Dental Care: Safe During Pregnancy
Breaking Down the Barriers to Oral Health Care for Pregnant Women
“I’ve been calling around to a few dentists and they don’t want to see me. They say that Medi-Cal doesn’t cover dental care for pregnant women.”
She is not alone.
According to a 2010 survey by the California HealthCare Foundation, only 1 in 4 California dentists provides services to Medi-Cal beneficiaries.i
Getting good oral health care is essential to a healthy pregnancy. “Oral health care” is dental care for the teeth, gums, jawbone, and supporting tissues.
Why Oral Health Care during Pregnancy Matters
Being pregnant means a woman has a higher risk of experiencing periodontal, or gum, disease. This results from normal hormonal changes that occur during pregnancy.
Gum disease during pregnancy is serious because it is linked with premature birth and low birth weight in newborns. As many as 18 percent of low-birth-weight and preterm births may be attributable to periodontal disease in pregnant women, according to one report. Preterm birth is the leading cause of death for babies younger than one month.ii
Here’s what makes dental care during pregnancy so important: Treating periodontal disease during pregnancy can reduce the risk of preterm birth by as much as 50 percent.iii
Yet, many pregnant women are not getting the dental care they need. A study by the National Institutes of Health found that 65 percent of California women did not visit the dentist during their pregnancy.iv
Why More Pregnant Women Don’t Get Dental Care
At least 40 percent of pregnant women experience some form of periodontal disease. This includes cavities, gingivitis (inflamed gums), and periodontitis (inflammation of the ligaments and bones that support the teeth)v. Left untreated, periodontal disease worsens.
So why aren’t more pregnant women getting dental care?
There are many reasons, ranging from:
- Some dentists are reluctant to treat pregnant patients. In a 2009 national survey of 351 OB/GYNs, 77 percent reported that some of their patients had been “declined dental services because of pregnancy.”vi
- Some OB/GYNs fail to check their pregnant patients for dental problems and refer them for dental care.
- Some patients fear receiving dental treatments while pregnant.
- Some patients can’t afford to see the dentist. To make good oral health care affordable for more pregnant women, California offers Medi-Cal dental benefits (Denti-Cal) to low-income expectant mothers.
In 2013, the American College of Obstetricians and Gynecologists began advising OB/GYNs to check their patients for oral health issues during the first prenatal visit.vii
Is Dental Work during Pregnancy Safe?
Routine teeth cleanings, dental X-rays, and local anesthesia, generally, are safe during pregnancy. Doctors often recommend having these services performed during the second trimester.
Even filling cavities and performing root canals should not be put off during pregnancy because the delay in treatment can potentially lead to further complications.
The National Maternal and Child Oral Health Resource Center at Georgetown University recommends that OB/GYNs check patients for bleeding gums or oral infection. Patients who have not seen a dentist for more than six months should be referred for dental care.viii
Improving a woman’s oral health during pregnancy can have the side benefit of decreasing the transmission of bacteria from mother to baby that can cause her child to have cavities as well.
Why the Need for Dental Care Increases During Pregnancy
Hormonal changes during pregnancy can directly affect oral health. Problems that may appear or increase during pregnancy include:
- Cavities or tooth decay. Hormones during pregnancy increase the levels of acidity in the mouth. This increases the risk of tooth decay. Morning sickness that leads to frequent vomiting can worsen the problem by exposing the teeth to more gastric acid.
- Gum disease. Many women develop pregnancy gingivitis as a result of pregnancy-driven hormonal changes that begin during the second and third months of pregnancy. Gingivitis is an inflammation of gum tissue. This is a mild form of gum disease that causes gums to bleed, turn red, and become very tender or sore. Left untreated, this can lead to periodontitis, a more serious gum disease. Advanced gum disease has been associated with premature birth and low birth weight.
- Loose teeth. The teeth may loosen during pregnancy even if there are no signs of gum disease. This is because increased levels of progesterone and estrogen can weaken the ligaments and bones that support the teeth. Without proper care, loss of the teeth can result.ix
Gingivitis can be prevented by good daily oral care and regular visits to the dentist for professional cleanings.
EPFMC Providers Perform Dental Work during Pregnancy
Eisner Pediatric & Family Medical Center dentists provide dental care services to pregnant women. See one of our dentists early during your pregnancy to have a complete oral exam. It’s important to inform the office that you’re pregnant when making the appointment.
Throughout your pregnancy, pay attention to signs of periodontal disease, such as red or bleeding gums, loose teeth, toothaches, mouth sores, and bad breath.
If you’re pregnant and have not visited a dentist, call (213) 747-5542 for an appointment.
i Children’s Dental Health Project (CDHP) and National Institute for Health Care Management Research and Educational Foundation (NIHCM Foundation). “Improving Access to Perinatal Oral Health Care: Strategies & Considerations for Health Plans.” Washington, DC, July 2010.
iv Kristen S. Marchi, MPH, Susan A. Fisher-Owens, MD, MPH, Jane A. Weintraub, DDS, MPH, Zhiwei Yu, MPH, and Paula A. Braveman, MD, MPH. “Most Pregnant Women in California Do Not Receive Dental Care: Findings from a Population-Based Study.” Public Health Reports 125(6): 831–842. Nov-Dec 2010.
v American Congress of Obstetricians and Gynecologists (ACOG). Dental X-Rays, Teeth Cleanings = Safe During Pregnancy. Committee Opinion #569, July 26, 2013.
vii Catherine Saint Louis. “Obstacles for Pregnant Women Seeking Dental Care.” Well Blogs. New York Times, May 6, 2013. http://well.blogs.nytimes.com/2013/05/06/obstacles-for-pregnant-women-seeking-dental-care/?_php=true&_type=blogs&_r=0.
ix Mary M. Murry, R.N., C.N.M. “Dental Health during Pregnancy.” Pregnancy and You Blog. Mayo Clinic, June 2, 2009. http://www.mayoclinic.org/healthy-living/pregnancy-week-by-week/expert-blog/dental-health-during-pregnancy/bgp-20055788.