Tooth care in pregnancy
Tooth care in pregnancy
One of the issues that is being addressed in schools for pregnant women is also tooth care. Not without reason, as many future mothers complain that during a pregnancy, they damage or even lose their teeth.
Is this “sacrifice” inevitable? Can it be prevented? We found the answer in the dental service of the Health Center Savski venac, from the oral surgeon Dr. Zoran Milosavljevic.
Does the quality of teeth change during pregnancy?
– The teeth do not change during pregnancy, their structure remains the same. There is no decalcification (loss of calcium), as future mothers often think they are happening to them. However, dental problems during pregnancy are due to the effect of hormones on the composition of the gingiva or soft tissue. This is the first symptom, the so-called gravid gingivitis, which is a normal physiological occurrence in pregnancy, and is due to altered hormonal status.
How is Gradual Gingivitis Manifested?
– It is manifested by ball-like enlargement of the gums, which are most often inflamed and therefore easier bleeding, but at the first touch with brush or food. This is the first symptom. With greater permeability of blood vessels during pregnancy, and even blood vessels in the right, it is easier to create soft deposits – the so-called plaque. Soft deposits (which are “adopted” from food) are a secondary symptom – which, unlike ball-like enlargement of the gums and bleeding from them, can not be seen.
Gravid gingivitis “masks” a larger area of the tooth because the right is enlarged, so it is difficult to self-purify – which is achieved by abrasive foods, cheeks, tongue. From food and saliva, soft deposits, sticky substances dextran and levan, which promote the formation of dental plaque, are deposited during welding. All this creates a wrong circle – which, if not broken by a good and regular washing of teeth after each meal, progressively leads to paradentopathy and to the reduction of teeth in the advanced stage.
Can pregnancy pass without such problems?
– The rule that insists on pregnancy education is the regular maintenance of hygiene of the mouth and teeth. However, frightened by bleeding, they usually quit regular maintenance of mouth hygiene and stop washing their teeth after each meal. And that’s exactly what contributes to the gums strengthening, bleeding alleviating and avoiding changes that occur in the mouth during pregnancy. On the hygiene of the mouth, patients who have so-called teething problems have to do their best. They need a thread for proper maintenance because the brush can not enter a tight space between the teeth.
Gum sensitivity and bleeding may persist throughout the pregnancy. But when after the delivery, hormones return to their physiological status, the occurrence of gravid gingivitis, as well as gravid haemorrhage (bleeding), ceases. However, due to unhealthiness, or lack of training in proper dental care, with the changes that occur due to hormonal status, secondary effects are created: caries and changes on the very tissue of the teeth. Because of such changes, which are sometimes painful, and could be prevented by better hygiene, pregnant women contact dentists.
Are dental interventions in pregnancy safe for the fetus?
– It is best for a dentist to come before pregnancy, while pregnancy is being planned, in order to repair possible problems. As far as intervention is concerned, they should be avoided in the first three months. During this period, the placental blood flow is most permeable, so that some medications can work toxic to the fetus. Later, when interventions on pregnant teeth are possible, a dentist should not do anything without consulting a gynecologist who is following it. This is particularly important in the case of interventions that require local anesthesia. Namely, a local anesthetic contains oxytocin, a hormone that causes smooth muscle contractions, such as the uterus, and can lead to contractions and spontaneous labor.
The opinion of a gynecologist is necessary because there are also risky pregnancies. It happens that future mothers sometimes “mask” their real state, so the dentist does not know if the patient’s pregnancy is stable or risky, and to what extent. Therefore, there must be synchronization in the functioning of the gynecologist and dentist when the patient is a pregnant woman.
Is it possible to take more serious interventions during pregnancy (tooth extraction, for example)?
If pregnancy is stable, all interventions that do not accompany bleeding or pain can be done, because pain itself leads to the elimination of adrenaline, which can act in a toxic, not only physiologically. My opinion is that nothing should be done without a gynecologist, without his instructions on the course of pregnancy, especially when it comes to interventions in which there is inevitable bleeding, which is a common occurrence in the removal of teeth. The gynecologist must give approval for it.