Due to hormone shifts and diet changes, pregnant women face a higher risk of oral health problems including gum disease and tooth decay. Along with taking steps to prevent oral health problems, it’s important for pregnant women to get any cavities treated right away, as strong evidence points to mothers as a primary source of the bacteria that causes tooth decay in infants and toddlers.

In addition to problems after birth, poor oral health can have consequences for the pregnancy itself. Gum disease has been linked to preterm birth, low birth weight babies, low birth weight babies being born prematurely, and the development of preeclampsia (a pregnancy complication that can lead to serious or even fatal outcomes).

Gingivitis and Gum Disease

According to the Illinois Department of Health, gingivitis occurs to some degree in 60 to 75% of all pregnant women. One reason for this is that they tend to have a more severe reaction to the plaque bacteria due to increased levels of the hormone, progesterone.

While it’s common and can be managed with good dental hygiene, when left untreated it can affect the tissue that holds the teeth in place, even resulting in tooth loss if the problem becomes severe.

The main symptoms of gingivitis are red, swollen gums and bleeding, If you start to notice a greater degree of sensitivity in your gums or bleeding during brushing, pay extra attention to your oral health habits. Brushing twice a day and flossing is always a good practice, but it’s especially important when you are experiencing symptoms of gingivitis.

In addition to normal oral health habits, it’s helpful to brush and rinse your mouth after every meal and snack. Be sure to contact your dentist as he or she may recommend extra professional cleanings as well.

Cavities and Tooth Erosion

Pregnant women have a higher risk of developing cavities due to several main factors such as increased acidity in the mouth for those with frequent vomiting and dry mouth due to hormonal changes for some. On top of that, more frequent snacking on less healthy foods because of cravings increases the risk of tooth decay, and some pregnant women find it harder to stay consistent with oral hygiene due to a heightened gag reflex causing nausea and vomiting when trying to brush their teeth.
Symptoms of cavities include:

• A toothache
• Tooth sensitivity
• Mild to sharp pain when eating or drinking something sweet, hot, or cold
• Visible holes or pits in a tooth
• Brown, black or white staining on any surface of a tooth
• Pain when biting down

Tooth decay is treatable and preventable if you are consistent and proactive.

If you suspect that you may have a cavity, schedule an appointment with your dentist as soon as possible to prevent further decay. As mentioned earlier, the bacteria that cause tooth decay are often transmitted from a child’s mother, so it’s important to take care of the problem sooner rather than later.

While pregnant women are at a higher risk of tooth decay, it’s still preventable if you stay on top of brushing and flossing. In addition to the normal twice-a-day-routine, brushing and rinsing after all snacks and meals is an added step you can take to protect your teeth. If you find yourself craving unhealthy foods, substituting healthier snacks (low or no sugar) will help to cut down on potential oral health problems.

While it may seem advantageous to brush your teeth immediately after vomiting, it’s actually counterproductive unless you first rinse your mouth with a mixture of water and baking soda to neutralize the stomach acid from your vomit.

If you find it challenging to brush your teeth due to a strong gag-reflex, don’t give up! Instead, change up your routine by trying things like using a small, soft toothbrush designed for children, brushing later in the morning when you don’t gag as much, and concentrating on your breathing as you brush your back teeth.

Pyogenic Granuloma (“Pregnancy Tumors”)

While the name sounds alarming, “pregnancy tumors” aren’t cancerous and typically don’t lead to any serious medical complications. They appear as small, red or fleshy colored lumps of tissue located between the teeth or along the gum line. They are relatively uncommon as they only develop in up to 5% of pregnancies.

If the lump is small and doesn’t bother you, you may not need to treat it – they often go away after pregnancy on their own. If it does bother you, it may be removed under local anesthetic. Consult your dentist.

Safety Concerns for Oral Health Treatment in Pregnant Women

Not all medications related to oral health treatment are safe.

Among others, Nitrous Oxide (or laughing gas) is considered to be risky for pregnant women. Always be sure to consult your doctor or pharmacist before taking any medication.

Oral x-rays are considered to be safe during pregnancy.

As long as proper shielding of the stomach and thyroid is in place, it’s safe to get x-rays of your mouth when you are pregnant. Leaded vests are used to shield the fetus from the small dose of radiation in x-rays.

