Achieving a gleaming smile with teeth whitening products is becoming increasingly popular, but is this something you can safely do when you're pregnant?
There isn’t any evidence that teeth whitening is dangerous for pregnant people, but there isn’t any evidence that it’s safe, either. Dr Ben Atkins, dentist and trustee of the Oral Health Foundation, says: 'Cosmetic treatment isn't a medical necessity so should probably be avoided until after the baby is born, especially as your gums can be far more sensitive during pregnancy.'
But what else should you think about when it comes to your teeth during pregnancy? We've listed some of the most common dental concerns, below, along with expert advice from Dr Atkins on pregnancy care.
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How does pregnancy affect teeth?
The hormone relaxin, which gets the body ready for childbirth, can temporarily loosen mouth and jaw ligaments that normally keep teeth securely in place, plus a rise in other hormones makes the gums more sensitive to bacteria.
Morning sickness vomiting (which creates an acid environment in the mouth), a decrease in saliva flow (which increases the risk of decay) and a craving for sugary foods in the early trimesters of pregnancy may also add to the mix.
As a result you're at risk of dental problems ranging from swollen and sore gums (pregnancy gingivitis) to severe gum infection (periodontitis), tooth decay or, at worst, tooth loss and destruction of the bone supporting your teeth.
Dr Atkins says: 'Good oral hygiene is key to keeping your teeth in good shape in pregnancy, as well as actually retaining them.'
Fortunately, in most cases, any teeth or gum changes in pregnancy will be temporary and reversible once you've had your baby.
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Can I go to the dentist when pregnant?
Dr Atkins says: 'You should certainly go and see your dentist while you're pregnant, and inform them that you are. During pregnancy, your body changes and so can your mouth.'
You don't need to make extra dental appointments just because you are pregnant - except if you are in pain or you've broken a tooth - but stick with routine appointments if they're already scheduled.
Do I have to pay for a dentist when pregnant?
You are entitled to free medically needed NHS dental care if you are pregnant when you start your treatment and for 12 months after your baby is born - just tell the receptionist you're pregnant and want NHS treatment when you make your dental appointment.
Most treatment is free - the NHS says it will provide 'any clinically necessary treatment needed to keep your mouth, teeth and gums healthy and free of pain' - but some isn't, such as gold or white fillings.
Get a MATB1 certificate from your midwife or GP so you can fill in the forms for free treatment and prescriptions, but if you've paid for dental treatment before your certificate arrives, you can claim a refund with a form FP64 from your dentist.
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Can I fix my teeth while pregnant?
Fixing your teeth while pregnant is absolutely fine but it should really be to help your health rather than for cosmetic reasons. Dr Atkins says: 'Your dentist will diagnose what needs to be done and use the least invasive procedures where possible.'
- Fillings:Mercury amalgam fillings aren't used or removed during pregnancy or breastfeeding unless absolutely necessary - gold or white-coloured fillings should be used instead but apart from a few clinical exceptions, you'll need to pay for these. You could also get a temporary white filling until after you've given birth or finished breastfeeding and can opt for amalgam ones instead.
- X-rays:The Oral Health Foundation says x-rays should be avoided in pregnancy unless there's a clear justification for them.
- Root canal treatment or tooth extraction:Root canal treatments themselves aren't the issue but rather the x-rays that may be needed when you have them.
- Antibiotics, painkillers and anaesthetic:Antibiotics and common painkillers such as paracetamol are generally safe in pregnancy, as is local anaesthetic. General anaesthetics and sedation are usually avoided in case of complications.
- Braces (including clear aligners):Dr Atkins says: 'Some braces can inflict pain while going through treatment as the gums may be uncomfortable and tender during pregnancy, so it might be better to wait until afterwards.'
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How to protect your teeth during pregnancy
- Talk to your dentist. If you have any concerns about your oral health in pregnancy - such as being unable to brush your teeth without gagging - see your dentist. 'They can recommend slight changes or make suggestions to help you,' says Dr Atkins.
- Brush and floss. Whether your toothbrush is electric or manual (preferably with soft bristles), brush twice a day for two minutes with a 1,350 to 1,500ppm of fluoride toothpaste, as well as cleaning interdental spaces (with floss or brushes) once a day. If you can't face brushing in the morning, leave it until later.
- Avoid too much sugar.Grazing on sugary snacks and drinks can increase your risk of pregnancy gingivitis and tooth decay. 'By eating healthily and brushing correctly, you can keep your mouth in good shape,' says Dr Atkins.
- Rinse daily with salt water every day.Use a teaspoon of salt dissolved in a cup of warm water to reduce gum inflammation but remember not to swallow it. Avoid mouthwash containing alcohol and use at least an hour after brushing to avoid washing away the higher strength fluoride in toothpaste.
- Rinse with water each time you've vomited if you have morning sickness and wait an hour before brushing as stomach acid softens teeth.
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