Pregnancy and Dentistry

As a founding member of the American Academy of Oral Systemic Health, my focus as a dentist is to treat the mouth as the entryway to the entire body and stress the importance that a healthy body starts with a healthy mouth.

For years the mouth has not really been considered part of the systemic body, and medical physicians and dentists have not teamed together well enough to provide optimum oral systemic health. This is starting to change as more evidence emerges linking oral health to other parts of the body.

I have come across many situations where oral neglect leads to emergency dentistry at inopportune times.  In the case of pregnancy, women who are trying to become pregnant should see their dentists before becoming pregnant, as early as possible to ensure their gums and teeth are completely healthy and bacteria free.

• Studies show that women with gum disease take, on average, two months longer to get pregnant than those who do not.
• Non-Caucasians with periodontal disease take, on average, 12 months longer to get pregnant.

One simple appointment can save you months of trying.

Oral Systemic Health
An expecting mother should have the goal to do whatever she can to provide the best possible environment for her unborn child. We want to prevent pre-term birth and low birth weight and provide a healthy environment for optimal growth and health.
Newborns deserve the right to enter life with the best chance to thrive. This can be accomplished through the mother taking extra special care of her mouth and her body prior to giving birth, and continuing preventative and maintenance care throughout her life.

In 2001, the Surgeon General declared that periodontal health is of utmost importance and periodontal disease must be treated as a disease of the mouth as well as the body. In fact, it has been well documented that periodontal disease has been intimately linked to:

• Pre-Term Birth
• Low Birth Weight
• Fetal Development
• Transmission of Infection

Pregnancy and Dental Work
Being pregnant is a very exciting time. Your body goes through multiple changes and priorities change. As a dentist, a valuable message I like to pass along is: Don’t neglect your dental health! Recent research has found that maintaining oral hygiene can prevent many problems not only with a mother’s health, but also with a baby’s birth and health. Excessive bacteria from the mouth can enter the bloodstream through your gums; the bacteria can travel to the uterus, triggering the production of chemicals called prostaglandins, which are suspected to induce premature labor.

Pregnancy Gingivitis
The shocking truth is that pregnancy gingivitis affects anywhere from 50 to 70 percent of pregnant women, and those with the disease are 7 times more likely to go into preterm labor, preeclampsia, and have low-birth-weight babies! Pre-mature infants are at greater risk for short and long term complications, including disabilities and impediments in growth and mental development. Additionally, if an expectant mom had untreated tooth decay and/or consumed a lot of sugar, their children have 4 times the risk of developing tooth decay!

Ultimately, hormonal changes during pregnancy affect the body’s natural response to dental plaque, which affect how gum tissues react to the bacteria in plaque; thus resulting in a higher chance of pregnant women getting gingivitis. Moreover, if you already have gingivitis going into a pregnancy, it will likely get worse during pregnancy if you do not seek treatment. Although gingivitis generally subsides shortly after birth, it should be periodically monitored by your dentist (during and after pregnancy), in order to prevent the gingivitis from turning into the more serious (and irreversible) form known as periodontitis.

To sum up, pregnancy gingivitis is a real and prevalent threat; but so long as you take the appropriate steps, it can be managed with relative ease.

The following are guidelines suggested by the American Academy of Pediatrics (AAP), in response to the increased concern about oral health during pregnancy:

1. Oral Health Education – DO have consultations with your dentist before, during, and after your pregnancy. Early intervention is key, but ongoing care is just as important!
2. Oral Hygiene – DO brush and floss regularly – and properly. It is especially important to try and always brush after meals and snacks, especially sugary ones. Also, have more frequent dental cleanings than you normally would (2-3 during your pregnancy is about right). This will greatly increase the amount of plaque that is removed from the teeth and gums, thereby lowering your risk.
3. Nutrition – DON’T eat junk food. This is good advice in general during your pregnancy, but just know that proper diet and nutrition during pregnancy will limit sugar intake, which, in turn, will minimize plaque build up.
4. Treat Tooth Decay – DO try and have all urgent dental work completed prior to becoming pregnant. Although, it is safe to perform certain emergency dental procedures during your pregnancy, it is best to have it done prior to becoming pregnant, and especially prior to it becoming an emergency dental treatment!
5. Transmission of Bacteria – DON’T share food and utensils, so as not to potentially transmit bacteria known to cause tooth decay.
6. Use of Xylitol Gum – DO chew gum. Expectant mothers, and everyone, are encouraged to chew xylitol gum (around 4x/day), since research suggests that it may decrease the rate of tooth decay. Chewing sugarless gum increases saliva and thus increases the production of salivary enzymes that help equalize the pH in the mouth and thus reduce cavity growth.

Prevent Tooth Decay From “Morning Sickness”

1. Rinsing with a teaspoon of baking soda in a cup of water will neutralize the stomach acids remaining in the mouth after regurgitation.
2. Chewing sugarless gum containing xylitol after eating will reduce bacteria and clean teeth with- out leaving behind cavity-causing sugar.

Traditionally, mothers-to-be have been reluctant to attend to their dental and oral health needs for fear that diagnostic x-rays and dental procedures could harm their fetus.

• A study conducted by researchers at the Harvard School of Dental Medicine found that pregnant women saw a 34 percent reduction in the risk of a preterm labor if they underwent a simple dental procedure. In a study published in the Journal of Periodontal Medicine, the researchers described how expectant mothers with a high risk of preterm birth saw that risk cut by a third if they underwent a technique called scaling and root planing.
• Nearly 500,000 (or 1 in 8 infants) are born preterm each year, according to the Centers for Disease Control and Prevention.
• Premature births have been linked to various severe health ailments, like cerebral palsy, respiratory problems and hearing loss.

The fact is that untreated oral health problems such as periodontal disease and dental decay are now identified as risk factors for diabetes, dangerously high blood pressure, low birth weight and pre-term delivery.

Women need to be reassured that it is now safe to receive dental care, including digital x-rays and local anesthetics, during all phases of pregnancy. Today’s dentists are equipped to provide dental care as an essential component of prenatal care.

Summary
Being Pregnant is a very exciting time in your life. Be sure to consider your overall and dental health and provide an optimum environment for your unborn child and soon to be newborn!

Recently in the news

• http://well.blogs.nytimes.com/2013/05/06/obstacles-for-pregnant-women-seeking-dental-care/
• http://www.wjla.com/articles/2013/05/dental-hygiene-especially-important-for-mothers-to-be-88734.html
• http://www.youtube.com/watch?v=8XRbnf4aNGQ

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Frank Orlando, DDS, FAGD, FICOI maintains a private dental office in Midtown Manhattan focused on Comprehensive Cosmetic and Implant Dentistry with a specific focus on Oral Systemic Health. He strives to educate patients on oral health as an integral part to systemic health. As a founding member of the American Academy of Oral Systemic Health and a Fellow in the Academy of General Dentistry and The International Congress of Oral Implantologists, Dr. Orlando is well versed in all aspects of general and advanced dentistry with a continual focus on improving your oral health to optimize your overall systemic health.

For a free list of oral and dental health DO’s and DON’Ts for new mothers and mothers-to-be, or to receive an oral health consultation, women who are pregnant or in the planning stages may contact him:

Frank Orlando, DDS, FAGD, FICOI
24 West 57th Street, Suite 701
New York, NY 10019
(646) 926-7402
drfrankorlando@gmail.com
www.drfrankorlando.com

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