It's safe for pregnant women to go to the dentist

December 8, 2016 by David Leader, The Conversation
It’s safe. Credit:

According to research from the Massachusetts Department of Public Health, in 2011 about two-thirds of pregnant women had their teeth cleaned in the year prior to delivery, but only about one-half had their teeth cleaned during pregnancy. While plenty of factors may keep pregnant women from getting to the dentist, some may avoid going because they are unsure if it's safe.

I am a dental school professor and a practicing dentist, and over the years, some pregnant women told me that they will not see a dentist until after the baby is born. I've had pregnant women ask me to diagnose and treat dental infections without dental x-rays. In fact, x-rays, routine cleanings, root canal treatment and many local anesthetics are safe during pregnancy.

Despite that fact, many oral and medical are unsure of the safety of routine dental care for pregnant women and their unborn child.

Yet not only are women are more likely to have problems when they are pregnant, but these may lead to systemic health issues for mother and baby.

Where did this myth come from?

It's hard to pin down when the perception that dental care might not be safe during pregnancy began, but it seems that this particular belief has been with us for a long time. Take for instance, this case report from a 19th-century dentist detailing a patient's miscarriage 24 hours after a tooth extraction. The dentist, Dr. Jonaston, thought that this confirmed that women are fragile, especially when pregnant.

Today, a general sense of caution about pregnancy – and perhaps even confusion about what is or isn't safe – contributes to keeping this particular myth alive for patients and dentists alike.

For example, a 2014 survey of dentists in North Carolina found that over 80 percent of responding dentists feel confident when discussing the risks of oral health treatment during pregnancy with their patients. However, only about half felt confident to provide treatment to patients who may be at risk for adverse pregnancy outcomes.

Avoiding is a problem, because normal health changes during pregnancy cause women to have more gum disease, called periodontitis, and tooth decay. The growing womb presses on the stomach, which can cause heartburn or gastric reflux, softening or dissolving tooth enamel. Teeth with thin or weak enamel have a high risk of decay and are sensitive to cold food and drink.

During pregnancy, increased hormone levels cause gums to be more sensitive to bacterial plaque that normally forms on teeth. Women may notice that their gums are swollen or tender and bleed more easily.

A 2011 study found that periodontitis was a risk factor preterm labor and low birth weight. There is a similarity between inflammation and infection due to bacterial vaginosis, a proven risk factor for preterm labor and low birth weight, and inflammation and infection due to periodontitis. Other studies have found that periodontis is risk factor. Yet, it is not possible to confirm a causal relationship between periodontal disease and pregnancy outcomes due to alternate risk factors.

Teeth cleaning to remove plaque and hardened plaque known as tartar or calculus from the teeth is a good way to prevent and reduce this problem. Brushing and flossing make a big difference as well.

What about x-rays?

Some women are wary of being exposed to the small doses of radiation involved, even if they wear protective gear.

A 2004 study in the Journal of the American Medical Association demonstrated a statistical relationship between dental radiography while pregnant and low birth weight, and the paper's conclusion was reported in many publications with little analysis.

But that study was flawed, and the results aren't trustworthy. Responses to the study express concerns that researchers significantly overestimated radiation exposure and that they did not effectively screen subjects for known for such as gum disease, lead exposure and previous preterm births. For example, subjects with poor oral health were more likely to have x-rays than subjects with better oral health.

The American College of Obstetrics and Gynecology advises that all dental x-ray examinations (with the usual lead shielding over the abdomen and thyroid) are safe during pregnancy.

Go to the dentist

The recommendation for pregnant women is simple. See your dentist regularly just as you did before your pregnancy. Dentists should administer and prescribe only medications that are safe during pregnancy, and should check pregnant patients' blood pressure at every visit.

Otherwise, pregnant women can receive the same care – including x-rays – that any patient would. Delaying treatment is not necessary or recommended at any time for healthy, . This applies to any form of dental treatment including periodontal treatment, and extractions.

The American College of Obstetricians and Gynecologists calls a "teachable moment." Pregnant women take a deep interest in their own health to benefit their developing child. Speaking with pregnant patients about their oral health may instill new habits that will last a lifetime.

Explore further: Expectant mothers' periodontal health vital to health of her baby

Related Stories

Expectant mothers' periodontal health vital to health of her baby

August 28, 2013
When a woman becomes pregnant, she knows it is important to maintain a healthy lifestyle to ensure both the health of herself and the health of her baby. New clinical recommendations from the American Academy of Periodontology ...

CDC: Oral health in young women needs improvement

September 22, 2014
(HealthDay)—Women of childbearing age in the United States should be encouraged to maintain better oral care and visit the dentist routinely, according to a study published Sept. 18 in the U.S. Centers for Disease Control ...

Gum disease joins hot flashes and PMS associated with women's hormones

May 29, 2012
Women, keep those toothbrushes and dental floss handy. A comprehensive review of women's health studies by Charlene Krejci, associate clinical professor at the Case Western Reserve University School of Dental Medicine, has ...

A head start against tooth decay

January 7, 2015
Massachusetts public health advocates have developed oral health guidelines to ensure the well-being of the 70,000 babies born in the state each year as well as that of their mothers.

Hospitalizations in pregnancy, delivery stable for HIV-infected

October 10, 2016
(HealthDay)—From 2004 to 2011 there was no increase in the number of hospitalizations during pregnancy and delivery for HIV-infected women, according to a study published in the October issue of the American Journal of ...

Recommended for you

Essure female sterilization device appears safe: study

January 23, 2018
(HealthDay)—Essure implants used in female sterilization have come under fire in recent years, with women reporting a wide array of problems to the U.S. Food and Drug Administration.

Premature births linked to changes in mother's bacteria

January 23, 2018
Changes to the communities of microbes living in the reproductive tract of pregnant women could help to spot those at risk of giving birth prematurely.

Study shows how fetal infections may cause adult heart disease

January 23, 2018
Recent studies have shown that infants born prematurely have a higher risk of developing heart disease later in life. Now, a study led by researchers at the University of Washington School of Medicine in Seattle shows that, ...

Cavity prevention approach effectively reduces tooth decay

January 22, 2018
A scientifically based approach that includes a tooth-decay risk assessment, aggressive preventive measures and conservative restorations can dramatically reduce decay in community dental practices, according to a study by ...

Rise in preterm births linked to clinical intervention

January 18, 2018
Research at the University of Adelaide shows preterm births in South Australia have increased by 40 percent over 28 years and early intervention by medical professionals has resulted in the majority of the increase.

New report calls into question effectiveness of pregnancy anti-nausea drug

January 17, 2018
Previously unpublished information from the clinical trial that the U.S. Food and Drug Administration relied on to approve the most commonly prescribed medicine for nausea in pregnancy indicates the drug is not effective, ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.