Top 5 Oral Health Issues in Pregnant Women

Expecting a baby is already a lot to think about.

Nonetheless, it is also important to not forget about your oral health during this wonderful journey.

Pregnancy has a number of effects on different parts of the body, and the mouth is no exception. It can trigger a number of changes in oral health, which include the following:

1. Pregnancy Gingivitis:

Gum disease is the most common oral health issue among pregnant women, and this is primarily due to the hormones associated with pregnancy.

Pregnancy gingivitis is the inflammation of the gum tissue that commonly occurs – or worsens if the patient already has some form of gingivitis prior to pregnancy – during the second trimester.

This condition causes the gums to become swollen and bleed easily when brushing or flossing.

Plaque is still the cause of inflammation, but the body’s immune response to the bacterial invasion in the gum tissue is exaggerated as a result of increased hormone levels.

While some women experience spontaneous resolution of pregnancy gingivitis, most cases result in a more severe form of gum disease known as periodontitis.

If left untreated, periodontitis may lead to tooth loss.

It is, therefore, important to have your gums examined by a dentist as soon as possible after giving birth.

Pregnancy gingivitis can be prevented by good oral hygiene. Do thorough toothbrushing at least at least twice a day and floss to remove plaque in-between teeth.

Professional cleaning is also advised, ideally during the second trimester.

2. Pregnancy Epulis:

Pregnancy epulis, otherwise known as pregnancy tumor or pyogenic granuloma, pertains to the localized enlargement of the gum tissue.

It can also appear on the palate and tongue. It is caused by increased levels of progesterone, along with a plaque and other local irritants in the mouth.

It usually occurs during the second or third trimester, sometimes during the last month of pregnancy. It appears red, swollen and tends to bleed profusely even upon slight manipulation, though it is generally painless.

Some women who have pregnancy epulis choose to have the tumor excised for cosmetic purposes or when it interferes with function.

But even without treatment, the tumor usually disappears after childbirth. Professional cleaning may aid in the faster resolution of this condition.

3. Tooth decay:

Tooth decay is also quite common, especially since pregnant women tend to have cravings for sweet treats yet limited attention to their oral hygiene.

In addition, hormonal changes during pregnancy as well as vomiting due to morning sickness can also increase their risk for this dental problem.

Such risk can be lowered, again, by practicing good oral hygiene.

Extensive tooth decay may lead to abscess and facial cellulitis if left untreated, so it is advised to have the involved teeth restored by a dentist whenever possible.

4. Tooth sensitivity:

Frequent vomiting, in addition to tooth decay, may first and foremost lead to the erosion of the tooth enamel.

Enamel dissolution exposes the dentin underneath, resulting in tooth sensitivity.

This sensitivity is characterized by sharp pain and is triggered by cold, hot, sweet, and sour. Management is more medical than dental and involves prescription of antacids, anti-emetics, or a combination of both.

In addition, your dentist will also recommend using soft-bristled toothbrushes and instruct you to avoid brushing your teeth right after vomiting to avoid further damage.

He/she may also ask you to use fluoride mouth rinse for further protection.

5. Mobile teeth:

Pregnant women can also experience loosening of their teeth due to advanced gum disease.

It can also be due to increased levels of estrogen and progesterone directly affecting the supporting structures of the teeth.

If tooth mobility is associated with gum disease, professional cleaning would be necessary to prevent eventual tooth loss, otherwise, this problem is only temporary and will resolve on its own.

Understanding Your Dental X-rays

Dental x-rays are classified as either intraoral or extraoral.

Intraoral x-rays requires the x-ray film to be positioned inside the patient’s mouth while in extraoral, the film is outside the mouth.

The most common intraoral x-rays include periapical, bitewing, and occlusal x-rays. Extraoral x-rays, on the other hand, are your panoramic and cephalometric x-rays.

As mentioned in the previous article (A Patient’s Guide to Dental X-rays), different conditions and procedures require different types of dental x-ray. Each type provides different views of the teeth and associated structures.

Periapical:

A periapical x-ray captures the image of a single tooth (or sometimes two) from the crown to its root/s and supporting bone.

It uses a small film that fits inside the patient’s mouth.

It is the most detailed of all the dental x-rays (intraoral or extraoral) and thus most often required in determining the extent of tooth decay.

It is also the one used in procedures such as extraction and more importantly, in root canal treatment.

Bitewing:

A bitewing x-ray produces an image of both the upper and lower back teeth when in full contact with each, a.k.a. bite – hence the name.

It shows the crown of these teeth only and not the roots and supporting bone.

It is used to assess the extent of decay in-between teeth. The small film used for periapical x-ray is also the one used in this type of dental x-ray.

When taking bitewing x-ray, a small tab is used to position the film beside the involved teeth.

Occlusal:

An occlusal x-ray shows the whole dental arch viewed from the biting (occlusal) surface of the teeth.

It is done to see how the upper and lower teeth line up when in contact with each other.

It may also show abnormalities in the palate or roof of the mouth. The film used is slightly bigger than the ones used in periapical and bitewing x-rays.

Panoramic:

A panoramic x-ray captures the upper and lower teeth – all 32 of them, including the wisdom teeth – in one film.

It shows the jaws (both upper and lower) and other surrounding structures as well.

This type of x-ray is shot by a machine that revolves around the head. This type of dental x-ray is used to identify the presence of impacted wisdom teeth or to plan an orthodontic treatment.

It may also be a useful aid in diagnosing advanced cases of periodontal disease, investigating jaw problems, or determining the feasibility of an implant surgery.

A panoramic x-ray is otherwise known as orthopantomogram.

Cephalometric:

A cephalometric x-ray is the primary type of x-ray required from patients who wish to undergo orthodontic treatment, along with panoramic x-ray.

