Pregnancy and your teeth-what to watch.
Monday, July 24, 2006
Dr Derek Lewis, Chairman of the Australian Dental Asssociation's Oral Health Committee was recently interviewed about issues regarding pregnancy and oral hygiene. This interview is produced here for your information.
a) How might pica affect a woman's teeth and does this vary depending on what she eats? Is pagophagia (eating ice) particularly destructive to teeth?
Eating non-food substances is unlikely to cause any detrimental effect to the teeth unless the substances are especially abrasive or hard. Eating ice risks fracturing teeth that have fillings in them, and may even risk fracture of otherwise intact teeth if the habit continues for a long time. If it is only associated with a ‘craving’ during pregnancy, it is unlikely to be of any great issue for teeth.
b) How might bulimia affect a woman's teeth? What visible signs/clues can the dentist detect?
Repeated exposure of teeth to stomach acid through bulimia can lead to erosion and wearing to the tooth structure, particularly enamel. Characteristically, this erosion attacks the inside and biting surfaces of the teeth because these are more likely to be exposed to the acid rather than the outside of the teeth. In extreme cases, the erosion can be so severe so as to cause tooth sensitivity and visible loss of tooth structure. Dental erosion is a ‘silent epidemic’ as acid from any source (soft drink, sports drinks, juices, excessive citrus fruits etc) can cause erosion. Dentists are well trained to detect signs of erosion from whatever cause. It is unlikely that vomiting/nausea associated with morning sickness will lead to visible changes due to erosion, unless the woman was already at-risk for dental erosion.
c) How common are dental signs of these conditions? Or if this
information is not available, is it common for dentists to detect signs of pica or bulimia in pregnant women?
In the general population, dental erosion is quite common primarily due to the intake of acidic drinks. Likewise, many people in the general population eat ice, and while some may not experience any dental problem (if they only eat crushed ice or only eat ice occasionally), some people who eat hard ice frequently are at risk of tooth damage. This risk is no less or greater if the person is pregnant or not. Unless pica involves particularly damaging objects, or the patient admits to it, it is unlikely that the dentist will notice any effect on the teeth if the habit is only present during pregnancy. As teeth are fairly tough structures, some time is usually required for damaging habits to cause visible signs.
d) Why is elective dental treatment discouraged during pregnancy?
While the provision of routine dental care during pregnancy is quite safe, the philosophy of risk avoidance is usually followed. That is to say, during this important and happy time in a woman’s life, unless treatment is absolutely necessary, then it is usually deferred until after baby arrives. If treatment is required, then it is usually performed in the middle trimester as all the baby’s major organs have formed, and any morning sickness is finished.
While care can be provided during the last trimester, the mother is sometimes uncomfortable lying back for dental care. Emergency dental care can be provided at any time during the pregnancy, but this is usually limited and kept as simple as possible to obtain pain relief. It is suggested that when women are planning to start a family that they consult their dentist for a comprehensive examination (including radiographs and cleaning) before falling pregnant.