What to expect when you're expecting (80 page)

“My mouth has suddenly become a disaster area. My gums bleed every time I brush, and I think I have a cavity. Is it safe to have dental work done?”

Smile—you’re pregnant! But with so much of your attention centered on your belly during pregnancy, it’s easy to overlook your mouth—until it starts screaming for equal time, as frequently happens during pregnancy. For starters, pregnancy hormones aren’t kind to your gums—which, like your other mucous membranes, become swollen, inflamed, and tend to bleed easily. Those same hormones also make the gums more susceptible to plaque and bacteria, which can soon make matters worse in some women, possibly leading to gingivitis (inflammation of the gums) and even tooth decay.

To keep your mouth happy—and your smile safe—while you’re growing a baby:

Floss and brush regularly, and use toothpaste with fluoride for cavity protection. Brushing your tongue while you’re at it will also help combat bacteria while keeping your breath fresher.

Ask your dentist to recommend a rinse to reduce bacteria and plaque, protecting your gums and your teeth.

A Gum Alert

If it’s not one thing in pregnancy, it’s another. If you notice a nodule on the side of your gum that bleeds when you brush, get it checked out. It’s most likely a canker sore or something called a pyogenic granuloma (also known by the ominous-sounding term “pregnancy tumor,” despite the fact that it’s perfectly harmless). More of a nuisance than anything else, such nodules usually regress on their own after delivery, but if it becomes very annoying before that, it can be removed by a doctor or dentist.

When you can’t brush after eating, chew a stick of sugarless gum (the action of chewing increases the amount of saliva, which rinses the teeth—and if the gum’s sweetened with xylitol, chewing can actually help prevent decay). Or nibble on a chunk of hard cheese (it decreases the acidity in your mouth, and it’s the acid that causes tooth decay).

Watch what you eat, particularly between meals. Save sweets (particularly sticky ones) for times when you can brush soon after. Consume plenty of foods high in vitamin C, which strengthens gums, reducing the possibility of bleeding. Also be sure to fill your calcium requirements daily. Calcium is needed throughout life to keep teeth strong and healthy.

Pearly White Wisdom

Wondering if you can use teeth-whitening products while you’re pregnant? Check out
page 147
for the latest facts.

Whether or not you’re experiencing dental discomfort, be sure to make an appointment with your dentist at least once during the nine months for a checkup and cleaning, preferably earlier than later. The cleaning is important to remove plaque, which can not only increase the risk of cavities but also make your gum problems worse. If you’ve had gum problems in the past, also see your periodontist during your pregnancy.

If you suspect a cavity or other tooth or gum trouble, make an appointment with your dentist or periodontist right away. Untreated gingivitis can develop into a more serious gum condition, periodontitis, which has actually been associated with a variety of pregnancy complications. Decay that isn’t cleaned up or other tooth issues that aren’t tended to can also become a source of infection (and infection isn’t good for you or your baby).

What happens if major dental work becomes necessary during pregnancy? Luckily, in most dental procedures, a local anesthetic will suffice, and that’s safe. A low dose of nitrous oxide (laughing gas) is also safe to use after the first trimester, but more serious sedation should be avoided during pregnancy. In some cases, it may be necessary to take an antibiotic before or after major dental work; check with your practitioner.

“Sometimes I feel a little breathless. Is this normal?”

Take a deep breath (if you can!) and relax. Mild breathlessness is normal, and many pregnant women experience it beginning in the second trimester.
And, once again, you can blame your pregnancy hormones. Here’s why: Those hormones stimulate the respiratory center to increase the frequency and depth of your breaths, giving you that out-of-breath feeling after nothing. more strenuous than a trip to the bathroom. They also swell the capillaries in the body—including those of the respiratory tract—and relax the muscles of the lungs and bronchial tubes, making those breaths seem even harder to catch. Your uterus will also likely contribute to your breathlessness as pregnancy progresses, pushing up against your diaphragm as it grows, crowding your lungs and making it more difficult for them to expand fully.

Fortunately, though the mild breathlessness you’re experiencing may make you feel uncomfortable, it doesn’t affect your baby—who’s kept well stocked with oxygen through the placenta. But if you’re having a very hard time breathing, if your lips or fingertips seem to be turning bluish, or if you have chest pain and a rapid pulse, call your practitioner right away.

Expecting X-Rays?

Routine dental X-rays (and other routine X-rays or CT scans) are usually postponed until after delivery, just to be on the extra-safe side. But if putting off dental (or other) X-rays during pregnancy just isn’t a good idea (the risk of having one is outweighed by the risk of not having one), most practitioners will green-light the procedure. That’s because the risks of X-rays during pregnancy are really very low and can be easily made even lower. Dental X-rays are targeted to your mouth, of course, which means the rays are directed far away from your uterus. What’s more, a typical diagnostic X-ray of any kind rarely delivers more radiation than you’d get from spending a few days in the sun at the beach. Harm to a fetus, however, only occurs at very high doses, doses you’re extremely unlikely to ever be exposed to. Still, if you do need an X-ray during pregnancy, keep the following guidelines in mind:

Always inform the doctor ordering the X-ray and the technician performing it that you’re pregnant, even if you’re pretty sure they know.

Have any necessary X-ray done in a licensed facility with well-trained technicians.

The X-ray equipment should, when possible, be directed so that only the minimum area necessary is exposed to radiation. A lead apron should be used to shield your uterus and a thyroid collar should protect your neck.