Pregnancy & Dental Care – Boston, MA
Protecting You & Your Little One
If you are expecting, please inform us so we can ensure your dental health is optimally maintained throughout your pregnancy. At Dental Health and Wellness Boston, we serve as your trusted resource for oral health during this significant time. Our expert team is dedicated to addressing any specific concerns you may have and alleviating any anxieties about dental care. You can count on us to provide exceptional, personalized care that supports both your and your baby’s well-being.
Why Choose Dental Health & Wellness Boston for Pregnancy Dental Care?
- Practice Led by a Mother of Three
- 25+ Years of Experience Serving Downtown Boston
- Specialized Treatment Plans for Pregnant Patients
The Oral Health of Mother and Baby
The oral health of a mother can affect the oral health of her baby. Anticipating these risks for a baby in utero can prevent dental caries (tooth decay, or, cavities) that develop early in a child’s life. During pregnancy, a mother must maintain routine dental healthcare, for herself and her child. The Perinatal Oral Health Consensus Statement from the American Congress of Obstetricians and Gynecologists states:
“Prevention, diagnosis, and treatment of oral diseases, including needed dental radiographs and use of local anesthesia, are highly beneficial and can be undertaken during pregnancy with no additional fetal or maternal risk when compared to the risk of not providing care. Good oral health and control of oral disease protects a woman’s health and quality of life and has the potential to reduce the transmission of pathogenic bacteria from mothers to their children.”
How Changes to the Body Affect Dental Health
Physiological changes in the mouth of a pregnant woman put her at a higher risk for dental infection. This risk is also increased due to changes in the immune system during pregnancy. According to the California Dental Association, control of oral disease in pregnant women has the potential to reduce the transmission from new mothers to their infants. Hormonal fluctuations associated with pregnancy can exaggerate some dental disorders, and recent studies have shown a link between gum disease and premature births and babies with low birth weight.
Our Role as Your Dentist During Pregnancy
As your oral health care professionals throughout your pregnancy, we are dedicated to ensuring that your dental care remains safe and effective. We address any specific concerns and work to ease any fears you may have about receiving dental treatment. Our approach includes explaining that preventive care, accurate diagnosis, and necessary treatments—such as dental X-rays and local anesthesia—are beneficial and pose no additional risk to you or your baby. At Dental Health & Wellness Boston, we will develop a tailored treatment plan that prioritizes the dental health of both mother and child, based on established oral health considerations, including:
- Chief complaint and health history
- History of tobacco, alcohol, or other substance use
- Clinical evaluation
- Radiographs and other diagnostics when indicated”
- We will also care for each patient individually, as we always go through the following process with our pregnant patients:
- Develop and discussion of a comprehensive treatment plan that includes preventive, treatment, and maintenance care throughout pregnancy.
- Discuss the benefits, risks, and alternatives to treatments.
- Provide emergency/acute care at any time during pregnancy as indicated by the oral condition of the patient.
- Perform a comprehensive periodontal examination, which includes a periodontal probing depth record.
- Recommend that all women of childbearing age take a multivitamin supplement containing folic acid.
- Support a woman’s decision to breastfeed and have ready access to patient education resources.
- Reinforce tobacco and alcohol cessation and other medical recommendations at oral health office visits.
- Place pregnant women in a semi-reclining position as tolerated, encourage frequent position changes, and/or place a small pillow under her hip to prevent postural hypotensive syndrome.
- Utilize a rubber dam during restorative procedures and endodontic procedures.
- Use safe amalgam and safe composite practices when placing restorative materials intraorally.
- Consult with the prenatal care provider when considering certain procedures
- Provide necessary follow-up evaluation to determine if oral health care interventions have been effective.
- Provide health education and anticipatory guidance about oral health practices for children to prevent early childhood caries.
- Encourage patients to use the internet to learn more about oral health during pregnancy and early childhood.
- Encourage and advise patients to continue to receive dental care during the postpartum period and thereafter.
