Tooth Decay During Pregnancy: Causes And Prevention Tips

The American Dental Association (ADA) defines tooth decay as a “biofilm-mediated, sugar-driven, multifactorial, dynamic disease that results in the phasic demineralization and remineralization of dental hard tissues” (1).

Tooth decay during pregnancy comes with its share of challenges due to some diagnostic and treatment limitations. This post elaborates on the symptoms, treatment, and prevention of tooth decay during pregnancy.

Is It Common To Get Cavities While Pregnant?

There is a very common belief that you lose a tooth for every baby. But that is not true.

Pregnancy has no direct impact on the occurrence of dental cavities, but the hormonal and lifestyle-based changes that occur in pregnancy may cause dental cavities among other dental problems.

A bad oral health in pregnancy may lead to a premature delivery, low birth weight baby, preeclampsia, pregnancy granuloma, gingivitis, pregnancy tumors, loose teeth, mouth dryness and dental erosion.

What Are The Causes Of Tooth Decay During Pregnancy?

According to the ADA, one-fourth of all women in the reproductive age range have dental decay (2).

Pregnant women are at a higher risk of developing dental decay due to an increase in the acidic environment of the oral cavity, excess consumption of sugary foods, neglecting oral health, and some other reasons mentioned next (3).

1. Increased acidity in the oral cavity: Around 66% of all pregnant women are said to experience nausea and vomiting due to hormonal changes (4). The expanding uterus and hormonal changes may also slow down digestion in the woman’s body, leading to acid reflux. This increased acidic environment in the oral cavity leads to demineralization of the enamel and leads to cavities.

2. Food cravings: Many pregnant women tend to have cravings for foods rich in sugar and carbohydrates. This could lead to an increased incidence of dental decay during pregnancy.

3. Limited attention to oral health: A woman’s body undergoes several changes during pregnancy, and this can be overwhelming for most women. During such a time, most pregnant women tend to neglect their oral health. Many women complain of retching while they try to brush their teeth, because of which they may not brush their teeth properly or at all (5). Less attention to oral hygiene could result in dental cavities.

4. Frequent snacking: Due to increased hunger during pregnancy, many women fall into the habit of frequent snacking. Some women also snack in the nighttime, due to hunger pangs. This leads to increased bacterial count in the oral cavity and makes a woman more susceptible to dental caries.

5. Dry mouth: Salivary flow is less in pregnant women when compared to non-pregnant women (6). Saliva has a self-cleansing action on the teeth as it helps in the removal of food debris. A dry mouth makes a woman more prone to develop dental decay (7).

Most of these causes are not persistent after delivery. You can consult a dentist if you are pregnant and plan for prevention or treatment of decay accordingly.

Symptoms Of Tooth Decay In Pregnancy

Early tooth decay usually does not have any symptoms. But as the decay begins to progress towards the deeper layers of the tooth, you might notice one or more of the following symptoms: (8)

• White, brown, or black spots on the surface of the teeth.
• Cavities or holes on the surface of the teeth.
• Sensitivity to hot and cold food or beverages.
• Toothache, which might be mild to throbbing in intensity. At times, the pain also radiates to the ear and back of the neck or the head.
• An infection that leads to collection of pus at the root tip of the tooth is known as an abscess. It is a very painful condition and might cause intraoral or extraoral swelling, fever, tooth mobility, etc.

Home Remedies For Tooth Infection While Pregnant

There are no home remedies for dental decay and infection. Dental decay is an active infectious disease, and it needs medical intervention. Timely treatment might prevent more invasive treatment measures.

Read on to know more about the treatment of dental decay in pregnancy.

Tooth Decay Treatment During Pregnancy

Your dentist might do a thorough examination of the clinical features and ask for the severity of your symptoms to diagnose tooth decay.

The dentist might also need to take a radiograph for the infected tooth. It is safe to get an X-ray during pregnancy, as radiation from dental X-rays are extremely low. The dentist might get the X-ray done by covering the area below the neck with a lead apron that minimize exposure to the abdomen and your throat will be covered with a leaded collar to protect the thyroid from radiation.

Periodontal diseases are related to many systemic diseases including gestational complications.

After determining the diagnosis and considering your general health, the dentist might suggest one of the following treatment modalities for tooth decay in pregnancy (8).

1. Topical fluoride application

In the case of initial decay, fluoride varnish application might promote the natural healing of the cavity by repairing the enamel. (9)

2. Fillings

Your dentist might do resin-based dental fillings for your cavities to prevent further spread of the decay. Silver amalgam fillings that contain mercury are contraindicated in pregnancy (10).

3. Root canal treatment

Root canal treatment is not contraindicated in pregnancy. It can be done if necessary. If it is not an emergency procedure, the dentist might ask you to wait until delivery (11).

4. Extractions

Extractions are not contraindicated in pregnancy, but elective extractions, like non-symptomatic wisdom teeth extractions, should be postponed until delivery. If it is an emergency, an extraction can be done in pregnancy (12).

It is most suitable to do the dental treatment during the second trimester, as the baby’s organ formation is complete by the end of the first trimester. Moreover, the size of the uterus and the baby is relatively smaller than it is in the third trimester when you can experience positional discomfort. Therefore, it is easier for mothers to get the treatment done in the second trimester.

That said, emergency dental care can be given at any stage of pregnancy (2).

All other non-elective treatments, such as teeth whitening, or any cosmetic procedures, should be postponed until after the delivery. Take your dentist’s and the gynecologist’s approval before undergoing any dental treatment.

The ideal number of dental checks in the first trimester is two, and one each in the second and third trimesters.

Preventing Tooth Decay

Dental decay is preventable if proper measures are taken. The following are the suggested ways to prevent dental caries:

1. Brushing teeth twice a day

2. Flossing the teeth to get rid of food particles stuck between the teeth.

3. Gargling with salt water or using an alcohol-free mouthwash to rinse the oral cavity.

4. Getting a dental check-up before planning a pregnancy.

5. Getting the necessary preventive and therapeutic treatments done before pregnancy

6.  Brushing teeth with fluoridated toothpaste one hour after an episode of vomiting to reduce the chances of demineralization of the enamel. (5)

7. Avoid eating extremely sweet and processed food. Try and eat fruits instead to satisfy your sweet cravings.

8. Try and brush your teeth or rinse your mouth thoroughly after snacking.

9.  Drink more water to prevent dry mouth.

10. Use sugar-free chewing gum to produce more saliva in a dry mouth.

11. Take calcium supplements if your gynecologist approves, to prevent calcium loss from teeth to support the baby.

12. Consume fiber-rich food to improve digestion, which can result in less acid reflux.

13. Avoid smoking. Periodontal inflammation and destruction increases in women who smoke.

What Can You Take For A Tooth Infection While Pregnant?

There are a few drugs that pregnant women can take for tooth infection. Do not take any medicines without taking consent from your gynecologist, as the doctor needs to see if the benefits of the medicine will outweigh the risks.

According to the Food and Drug Administration (FDA) of the United States Department of Health and Human Services, the following medicines are usually prescribed for dental issues during pregnancy (4).

1. Analgesics (Pain killer)

• Acetaminophen
• Morphine
• Meperidine

2. Antibiotics

• Amoxicillin
• Metronidazole
• Erythromycin
• Penicillin v
• Cephalosporin
• Clindamycin

3. Local anesthetics

• Lidocaine
• Prilocaine
• Etidocaine
• Prednisolone

These drugs are usually safe but do not consume them without the doctor’s approval. Every pregnancy is unique, and the doctor will prescribe medicines only after considering all other factors of your health.

References

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