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DENTAL HEALTH TIPS
  FOR PREGNANCY

Good oral health habits are important for health of mom and her growing baby

Good Oral Health Begins in the Womb

     Pregnancy is the time to increase your oral health care.  Most parents are not aware of how important good dental care is to the health of the mother and baby.

     Dental health and nutrition for the expectant mother is important in that tooth development for your baby begins by approximately the sixth and eighth weeks of pregnancy and continues throughout pregnancy. Hardening of the baby teeth begins at four months.  

     What you eat affects your baby's developing teeth.  Slight deficiencies in your diet and dental health may cause changes in your baby's tooth formation that will leave a tooth at greater risk for decay later in life. At birth, your baby has all their primary teeth and many permanent teeth at different stages of development . During pregnancy good dental care and an adequate diet is necessary for optimal oral development of your baby and their teeth.

     Once pregnant, changes in estrogen and progesterone levels cause an increase incidence of dental health problems such as: increased sensitivity and puffiness of the gum disease, increase in cavities, increase in plaque formation, nausea, vomiting, and food cravings.

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     If mothers do not have good dental health* they can transmit cavity causing organisms known as streptococci mutants to their children.  These organisms are responsible for causing tooth decay.  They are passed from the mother to her baby through kissing and saliva.  Research shows that by following these suggestions you can significantly decrease the risk of exposing your baby to this bacteria.

1. If you have not received dental care before becoming pregnant you should visit your dentist during the first trimester of pregnancy for assessment of oral health problems and preventive counseling.  Dental procedures can be successfully completed during the second trimester.  Appointments during the third trimester should be kept as brief as possible, laying back in the dental chair can be very uncomfortable.  This could lead to dizziness or loss of consciousness and may cause unnecessary stress on the baby. Also during the third trimester you are  the most at risk for premature delivery.   Elective and extensive procedures can be done after your baby is born. Dental cleanings are essential during this time.  There are studies  linking untreated gum disease with premature and low birth weight babies.  Cleanings need to be don on a regular basis during pregnancy.  If  you have pregnancy gingivitis (the first step in the progression of gum disease) it is recommend that you have your teeth cleaned every three months during pregnancy, rather than the usual six month interval.
 

2.  Once you have determined you oral health status you can suppress or reduce the bacterial that causes cavities by:

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  • Brushing your teeth at least twice a day for two minutes, after each meal or snack is best. Use a soft toothbrush with a pea size amount of toothpaste that contains fluoride. During pregnancy there is a surge in hormones which is linked to an increase in the amount of plaque on your teeth leading to an increased risk towards decay.^

  • Floss at least once a day to disrupt  bacteria growth between teeth.  This increase in plaque development can also cause gingivitis---red, swollen, tender gums that can easily bleed. 

  • Use a  mouth rinse that is sugar and alcohol free and contains an antibacterial agent such as in BreathRx ™. At the end of the six month of pregnancy and throughout the rest of the pregnancy use BreathRx™ in a.m. and a fluoridated mouthrinse like Act™ before bed.   Be sure to brush or rinse after vomiting.

  • If you did not have your teeth cleaned before you found out that you were pregnant, than you will need to have your teeth cleaned professionally early in your pregnancy to help prevent most gum problems.

3. Chew gum containing xylitol, for a minimum of five minutes after each meal. Xylitol will: retard the growth of oral bacteria, neutralizing plaque acids to fight cavities and remineralize tooth enamel.  It is found in Trident™ Original, Bubblegum, Trident for Kids gum, Biotene gum.    

4.  Use fluoride.  During tooth development, fluoride is incorporated into the tooth structure making the tooth strong and decay resistant.  Use fluoride containing products daily:

  • Mouth rinse with fluoride, Act™ in morning and/or after vomiting 

  • Drink water with fluoride

  • Use toothpaste with fluoride

  • After brushing your teeth at night, apply fluoride gel

  • Schedule professional fluoride treatments every 3 months

5.  Be sure to eat a wide variety of foods. Making wise nutrition and food choices during pregnancy can help avoid malnutrition that may bring on hypoplasia, a condition characterized by inadequate development of the infant's tooth enamel. You should remember to consume dairy products, which are the best source for calcium, the main building block of bones and teeth. Also make sure you include foods in your diet that are a good sources of calcium and vitamin D; phosphorus; foods contains vitamin A and C; and protein.  By doing this as soon as you find out you are pregnant, you will be caring for your baby's teeth and bones.  

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6.  Dental problems also can be caused by snacking more often. When the snacks are sweet or sticky, tooth decay or cavities occur. It is important to snack less often on foods high in sugar, or eat these sweets at the end of a meal instead of between meals. You can also brush your teeth or rinse your mouth with water after eating these foods. Avoid sugary pop which leads to acid attack and tooth decay. Snack wisely.

7.  Restore and maintain optimum dental health for yourself by having a comprehensive exam and periodontal (gum tissue) probing.  Follow through on you dentist recommendations and have all of your cavities treated and your gum tissue restored to good health. Research in the last few years shows that dental preventive care should be a cornerstone of good prenatal care.   If you’re pregnant and haven’t had your teeth cleaned for a while, please make an appointment.  Preventing advanced gum disease during pregnancy is just as important to the baby as a good prenatal diet. 

8.  See your dentist at the first sign of problems such as pain, bleeding, inflammation or infection and every six month to maintain good dental health.  Dental emergencies can be treated during any trimester.  It is recommended to avoid routine x-rays during pregnancy, though x-rays needed for emergency treatment can be done safely after shielding your abdomen with a lead apron (for extra safety we double shield your abdomen). Remember the  amount of radiation is minute and the beam is limited to a small region of the face.

