Teeth For Two

There seem to be a lot of people who are expecting, or have recently had, children. While giving birth to and raising young has always been popular, there has been a rebirth (you should pardon the expression) of its popularity in the baby boom generation lately. It is therefore timely to discuss the dental concerns and considerations specific to pregnancy and young children.

Pregnancy can bring a whole new set of problems to a woman’s mouth. Hormonal changes can make her prone to painful, tender, swollen gums that are irritated and/or bleed easily. Morning sickness can expose her teeth to corrosive stomach acid. Frequent snacking, which often occurs during the third trimester due to decreased stomach capacity, can cause an increase of decay. Neglect of oral hygiene at this busy, hectic time also contributes to unhealthy gums and teeth. Fortunately, attention to diet and scrupulous home care (brushing and flossing) every day—especially after every snack that contains sugar and after every bout of morning sickness--can prevent and control these problems.

Women sometimes hear that the developing fetus removes calcium from the mother’s teeth or can cause tooth loss in the mother. This is just not the case. It is true that the mother’s calcium/phosphorus pool is being tapped by the developing child during the second and third trimesters, but these needs are ideally met from the mother’s diet, or if this is inadequate, from her bones, never from her teeth. Nutrition and diet are essential elements for both mother and fetus. Ninety percent of the calcium and phosphorus needs during pregnancy can be met by increasing the daily intake of dairy products from two to four servings. This should continue throughout lactation since a nursing mother may produce up to 30 oz. of milk a day. Adequate amounts of vitamins A, D, C, and K are also extremely important. Proper diet and supplements should be discussed with a health care professional. Deficiencies in the mother’s diet may cause abnormalities in the baby’s tooth formation.

Most obstetricians feel that pregnant women should see their dentist in order to prevent complications from dental problems. The second trimester is the best time to receive dental treatment. During the first trimester, some women are more anxious, nervous and nauseous. Also the fetus is developing most rapidly then and would be most affected. Extended sessions in the dental chair may be most uncomfortable for the mother during the third trimester. If there is a history of premature births, dental treatment should be avoided in the final months. Usually only emergency x-rays should be taken during pregnancy. Be sure your dentist protects you and your baby with a lead shield when x-rays are taken. This is an important precaution in general but especially during pregnancy. And, as you probably already know, it’s important to check with your physician before taking any medications to be sure they are safe for your baby. Also, be sure your dentist knows you’re pregnant and will therefore use safe medications (local anesthetics like novocain are not a problem) and procedures.

Once the baby is born, even before the teeth appear, the baby’s mouth should be cleaned to keep food and bacteria from damaging newly erupting teeth. After feeding, wipe the baby’s gums and teeth with a damp washcloth or gauze pad. The parents should begin brushing and flossing the infant’s teeth when it’s 2 1/2 to 3 years old. Use a small soft brush with little or no paste. By the age of 5 or 6, children can brush and floss themselves but they should be supervised and assisted until about age 8.

The first signs of teething are tender, swollen gums, excessive drooling, irritability and restlessness. Rubbing the baby’s gums with a clean finger or cool spoon and the use of a teething ring should bring some relief. In extreme cases, medicine to numb the gums may be prescribed by a pediatrician. Keep in mind that teething is a natural process and symptoms will vanish when the tooth emerges. Thumb-sucking is also normal and needn’t be a concern unless it continues past age 4.

It is extremely, important never to put a baby to bed with a bottle. By doing this, you risk development of “nursing bottle mouth”, a dental condition that causes the destruction of the baby’s teeth by rampant decay. The sweetened liquids in the bottle. (milk, formulas, juices, soft drinks, sweetened water) pool around the teeth when the baby is asleep and combine with the oral bacteria to ruin tooth enamel. Don’t substitute the bottle with a pacifier dipped in sugar or honey as this is equally destructive. If your baby must have a bottle before falling asleep, fill it with plain water but even this habit should be discouraged.

Having a baby is a joyful, exciting event. With some simple precautions, mother and child can easily be spared dental problems, and can look forward to visits from the tooth fairy.

-Richard B. Shapiro, D.D.S. (404)523-2514
Reprinted from The Bond Community Star.