How to look after your teeth in pregnancy

How do I brush when I’m feeling nauseous? Can I visit the dentist? Get answers to your bump-related dental posers.

Your body goes through plenty of changes during those nine long months of pregnancy. Some physical, others hormonal. “This includes an increase in oestrogen and progesterone and reduced immunity towards gum infections,” notes Dr Fu Jia Hui, a senior registrar specialising in Periodontics at the NUH University Dental Cluster.

While hormonal changes are good for your growing baby, it can create havoc on your immunity and health, especially when you have existing gum problems.

Dr Fu explains that during pregnancy, you’ll experience the following changes:
     * A decrease in maternal immunity against gum bacteria.
     * Gums may have a hyperactive response to plaque.
     * An increased formation of inflammatory proteins.
     * An increase in the types of bacteria which causes severe gum disease.

“As a result, the gums become redder, more tender, swollen and more prone to bleeding,” adds Dr Fu. “These signs and symptoms gradually increase from the first to the third trimester but slowly improve after delivery.”

“Bacteria from the gums may travel into the blood stream to the placenta to cause a systemic inflammatory response.”

Don’t compromise on your dental health when you’re growing that baby though. Several studies have shown a direct association between dental problems and pregnancy complications.

For example, periodontitis (chronic inflammation of the gums and bone) is associated with pre-eclampsia (high blood pressure during pregnancy), preterm labour and low birthweight babies. “Bacteria from the gums may travel into the blood stream to the placenta and cause a systemic inflammatory response,” explains Dr Fu. “This may induce uterine muscles to contract, leading to premature labour and babies of low birthweight.”

Dr Fu notes that pre-eclampsia is another condition that can flare up as a result of gum bacteria. “Inflammation caused by bacteria from the gums can result in the narrowing of blood vessels in the placenta and further release inflammatory proteins, which elevate the blood pressure of pregnant mothers.”

Wondering how to keep your teeth, gums and baby in the pink of health during pregnancy? Read on for our top tips.

FAQ #1: How do I maintain good dental hygiene when I have morning sickness?
Good dental hygiene is primarily maintained by a good toothbrushing technique which you should carry out for at least two minutes twice a day. Couple this with flossing and using mouthwash.

However, when you’re battling morning sickness, the mere thought of putting a brush into your mouth can result in a gag reflux. How do you maintain healthy teeth and gums?

Dr Fu has these suggestions:

Tip #1: Brush when you’re feeling well. For example, between meals when you’re not feeling nauseated.
Tip #2: Use a toothbrush with a small head like the ones kids use. A smaller toothbrush can better reach those hard-to-clean areas while minimising the gag reflex.
Tip #3: Since morning sickness is generally triggered by smell or taste, use just a smear of toothpaste. Or change to a milder or bland-tasting toothpaste, such as the less minty kind or children’s fruity toothpaste. You can also opt to not use toothpaste at all. “Bacterial plaque can be removed with good thorough toothbrushing, which has to be performed together with meticulous cleaning between teeth using floss or an interdental brush,” Dr Fu adds.
Tip #4: Rinse before brushing to clear any taste in the mouth. Spit and rinse as often as needed when brushing. Alternatively, face downwards, so that saliva flows out and there is minimal accumulation in the mouth, which can cause gagging.
Tip #5: Use an alcohol-free fluoride mouth rinse to reduce the speed of the plaque buildup and prevent tooth decay. “If the commercial mouth rinses do not work for you, try rinsing your mouth out with water. If you suffer from frequent bouts of vomiting, make your own mouth wash by mixing a teaspoon of baking soda with some water,” adds Dr Fu.
Tip #6: Avoid sticky and starchy food with a high sugar content. These foods increase your chances of tooth decay.
Tip #7: If all fails, bypass the brushing and stick to flossing to remove plaque between teeth. Then use an alcohol-free fluoride mouth rinse to reduce the speed of plaque buildup and prevent tooth decay.