Pregnant women are more prone to tooth decay due to upturn in the acidic environment of oral cavity, increased consumption of sugary diet and carelessness toward oral health. Recurrent vomiting becomes common in pregnancy that enhances acidic environment leading to progress of carious pathogens and an increased demineralization making teeth prone to caries. Untreated carious lesions increase the incidence of abscess and cellulitis.
2.1.1. Management
It is advisable for pregnant women to limit sugary diet, brush regularly with fluoridated tooth paste and use over the counter fluoridated mouth rinses to counteract the effect of demineralization due to vomiting. The role of topical applications of fluoride is well accepted for the prevention of caries. Fluoride releasing restorative materials such as glass ionomers can inhibit secondary caries.In addition, drugs such as methamphetamine that may further aggravate dental caries should be avoided.
2.2. Periodontal disease
About 30% of pregnant women suffer from periodontal diseases. While the role of elevated levels of circulating estrogen is well established in higher prevalence of gingivitis and gingival hyperplasia during pregnancy, the association between pregnancy and oral diseases like periodontitis require further research. The role of elevated levels of inflammatory markers (i.e. interleukin 6, interleukin 8 and PGE2) has been found in the amniotic fluid of child bearing women having periodontal conditions, which is considered to be associated with premature labor and low birth weight.
2.2.1. Management
Recent evidence clearly demonstrates that scaling and root planning is considered safe during pregnancy and improves both maternal and neonatal health. The management strategies to overcome periodontal disease in pregnant females embraces vigilant diagnosis by the dental health care professional, root planning/deep scaling and prescribing 0.12% daily chlorhexidine mouth rinses to limit the progress of disease. Chlorhexidine is categorized as FDA class B and measured safe to practice in pregnant women.
2.3. Gingivitis
Gingivitis or bleeding tender gums is the most common dental problem and contributes to around 60–70% of pregnant women. Such conditions are common due to decreased immune response, hormonal fluctuations of estrogens and progesterone and changes in normal oral flora.
2.3.1. Management
Commendations to improve the condition may comprise professional prophylaxis i.e. scaling, daily fluoridated tooth brushing, flossing and saline mouth rinses should be encouraged that may help in easing the irritant. In addition, chlorhexidine mouth rinses may provide added benefit.
2.4. Tooth mobility
Due to hormonal rush mineral changes in lamina dura and disturbance in the periodontal ligament attachment, affect mobility of teeth leading to periodontal diseases.
2.4.1. Management
This condition can be made reversible if given therapeutic doses of vitamin C along with removal of local gingival irritants.
2.5. Tooth erosion
Tooth erosion, another unwanted dental problem is considered to be caused by pregnancy induced vomiting. It is understood that dental erosion can be effectively controlled with the use of a solution containing sodium bicarbonate that neutralizes the acid and prevents damages. It is advised to consult patient’s physician and gastroenterologist to control the related medical conditions.