While tooth decay for young children is generally preventable, it’s a huge problem in America. Over 40% of children are affected by tooth decay by the time they reach kindergarten, and 53% of children 6 to 8 years of age have experience with cavities (untreated cavities, filled teeth, or missing teeth as a result of a cavity).

Infants

Establish a dental home by age 1.

The American Academy of Pediatric Dentistry (AAPD) recommends that all infants have a dentist home established by age one. However, a lack of education is a primary concern – a majority of pediatricians and general dentists aren’t advising parents to take their child to see a dentist by age one, and about half of all pediatric dentists don’t see infants by their first birthday.

Prevent the sharing of decay-causing bacteria.

Since the bacteria that cause tooth decay are transmittable from one person to another, the AAPD recommends that parents refrain from sharing spoons, bottles, pacifiers, etc. Also, be sure to thoroughly wash sippy cups and bottles between uses.

Painkillers and chilled teething rings can help to soothe gums during teething.

While not all infants and young children experience discomfort during teething, there are several good solutions for those who do. Painkillers such as infant acetaminophen or ibuprofen and chilled teething rings (or frozen washcloths) are recommended by the AAPD. However, over-the-counter teething gels (topical anesthetics) are not recommended due to “potential toxicity of these products in infants.”

Toddlers

Positive oral health habits should start with the arrival of a child’s first tooth.

Starting when the first tooth emerges, parents should begin brushing their children’s teeth after breakfast and before bed using a small headed, soft toothbrush. Under age three, it’s recommended that no more than a smear or rice-size bead of toothpaste containing fluoride be used. As soon as two teeth touch, start gently flossing between them once a day.

It’s also important to schedule and keep regular cleaning and evaluation appointments with a pediatric dentist. The typical frequency recommendation is every six months.

Start establishing healthy eating habits by 12 months of age.

If you want to lower your child’s risk of cavities (and other health problems), it’s important to start a healthy diet young since eating habits start to form as early as one year of age. Habits that increase the risk of tooth decay and other oral health problems include nighttime bottle feeding with juice, repeated use of a sippy or no-spill cup (without washing between uses), and frequent sugary snacks or drinks between meals.

Examples of snacks to limit include cookies, granola bars, soda, and even fruit juice – the AAPD recommends limiting juice intake to 4-6 ounces per day, and it should not be a substitute for whole fruit or used throughout the day to calm a fussy child.

The use of pacifiers and thumb sucking should stop by age four.

While many children gradually quit sucking on pacifiers or their fingers and thumbs between the ages of two and four, some children may need help breaking the habit. Prolonged thumb sucking can interfere with the proper growth of the mouth, and it can cause problems with the proper alignment of the teeth.

The American Dental Association (ADA) recommends the following steps:

• Don’t scold. Instead of scolding the child for thumb sucking, offer praise for not doing so.
• Focus on the root of the problem. Children often suck their fingers when feeling insecure. Focus on correcting the cause of the anxiety and comfort the child.
• Use rewards. Reward the child when he or she avoids thumb sucking during a difficult period, such as being separated from family members.
• Consult your doctor or dentist for extra help. If your child still can’t overcome the thumb-sucking habit, consult your pediatrician or dentist. There are medications and apparatuses designed to break kids of the habit.

Young Children

Start teaching your child to be responsible for their oral health.

While most children are ready to brush their teeth without supervision by age seven or eight, each child is different. Other than the obvious concern of being able to brush your teeth without swallowing toothpaste, children are ready to brush their teeth when they have the motor skills and discipline to brush all of the surfaces on their teeth (as opposed to just a few strokes on the front teeth).

Here are some tips for helping your child to develop excellent oral health habits:

• Be consistent yourself. Kids tend to emulate what they see their parents do. If you consistently brush and floss your teeth, it will be much easier to insist that they do it as well.
• Make it enjoyable. While you are still assisting your children in brushing their teeth, consider ideas like reading a 2-minute book or dancing to their favorite song. You can also try rewarding your child with a sticker chart.
• Insist on consistency. The more brushing and flossing becomes second nature, the better your kids long-term oral health. Try not to skip brushing even on long days or vacation.
• Be thorough. Your dentist can assist in demonstrating the proper method of brushing your child’s teeth. Be sure that they are following the general guidelines: two minutes of brushing front, bottom and back of all teeth. “Smart” toothbrushes can make this process easier by vibrating when it’s time to stop brushing and keeping track of how long they brushed their teeth.
• Don’t forget the tongue. A good routine includes brushing your tongue to ensure fresh breath and kill germs
• Flossing is a vital piece of the routine. Flossing once a day before brushing is important. Floss picks (or other devices) may be easier for some kids to use if they struggle with traditional floss.