Common Oral Conditions During Pregnancy
It is a fact that physiologic changes occur in the mouth of a woman during pregnancy and it is important to understand that these changes place pregnant women at a higher risk for dental infection. Though gingivitis is the most common oral condition, other common oral conditions that affect dental health during pregnancy include the following:
- Single, tumor-like growths of gingival enlargement may also appear during pregnancy. These growths often referred to as a “pregnancy tumor,” “epulis gravidarum,” or “pregnancy granuloma” are frequently associated with inflammatory gingivitis, or some other irritation. Poor oral hygiene is a cause of these growths. Plaque deposits, as well as calculus, are also present on the teeth adjacent to the lesion. To fix this problem, scaling and root planning is necessary, as well as intensive oral hygiene instruction. The growth generally fades postpartum; however, in some cases, the growth is removed due to discomfort, disturbing the alignment of the teeth, or bleeding on mastication.
- Teeth mobility is another problem that could occur during pregnancy and is often related to “the degree of gingival diseases disturbing the attachment apparatus, as well as to mineral changes in the lamina dura.” There is normally no permanent loss of clinical attachment; however, in some individuals, the progression of periodontitis can and does occur and can be permanent.
- “Physiologic xerostomia (abnormal dryness of the mouth) is a common oral complaint.” Xerostomia is most commonly reported in accordance with the use of certain medications that produce dryness as a side effect, such as antispasmodics, antidepressants, antihistamines, anticonvulsants, and others. Xerostomia can also occur during sleep. It is important to use increased oral hygiene, frequent fluoride exposure, and to remove plaque from teeth before bedtime as treatment for this condition.
- White Blood Cell Suppression: During pregnancy, the woman’s immune system changes, particularly in the suppression of some neutrophil (white blood cell) functions. Because of these changes, the exacerbation of plaque-induced gingival inflammation can occur, for example. “Inhibition of neutrophils is particularly important in pregnancy-periodontal disease associations.”
- Nausea and vomiting are very common during pregnancy; 70-85% of women experience these symptoms. Although nausea and vomiting during pregnancy (NVP) are predominantly associated with early pregnancy, some women may experience it past the first trimester. Hyperemesis gravidarum is a severe form of NVP that occurs in about 0.3-2.0% of pregnancies, and may lead to surface enamel loss primarily through acid-induced erosion.”
- Changes in salivary composition in late pregnancy and during lactation may temporarily predispose to erosion as well as dental caries, however, there is no convincing data to show that dental caries incidence increases during pregnancy or the immediate postpartum period, though existing, untreated caries will likely progress.”
- Periodontal disease (gum disease) affects about 15% of women of childbearing age and up to 40% of pregnant women. The most common clinical periodontal condition in women during pregnancy is gingivitis due to the accumulation of dental plaque. This occurs in 60-75% of women generally between three and eight months of pregnancy, which reinforces the importance of periodontal preventive and treatment measures during pregnancy. Gingival changes usually occur in association with poor oral hygiene and local irritants; however, the hormonal and vascular changes taking place in a pregnant woman often exaggerate the inflammatory response to these local irritants. Gingivitis results from the buildup of plaque, the sticky, harmful bacteria on teeth. Periodontal care should be provided during pregnancy because it is safe and effective in reducing periodontal disease and periodontal pathogens. It is important to maintain routine dental healthcare to prevent gum disease that may become aggravated during pregnancy.
Medical Conditions Related to Dental Care
Common pregnancy complications such as miscarriage, preterm birth, preeclampsia, and gestational diabetes are sometimes believed to be associated with dental care, but this is not the case. According to studies:
- Miscarriage is not related to the first trimester of oral healthcare or dental procedures.
- Although research is ongoing, the most current evidence shows that periodontal treatment does not affect birth outcomes of preterm labor and low preterm birth weight. It is safe for the mother and the fetus.
- Preeclampsia is not a contraindication to dental care.
- Although oral health indicators have been linked to diabetes, gestational diabetes is not related to receiving dental healthcare during pregnancy. For more information about diabetes and dental health, please visit our Dentistry for Diabetics page.