Expert interview: This is why dental care is so important during pregnancy

Why is a regular visit to the dentist so important with regard to the desire to have children and also during pregnancy?

dr medical dent. Ulrike Uhlmann: Especially if you want to have children, you should make sure that you don’t have any decayed teeth and that your gums are healthy and free of inflammation. Especially with regard to the periodontium (meaning the gums and the underlying bone), there seems to be a connection between its disease (= periodontitis) and certain pregnancy complications. Studies suggest that the most effective way to reduce the risk of low birth weight, preeclampsia (also known as pregnancy poisoning) or premature birth is to treat a diseased periodontium before pregnancy.

Furthermore, special precautionary measures apply to certain interventions, especially in the first and last trimester of pregnancy, so that it is advisable in any case to be sanitized beforehand. Regular check-ups at the dentist are also very important, because particularities that affect oral health can occur during pregnancy. For one thing, many women who struggle with nausea have trouble doing their daily (especially morning) oral hygiene routine. On the other hand, special cravings, for example sweet or sour, and/or frequent vomiting can damage tooth enamel.

In addition to these peculiarities, there are also hormone-related changes in the mouth during pregnancy, which also make close monitoring necessary.

What changes can occur in the mouth during pregnancy and why is dental care so important during pregnancy?

Progesterone, the hormone that maintains pregnancy, changes blood flow and vascular conditions throughout the body. Although the increasing blood flow and the increasing permeability of the vessels is good and important for the care of the embryo, it can lead to bleeding gums and inflammation in the oral cavity. This so-called pregnancy gingivitis can also be associated with swelling of the gums and pain. This inflammation is initially limited to the gums (= gingivitis), but if left untreated it can also affect the bones below the gums, i.e. the periodontium itself (= periodontitis).

An existing inflammation of the gums or an existing periodontitis often worsens during pregnancy due to hormones. Hence the saying “every pregnancy costs a tooth”. This does not have to happen with the right prevention, oral hygiene and dental care. Since this inflammation is always caused by deposits, it is particularly important to attach great importance to daily oral hygiene and, if necessary, to take advantage of professional tooth cleaning at the dentist.

What should pregnant women consider when taking care of their teeth to prevent problems? Are there special dental care products that make sense during pregnancy?

Brushing your teeth thoroughly two to three times with a fluoride-containing (!) toothpaste normally prevents all relevant carious diseases. In addition, pregnant women should clean the spaces between their teeth with dental floss several times a week, because a normal toothbrush cannot reach them. If oral hygiene is temporarily limited due to severe nausea, special alcohol-free mouthwash solutions can make sense, which should only be used for a limited time and after consultation with a dentist.

Does the dental health of the parents affect the unborn baby?

Definitely and not only on the unborn child, but the dental health of the parents continues to influence the children even after the pregnancy. As already described, the mother’s dental health has an influence on the risk of pregnancy complications.

Furthermore, it has been proven that children of parents with healthy teeth also have a lower risk of caries later on. But this has nothing to do with heredity, as is often wrongly assumed. Rather, parents transmit their oral bacteria to their children (both beneficial and harmful) and, together with their diet and role model function in oral hygiene, lay the foundation for their children’s dental health. “Bad teeth” are not inherited per se, but bad habits are passed on.

How often should pregnant women go to the dentist?

I would recommend a dental check-up every trimester of pregnancy. In the first trimester of pregnancy, advice can be given on hormone-related changes, it can be checked whether, for example, gingivitis that requires treatment is present and tips on correct oral hygiene can be given for existing problems, such as morning sickness.

The second third is best for any necessary treatments. Depending on the need, I would also recommend professional teeth cleaning during this period. A visit, preferably at the beginning of the last trimester of pregnancy, can be used for a check-up, if necessary for further treatment planning and the mother can already arrange the first check-up appointment for the baby. This should be done with the first tooth, i.e. around 6 months.

During the first and last trimester of pregnancy, only preventive and – if necessary – acute pain treatments are carried out at the dentist. X-rays and some medications are reserved for acute pain conditions and are subject to a more strictly assessed area of ​​application during pregnancy. Some treatments can only be started during pregnancy, but can only be definitively completed after the end of the pregnancy.

For this reason alone, it is important to focus on your oral health before you become pregnant. But what expectant mothers should also know: If toothache occurs during pregnancy, go to the dentist immediately and inform them about the pregnancy. Even during pregnancy, the dentist can, if necessary, use a local anesthetic and painkillers without risk for mother and child and thus make the treatment painless! This also applies to breastfeeding. No pregnant woman has to “endure” pain during a dental treatment and no mother has to wean as a result.

In summary, one can say: During pregnancy, as little treatment as possible is given, but as much as necessary. The best time for necessary treatments is the second trimester of pregnancy. However, this also means that cosmetic treatments such as bleaching should not be carried out. X-rays should be avoided, but they are safe for mother and child in the case of acute pain or illnesses that require treatment. Teeth cleaning is also possible and often useful and necessary. For the reasons mentioned, the treatment of periodontitis is also possible and sensible in the second trimester of pregnancy.