9.  Acceptable antibiotics include penicillin, amoxicillin and clindamycin.  Avoid tetracycline and narcotic pain medication and aspirin.  Acetaminophen should be used in most cases if you are not allergic to this product.  Dental anesthetics at regular doses are not harmful to the unborn baby. Dental discomfort can be treated with Tylenol in most cases. 

10.  If you are experiencing morning sickness, it is important to neutralize the acid cause by vomiting which causes tooth erosion.  Try using a paste made of baking soda and water, rubbing it on the teeth.  After 30 seconds, rinse off the paste, then brush and floss.  If this is not possible, rinse with water.

11.  Antibiotics use and breastfeeding recommendations: Antibiotics and Breastfeeding Safety

 Women with periodontal disease are at three to five times greater risk of preterm birth than those who are periodontally healthy.

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(*The old saying that "the mother will lose a tooth for every child"  is based on the false assumption that the developing baby draws calcium from the mother's teeth. The baby's calcium needs are provided by the mother's diet.   When the mother's diet is not sufficient in calcium her body may try to compensate for this lack by drawing some calcium from her bones; however, her teeth will NOT be affected.  While oral health can be affected during pregnancy, it is often because of poor oral hygiene.)

^Dentalnotes, Winter 2002.

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Updates

Mercury Fillings in Moms Don't Lead to Small Babies
Risk of low birth weight infants debunked in new study

  In good news for expectant moms with cavities, a new study suggests pregnant women aren't threatening their newborn's birth weight by getting mercury-based silver amalgam fillings.

This latest research revealed no connection between use of the fillings and low birth weight.You cannot prove absolute safety, but mercury seems to have quite a bit of data on it now indicating that it shouldn't be of concern.

The use of silver amalgam fillings has dipped over the past couple of decades. They made up 68 percent of all fillings in the United States in 1990, but dropped to 30 percent in 2003.Resin-based fillings known as "white" fillings have become more popular, and some dentists have abandoned silver fillings because of concerns about the safety of mercury.

While silver amalgam fillings are commonly known just as "silver," they're actually made of several metals, including silver, tin, mercury and copper. The fillings "are a very good filling material. They're very long-lasting and have good properties as far as dental material.

Concerns about mercury exposure have grown in recent years, especially regarding its presence in foods such as fish. However, the U.S. government has declared that there is "scant evidence that the health of the vast majority of people with amalgam (fillings) is compromised."

In the new study, Hujoel and his colleagues studied a dental insurance company's records of 1,117 Washington state women who gave birth to low-weight infants and 4,468 women who gave birth to infants of normal weight.

The findings appear in the April 15 issue of the American Journal of Epidemiology.

The researchers found no connection between getting amalgam fillings during pregnancy -- nearly 5 percent of the women did so -- and giving birth to a underweight baby. Even women who had as many as 11 fillings during pregnancy weren't more likely to give birth to a low-weight child.

The study is another paper in a growing body of evidence that amalgam is safe and effective way to repair teeth that have been damaged by decay or trauma.

Learn more about amalgam fillings from the U.S. Centers for Disease Control and Prevention.

By Randy Dotinga HealthDay Reporter

SOURCES: Philippe P. Hujoel, Ph.D., D.D.S., professor, dental public health sciences, University of Washington, Seattle; Dr. Rod Mackert, D.M.D., Ph.D., spokesman, American Dental Association, and professor, dentistry, Medical College of Georgia, Augusta; April 15, 2005, American Journal of Epidemiology

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Safe Oral Sedation during Pregnancy

Many OB/GYN's suggest doxylamine succinate for the alleviation of nausea and vomiting attributed to "morning sickness" in pregnant folks. The great thing about doxylamine succinate is that it's readily known by it's trade name, Unisom, and is marketed as a night time sleep aid. During pregnancy you can be safely orally sedated with, doxylamine succinate (Unisom) 25-50 mg's PO. If Unisom were not available, diphenhydramine would be another acceptable alternative as they are both in the same class of drugs --antihistamines. N20 can be safely used with pregnant women, but limit its use to 2 hours or less.
 

Pregnancy may pose a number of concerns to the mother and the baby. . Transmission of caries-causing bacteria is one problem that can be minimized by utilizing Chlorhexidine rinses and xylitol containing chewing gum.

International Journal of Dental Hygiene Volume 1 Issue 3 Page 174 - August 2003

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Women's Dental Health Needs  

Head Start: An Opportunity to Improve the Oral Health of Children  and Families. Working with Health Professionals to Improve Access to Oral Health Care. Working with Parents to Improve Access to Oral Health Care.

You can receive copies of these publications at no charge from the Health Resources  and Services Administration (HRSA) Information Center at 2070 Chain Bridge Rd., Suite 450, Vienna, VA 22182-2536, or by calling (888) ASK-HRSA or emailing ask@hrsa.gov. The publications are also available on OHRC's  at www.mchoralhealth.org/pubs1.html. 

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Moms are the best role model for their daughters!

A recent national survey stated that 92% of girls ages 7-17 say their mom is their primary role model, particularly when it comes to eating healthy and drinking milk.

Half of all adult women in this country do not drink even one 8oz glass of milk a day.

Daughters are watching their moms closely for cues on how they should take care of their bodies.

Women need 1,000 mg of calcium a day or about three 8oz servings of milk a day.  Girls ages 6-8 need this same amount.  However, girls ages 9-18 need at least four 8oz servings for optional bone development.

Research shows that when mom consumes milk with her children their intake of calcium will increase.  It was also found that mothers were the single strongest predictor of their children's milk consumption.

How a mother feeds her daughter determines how her daughter feeds herself.

Source: Journal of American Dietetic Ass., Vol 98, 1998.

Visit: Why Milk

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