A common and unhelpful belief is that dental treatment should be avoided during pregnancy. Current guidance from health authorities in Australia and internationally is close to the opposite: routine dental care is important during pregnancy, and postponing necessary treatment tends to make matters worse rather than safer.
What follows is general information. Your dentist, doctor and midwife should know about each other, and anything specific to your circumstances is a conversation with them.
What changes in the mouth
Pregnancy gingivitis
Raised hormone levels amplify the gum’s inflammatory response to the same amount of plaque. Gums become red, swollen and bleed easily, often from the second month and peaking in the middle months. It is very common and it is not inevitable: it responds to the same thorough cleaning as ordinary gingivitis, and it is one of the better reasons to see a dentist during pregnancy rather than after.
Pregnancy epulis
A localised lump of overgrown gum tissue, usually between teeth, that bleeds easily. Harmless, and it typically resolves after delivery. It should be examined to confirm what it is, but rarely needs removal unless it is interfering with eating.
Erosion from morning sickness
Stomach acid is considerably stronger than anything in the diet, and repeated vomiting erodes enamel on the inner surfaces of the upper front teeth. The useful advice is counterintuitive: do not brush immediately afterwards, because the enamel is temporarily softened and brushing abrades it away. Rinse with water, or with a teaspoon of bicarbonate of soda in a cup of water, and wait at least thirty minutes before brushing. More on this in what erodes enamel.
Changes in diet and saliva
More frequent snacking, cravings for sweet or acidic food, and nausea that makes brushing difficult all raise decay risk. A blander toothpaste, a smaller brush head and brushing at a time of day when nausea is least can all help if the toothpaste flavour is a trigger.
What is usually fine
- Examinations and cleans at any stage. Actively recommended.
- Fillings and necessary restorative work. Treating a problem is generally lower risk than leaving it to become an infection.
- Local anaesthetic. Dental local anaesthetics are widely used in pregnancy. Tell the dentist you are pregnant so the choice and dose can be made accordingly.
- X-rays where clinically necessary, with a lead apron and thyroid collar. Modern dental x-rays involve very low doses directed away from the abdomen. Routine screening x-rays are usually deferred; x-rays needed to diagnose a problem are not.
- Treating infection. An untreated dental infection carries its own risks and should not be left.
What is usually timed or deferred
- Elective cosmetic treatment, including whitening, is generally deferred until after delivery and breastfeeding. This is a precaution rather than evidence of harm.
- Extensive elective work is often scheduled for the second trimester, when nausea has usually settled and lying back is more comfortable than it becomes later.
- Long appointments late in pregnancy can be uncomfortable. Lying flat can cause dizziness as the uterus presses on major blood vessels, so mention it; sitting more upright or tilting slightly to the left usually resolves it.
- Some medications, including certain antibiotics and pain relief. Always tell the dentist you are pregnant before anything is prescribed.
Looking after your mouth day to day
- Brush twice daily with a fluoride toothpaste, and clean between the teeth every day. See cleaning between your teeth.
- Rinse with water after vomiting, and wait before brushing.
- Keep sugary and acidic snacks to mealtimes where cravings allow.
- Drink water rather than juice or soft drink between meals.
- Book a check-up and clean during the pregnancy rather than putting it off.
- Mention bleeding gums rather than assuming they are simply part of it.
After the birth
Pregnancy gingivitis usually settles within a few months of delivery, though it will not resolve on its own if plaque and calculus have accumulated. A clean afterwards is worth booking. There is also no evidence for the old idea that a baby takes calcium from the mother’s teeth; decay during pregnancy is explained by diet, cleaning and morning sickness, not by mineral loss from teeth.
Once your child arrives, their first dental check is due around their first birthday or within six months of the first tooth appearing. See children’s dental visits.
What it costs
Our new patient consultation and clean package starts from $219 and includes an examination, scale and clean, fluoride treatment and two bitewing X-rays. Tooth-coloured fillings range from $209 to $450. We are a preferred provider for nib First Choice and Westfund with HICAPS available at the appointment. Current fees are on our price list, with more on cleans and check-ups at our Canberra practice.
Common questions
Should I tell the dentist I am pregnant?
Yes, as early as possible, including how many weeks. It affects positioning, imaging decisions and any medication.
Are dental x-rays safe in pregnancy?
Dental x-rays use very low doses and are directed away from the abdomen, with shielding used. Routine screening images are usually deferred; images needed to diagnose a problem are taken when clinically necessary.
My gums bleed constantly. Is that normal?
It is common in pregnancy but it is still inflammation, and it responds to thorough cleaning. Have it assessed rather than waiting it out. See bleeding gums.
Can I have whitening while pregnant or breastfeeding?
Elective cosmetic treatment is generally deferred. Discuss timing with your dentist and your doctor.
Booking an appointment in Canberra City
Civic Gentle Dental Care is a dentist in Canberra at Suite 8, Level 3/161 London Circuit, Canberra City, a short walk from the Canberra Centre. To arrange an appointment, call (02) 6247 0224 or send us a message through our contact page.
This article is general information only and is not a substitute for individual dental advice. Whether a treatment is suitable for you, and what it will involve, can only be determined after an examination by a dentist. Any prices mentioned are estimates drawn from our current price guide and are not a quote.