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5 things to know about oral health and pregnancy

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Jo Purssey*, Oral Health Therapist  and ORAL HEALTH ADVISORY PANEL MEMBER, ANSWERS YOUR QUESTIONS ABOUT ORAL HEALTH AND Pregnancy

1. If a customer visits the pharmacy and asks for advice about maintaining a good oral hygiene routine during pregnancy, what advice can I offer?

Contrary to the old wives’ tales, pregnancy itself doesn’t damage the mother’s teeth, however it can lead to issues with gum disease and increased risk of tooth decay.

As with all the life stages, maintaining an effective oral hygiene routine is essential during pregnancy to prevent dental decay and disease. This means brushing morning and night and morning with a fluoridated toothpaste, regular interdental cleaning, eating a balanced diet, and visiting your oral health professional regularly.

For optimal health during your pregnancy, a visit to your oral health professional as soon as you are planning a pregnancy or as soon as you know you are pregnant is recommended. This will allow plenty of time to assess, plan and attend to your own oral health, as well as provide much needed information on what is the ideal environment for your new baby to secure optimal oral health for their future.

2. If I notice a heavily pregnant customer browsing the mouth wash aisle in the pharmacy, what information about OTC products during pregnancy should I share with her?

Many over-the-counter products are safe to take during pregnancy. Mouth wash solutions that contain alcohol should also be avoided, as no known quantity of alcohol is considered safe during pregnancy.

You could suggest she try an alcohol-free, fluoridated mouth wash, which can help provide some additional protection against decay.

Ideally, the best suggestion to make is to ask if the customer has had a recent oral health check? Do they know the status of their own oral health, as this will directly impact on the babies oral health for life, once they are born?

3. If, while speaking with a customer who is obviously pregnant, I notice her gums look quite red and inflamed, what advice should I offer?

Hormonal changes can make pregnant women more susceptible to gum disease called gingivitis – where gums become red and inflamed, and prone to bleeding.

There have been some studies, which suggest a link between gum disease and preterm/low birth weight babies. While the current evidence is not predictable, it would be best to ensure your own oral health is being managed.

Signs of gum disease may include:

  • Red (instead of pink) and/or swollen gums
  • Bleeding gums (particularly when brushing or cleaning in between the teeth)
  • Unpleasant breath

Explain to your customer that the hormones swirling through her body during pregnancy have changed her bodies inflammatory response, and suggest she see her oral health professional for advice.

While hormones play a part, it is also important to advise her that it is still bacterial deposits or plaque that is the major cause of gum disease. Keeping teeth clean, paying particular attention to the gum line, will dramatically reduce a pregnant woman’s risk of gingivitis or more complex gum diseases. 

4. A customer asks me for advice about additional vitamins or supplements during her pregnancy to keep her teeth in top shape. What can I recommend?

Although supplements will have no effect on teeth calcium and vitamin D are of particular importance during pregnancy, for both the mother and the growing baby. Calcium protects the mother’s bone mass, and meets the nutritional needs of the baby, while vitamin D helps the mother’s body utilise that calcium more effectively.

Encourage your customer to increase her own calcium intake by consuming more dairy products, and other foods high in calcium like salmon or trout, leafy greens like kale and spinach, dried beans, almonds and chia seeds. Good food sources of vitamin D include cheese, fatty fish like tuna, mackerel or salmon, eggs, and foods fortified with vitamin D However, you should encourage your customer to check with her obstetrician, mid-wife or GP before making any decisions relating to supplements or dietary changes, to ensure there are no other medical considerations which may impact on the pregnancy and developing baby.

The best source of vitamin D is sunlight, so exposing skin to the sun each day can assist your customer to get adequate vitamin D. For fair skinned people around 5-10 minutes during summer, and 15-30 minutes during winter will suffice. People with darker skin need longer exposure as their darker skin reduces the penetration of UV light – from 15minutes up to an hour in summer, and from 20 minutes up to three hours in winter. Once again, you should encourage your patient to check with their medical professional, before taking any action regarding supplementary dosing or action.

5. If a customer comes to me regarding her dreadful morning sickness, which has her throwing up at least once a day, should I suggest she brush her teeth straight afterwards to combat bad breath? Is this the right advice?

Unfortunately, for many women, vomiting during pregnancy is not uncommon. While for most women this will stop after the first trimester, some will experience ‘morning sickness’ all day long for the duration of their pregnancy! Frequent vomiting increases the risk of tooth erosion and tooth decay, as the strong stomach acids associated with vomiting, change the pH level of the oral environment, which can damage enamel and alter the type of bacterial activity in the mouth.

It’s important to advise your customer to avoid brushing her teeth immediately after she has vomited, as this can actually damage the enamel that has been softened by the stomach acid. The best advice to give would be to rinse with plain tap water straight after she has vomited, and then wait at least half an hour before brushing her teeth.

Drinking plenty of water, Chewing sugar-free gum or sucking on sugar-free lozenges may also help to stimulate ‘protective saliva’, and neutralise the acid in her mouth.

*The Oral Health Advisory Panel (OHAP), is a group of independent healthcare professionals with the aim of raising awareness of the importance of good oral health and its impact on general wellness.  The Panel aims to take oral health beyond the dental clinic. Follow them via twitter @OHAPanel to stay up to date with practical advice on good oral health habits.

Read our other articles in this expert series by clicking here…

Resources:

Colgate Oral Care Centre ‘Oral Care During Pregnancy’ 

Colgate Oral Care Centre ‘Pregnancy Prenatal Care and Oral Health’ 

Dental Health Services Victoria ‘Advice for Pregnant Women’ 

Better Health Channel ‘Pregnancy and Teeth’ 

Osteoporosis Australia website, ‘Vitamin D’

PharmacyBook.net (UK) Povidone Iodine – Use, Dose and Effects