Be consistent with dental cleanings and checkups.

As a general rule, kids should be seen by a dentist for a checkup and cleaning every six months. Additionally, you should talk to your dentist about scheduling an appointment between cleanings if your child exhibits any of the following symptoms:

• White spots on the teeth
• Visible cavities that are brown or black
• Pain in the area around a tooth
• Sensitivity to sweet, hot, or cold foods and drinks

Limit sugary snacks.

As with toddlers, a good diet is a large part of preventing cavities and other oral health problems. Kids who eat a lot of sugary snacks and drink sugary drinks are at a higher risk of tooth decay.

Tooth decay is a serious problem for American youth – almost one out of five (18.6%) have untreated cavities. Among more mundane risks (such as a sugary diet) teens can sometimes have a much higher risk of oral health problems if they:

• Smoke or chew tobacco
• Have mouth jewelry
• Use meth (meth mouth)
• Have an eating disorder

Oral Health Routines

Tweens and Teens should be responsible for maintaining the habit of brushing their teeth twice daily and flossing once a day. However, it’s wise to check in and make sure they are staying on track. It’s important to discuss the benefits of good oral hygiene, as well as the consequences of poor oral health habits.

Due to the increase of sex hormones in teens, they are more susceptible to gingivitis (gum infection), which can generally be prevented by consistently practicing proper brushing and flossing techniques. Continue with regular dental cleanings and evaluations to be sure that their oral health is on track.

Diet

As tweens and teens begin to make their own decisions about the food they eat, it’s important to encourage them to make good decisions. Some teens face a higher risk of tooth decay due to regular consumption of sugary foods and acidic, sugary drinks such as soda.
The ADA recommends paying extra attention to the type and frequency of snacking, the amount of sugary drinks, and choosing sugarless chewing gum. Those who have braces should follow their orthodontist’s instructions and avoid foods that can cause brackets or wires to break.

Braces

If your child has a bad bite or teeth that are out of place, he or she may be at a higher risk of cavities or gum disease due to the difficulty in cleaning his or her teeth. Braces can help to correct these problems and decrease the risk of oral health problems in the future. They can also relieve the discomfort and difficulty when chewing that can come with a bad bite or misplaced teeth. On top of the tangible benefits of braces, they can also help to increase your child’s confidence by giving him or her the gift of a nice smile.

Depending on the needs of your child, metal braces typically cost between $3,000 and $7,000. Some insurance plans may cover a portion of the cost, so be sure to research the specifics of your plan.

While brushing and flossing is more difficult with braces, it’s even more important since all the brackets and wires create more places for plaque to collect. In addition to being consistent with oral hygiene while wearing braces, it’s also important for your child to follow through with the orthodontist’s instructions, such as wearing rubber bands. Failing to do so can delay his or her progress and require more time and expense before the braces can be removed.

Wisdom Teeth

A common dental issue for older teeth is problematic wisdom teeth. Wisdom teeth often grow incorrectly, or there may not be room in the mouth. Reasons for removing wisdom teeth include:

• Tooth pain
• Infection
• Cysts
• Tumors
• Damage to adjacent teeth
• Gum disease
• Tooth decay (if it is not possible or desirable to restore the tooth)

11 million (or 15%) of American children have “special health care needs” (SHCN), which means that they have any “physical, developmental, mental, sensory, behavioral, cognitive, or emotional impairment or limiting condition that requires medical management, health care intervention, and/or use of specialized services or programs.”

While a child’s disability and needs can sometimes take precedence over proper oral health habits, the negative impact of oral health diseases should not be overlooked. For instance, serious chronic illnesses (including heart disease, diabetes, and respiratory diseases) have been linked to poor oral health.

Challenges to Prevention and Treatment of Oral Health Problems

These children are at an increased risk for oral health problems due to factors such as:

• Regularly taking medication containing sugar
• Special diets
• The need to eat frequently
• Poor oral hygiene