swelling and soreness, according to the NHS, and it can often occur in the second trimester.
It is important to know that this is common. “It is estimated 60 to 65 per cent of pregnant women will experience gingivitis,” he notes. “If there was an underlying gum condition already present - such as gingivitis or periodontitis - these hormones will also lead to a heightened response and the condition could get worse.” Risking gum recession and exposure of the root surface, leading to sensitivity, which is why it’s important to brush properly and consult with a dentist if you are concerned.
2. Your teeth may become more sensitive
“Those who are pregnant may also experience sensitive teeth,” says Dr Mehra, principal dentist at The Neem Tree Dental Practice. There are a number of reasons why this may occur - including hormonal changes that can trigger gum inflammation, morning sickness which can risk acidity affecting the tooth’s surface, and a change of diet to include more sugary foods.
There are a number of ways to minimise this. ‘Try rinsing out the mouth with water if you are experiencing morning sickness regularly to help keep acid levels in your mouth low,” suggests Dr Mehra. It’s also key to pay attention to your oral hygiene, overall diet and go for regular dental check-ups.
3. Bad breath may become an issue
This is another unexpected pregnancy side-effect. Dr Crawford-Clarke notes that a dry mouth, caused by hormonal changes, can be to blame. “Saliva is protective in a number of ways - including helping to neutralise acids, washing away food debris and reducing plaque build up,” he explains. Certain food cravings and morning sickness can also leave a less than pleasant scent.
Fortunately, there are a number of ways to keep things fresh. These include brushing your teeth twice a day with a fluoride toothpaste, and using interdental cleaning - like floss or brushes. Sugar-free chewing gum is also helpful to have to hand, and you should visit your dentist to confirm that there isn’t anything else going on.
4. It’s a myth that your baby is taking calcium
“This is often a common myth when it comes to dental health and pregnancy,” notes Dr Mehra. “Many people think that because a growing baby needs calcium for their development, this in part comes from the mother's teeth - which inadvertently causes dental problems. However, this is not the case.”
Instead, she explains: “Calcium for a baby's growth will come from diet instead - which is why it is important during pregnancy that you eat foods rich in the mineral where possible.” Items high in the nutrient include dairy products, like milk, and green leafy vegetables. Dr Crawford-Clarke adds: “It is recommended to take a calcium supplement, and vitamin D to aid absorption, but I would advise speaking to your doctor or midwife for specific advice.”
5. Certain dental care should be avoided
According to the NHS, you should inform your dentist that you are pregnant - not only because they can give you specific advice, but also because certain dental treatments will need to be postponed until after you give birth. For example, Dr Crawford-Clarke says: “Manufacturers of the teeth whitening products we use recommend waiting until the baby has arrived.”
However, it is safe for you to have a dental X-ray during pregnancy. “This is because they are highly unlikely to be pointed at the pelvic area, meaning that any risk to the baby is extremely low,” explains Dr Mehra. “Protective measures, including leaded aprons, may also be used to minimise any exposure to radiation.” Your dentist will be able to best advise, taking into account that the benefits of being able to perform the X-ray may outweigh any small potential harm.
6. Your smile may look different
“While it isn't that common, teeth may move during pregnancy,” says Dr Mehra. “This is because when we’re pregnant, our body produces a chemical - known as relaxin - which can help to soften ligaments. However, as a result, this causes the ligaments within our mouths to also soften - which can trigger the teeth to shift.”
Dr Crawford-Clarke notes: “I have quite a few patients coming in saying they felt their teeth moved a lot since having kids. However, this could also be down to the effects of the jaw tending to narrow as we age anyway.” If you’re worried about your teeth shifting during your pregnancy, it is important that you seek the advice of your dentist.
7. Good dental hygiene is key
“Most importantly, those who are pregnant should keep up an effective oral care routine,” says Dr Mehra. “This means brushing teeth twice daily, as well as making sure that you floss.” She adds that, if you suffer from morning sickness, switching to a more bland toothpaste can help reduce feelings of nausea.” Using one containing fluoride is key to strengthening the tooth enamel.
Miranda Pascucci, a dental therapist for oral health brand TePe, adds: “You don’t need to brush too hard - simply clean along the line where the gum meets the teeth. Using too much pressure - or with too firm a toothbrush - can damage the gums, causing them to recede and exposing the root surfaces.” These are not protected by enamel and are much more sensitive to changes in temperature and tooth decay.
8. Don’t forget about a healthy diet
The chances are that a combination of food cravings and sleep deprivation may have an impact on how nutritious your meals are, but eating well can also be key for dental health. The NHS notes that sugary foods and drinks can lead to tooth decay.
“It is well-known during pregnancy that some will find such items particularly appetising - while these are fine in moderation, it is important you don’t go overboard,” warns Dr Mehra. “They can make you more prone to plaque buildup and, as a result, tooth decay and gum disease.”
9. Take up any free dental care
“Make sure that you take advantage of free NHS dental care during pregnancy to look after your oral health,” insists Dr Mehra. “Visit your dentist regularly during this time, as they might be able to help identify or catch any problems early on.”
You are entitled to free check-ups and treatment during pregnancy and for 12 months after you give birth. Dr Crawford-Clarke recommends having a dental check-up and hygiene treatment every three to six months to keep on top of any issues.
10. Make sure to log any changes
“Make a note of any changes that happen to your gums and teeth during pregnancy and flag these to your dentist when you attend your check-ups,” says Pascucci. “Don’t ignore any pain or bleeding gums, as it could be indicative of gum disease – as it’s always best to catch this early.” This is the best way to look after not only your own health, but also that of your baby.
11. Go easy on yourself throughout pregnancy
“All of the dental issues that you may encounter are treatable, so do not fear,” insists Dr Crawford-Clarke. “Just remember, you are doing your best so don't be too hard on yourself.” If you’re feeling overwhelmed, he adds: “The first step is to see your dentist, they are there to help you and offer any specific advice you need to maintain your oral health throughout your pregnancy.” You’re not in this alone.
We spoke to the following experts
Dr Smita Mehra, principal dentist at The Neem Tree Dental Practice, qualified as a dental surgeon from the University of Birmingham in 1997 and has since received her membership to the Faculty of General Dental Practitioners. She opened the first Neem Tree in 2004, and has expanded to two further practices in London’s Canary Wharf and Esher in Surrey.
Dr Tom Crawford-Clarke is the founder and principal dentist of LUCEO Dental. He is a full-mouth rehabilitation general and cosmetic dentist, who trained on London’s Harley Street. He is the previous winner of the Best Young Dentist and Best Young Private Dentist, and sits on the Committee of the British Academy of Cosmetic Dentistry.
Miranda Pascucci is a dental therapist and clinical education manager at TePe. She has worked in general practice for over 20 years. As a dental therapist, she has volunteered at the 2012 Olympics and Bridge2Aid, and also taught undergraduate dental therapy and postgraduate dentistry at the University of Central Lancashire