It is taken from the side of the head, and thus enables the orthodontist to evaluate the patient’s profile and predict how the treatment may affect the teeth and the surrounding bone.

It helps determine what course of treatment is most applicable to the patient’s case. This type of x-ray is sometimes ordered by an otorhinolaryngologist as well because it can show a good view of the airways. An otorhinolaryngologist is medical doctor who specializes in the conditions of the ears, nose, and throat.

A Patient’s Guide to Dental X-rays

Dental x-rays, which dentists call radiographs, pertain to the images of the teeth used to assess the health of teeth and associated structures.

It utilizes low levels of radiation that penetrate the tissues to form a radiographic image on an x-ray film.

It produces images of the interior or internal part of the teeth, as well the bone that supports it.

Dental x-rays are very important tools your dentist needs to come up with a correct diagnosis.

Why are dental x-rays taken?

Dental x-rays are taken to help dentist detect problems (i.e. deep and recurrent tooth decay, impacted teeth, etc.) that are not readily identified through visual examination.

They may also be performed on a regular basis to track or monitor response to treatment.

How often dental x-rays are needed depends on the patient’s age, history of oral diseases, risk for oral disease, and current oral health status.

Children may require dental x-rays more frequent than adults do because their teeth and jaw are still in the process of growth which dentists need to monitor on a regular basis.

This monitoring is necessary because it helps determine if there are baby teeth that have to be pulled out to allow the adult teeth to erupt into their proper alignment.

To determine if you need dental x-rays, your dentist will first review your medical and dental history and perform comprehensive oral examination.

If you are a new patient, x-rays are most likely needed to enable your dentist to assess your current oral health status and get a baseline upon which changes (that will occur later) can be compared to.

If you have any radiographs from your previous dentist and you switch to another dentist, the later may ask for these radiographs.

What procedures require dental x-rays?

Almost every dental procedure require x-rays first, but the ones where they are an absolute requirement include periodontal therapy, root canal treatment, orthodontic treatment, extraction (both simple and complicated), and implant placement.

Different conditions and procedures require different types of dental x-ray.

These types will be discussed in a separate article.

Are dental x-rays safe?

While dental x-rays requires exposure to radiation like your chest x-rays (and any other type of x-rays for that matter), the dose is so low and thus deemed safe even for children.

If digital x-rays are used, the dose is even lower and therefore much safer.

But even though radiation exposure is very low, it should still be limited as much as possible.

No one – dentist and patient alike – should receive more radiation than necessary.

This can be prevented by placing a lead apron over the chest, pelvic, and abdominal regions when taking x-rays.

A lead apron with collar is indicated for patients with thyroid problems, but it can be used in all patients whenever possible.

Although dental x-rays are generally safe, women who are pregnant or suspect they could be pregnant must x-rays, unless absolutely necessary.

It is dangerous for the developing baby to be exposed to any kind of radiation.

Be sure to tell your dentist if you think you may be pregnant.

If dental x-rays are part of the treatment plan, a collared lead apron should be enough to protect your developing baby from radiation exposure.

Implant-Supported Dentures

If you have had traditional dentures before, you understand the struggle and limitations – biting and chewing issues, mouth sores, and some difficulty talking.

Simply put, traditional dentures are do not function as good as your natural teeth.

And that’s because such type of denture basically just floats on the gums and do not stimulate the underlying bone.

As a consequence, the bone will resorb or shrink over time. But there is a solution: implant-supported denture.

What is an implant-supported denture?

An implant-supported denture, as the name suggests, is a denture that is anchored to the bone by dental implants.

A dental implant is a small titanium screw surgically placed into the jawbone to act as artificial tooth root.

It has a latching system on the top, upon which the denture will be locked firmly in order to function like natural teeth.

Benefits of implant-supported dentures

Implant-supported dentures offer the following benefits over traditional or conventional dentures:

Preservation of bone:

Implant-supported dentures preserve the remaining underlying bone by encouraging bone growth and preventing bone loss.

Traditional dentures just sit on the top of the bone, and it can’t do anything to prevent bone loss which eventually leads to premature aging, facial sagging, and loss of function.

Secured fit:

Dental implants are embedded and therefore firmly anchored into the bone.

The denture on top of it won’t slip, slide, or fall off no matter how much you talk, laugh, or chew. This will give you more confidence to face other people.

Comfort:

Implant-supported dentures, particularly upper dentures, require minimal palatal coverage; meaning, they don’t cover your whole palate unlike traditional dentures do.

Excellent restoration of function:

Implant-supported dentures, being more stable and secured than traditional dentures, can restore function much better.

According to studies, as much as 95% of normal function (that is, the biting and chewing ability normally provided by natural teeth) can be restored with implant-supported dentures versus the 25% of their traditional counterparts.

And because there is lesser palatal coverage, there is less denture component that will limit the taste of food.

You can therefore enjoy a wider variety of food with implant dentures.

In fact you can enjoy almost all the foods you were eating when you still have your natural teeth.

Cost-effectiveness

It may be costlier to replace missing teeth with an implant-supported denture, but given the benefits listed above, it actually pays off tremendously in the long run.

Because they don’t preserve the remaining bone, traditional dentures tend to get loose after about five years or so and will therefore have to be replaced.

With implant-supported dentures, there will be less need for relining, rebasing, or replacements.

As long as you practice good oral hygiene and you visit your dentist on a regular basis, your implant-supported denture can even last a lifetime.

Even with all the advantages of an implant-supported denture, there are still some patients who feel that a traditional denture is more suitable for their case.

Ultimately, it is your dentist who can determine which of type of dentures we’ve discuss is best for you.