Pregnancy and Postpartum

Health professionals should select the information in this section that is most appropriate, using clinical judgment to decide what is timely and relevant for each pregnant or postpartum woman.

Family Preparation

To prepare families for oral health supervision visits, health professionals can provide pregnant and postpartum women with a list of topics to discuss at the next visit. Topics may include the following:

• Changes in the teeth or gums
• Oral hygiene practices (frequency, problems)
• Use of fluoridated water for drinking and cooking
• Use of over-the-counter fluoride products (toothpaste, mouthrinse)
• Eating practices
• Illnesses or infections
• Use of over-the-counter and prescription medications

Interview Questions

Following are examples of questions that health professionals may ask pregnant and postpartum women. In addition to asking these or other interview questions, discuss any issues or concerns the pregnant or postpartum woman has.

• How often do you brush and floss your teeth? Do you use fluoridated toothpaste and mouthrinse?
• Have you had any problems with your gums or teeth? For example, swollen or bleeding gums, a toothache (pain), problems eating or chewing food, or other problems in your mouth?
• Do you have any questions or concerns about getting oral health care while you are pregnant or after your baby is born?
• Since becoming pregnant, have you had morning sickness (vomiting)? How often?
• After your baby is born, how can you help protect your baby's teeth from decay?

Examination

Pregnant and postpartum women should be seen according to a schedule recommended by the dentist, based on the individual's needs or susceptibility to disease.

Anticipatory Guidance

Discuss with Pregnant and Postpartum Women:

Oral Health Care

• The importance and safety of getting oral health care during pregnancy.
• Scheduling a dental appointment as soon as possible if the last dental visit took place more than 6 months ago or if there are any oral health problems or concerns.
• Informing the dental office about pregnancy and the due date to help the dental team provide the best possible care.
• Taking care of the mouth during pregnancy and after delivery. If gingivitis occurs, seek treatment to prevent more serious periodontal disease and tooth loss.
• Obtaining needed oral health care, including X-rays, pain medication, and local anesthesia throughout pregnancy.
• Getting oral health treatment, as recommended by an oral health professional, before delivery.

Oral Hygiene

• Brushing the teeth thoroughly twice a day (after breakfast and before bed) with fluoridated toothpaste. Spit out the toothpaste after brushing, but do not rinse with water. The small amount of fluoridated toothpaste that remains in the mouth helps prevent tooth decay. Clean between the teeth daily with floss or an interdental cleaner.
• Replacing toothbrush every 3 or 4 months, or more often if the bristles are frayed.
• Do not share toothbrushes.
• Rinsing every night with an over-the-counter fluoridated, alcohol-free mouthrinse.
• After eating, chewing xylitol-containing gum or using other xylitol-containing products, such as mints, which can help reduce bacteria that can cause tooth decay.

Nutrition

• Eating a variety of healthy foods such as fruits, vegetables, whole-grain products (cereals, bread, or crackers), and dairy products (milk, cheese, cottage cheese, and unsweetened yogurt). Meats, fish, chicken, eggs, beans, and nuts are also good choices for meals and snacks. Limit eating (grazing) between planned meals and snacks.
• Eating fewer foods with added sugar, such as candy, cookies, and cake, and drinking fewer beverages with added sugar, such as fruit-flavored drinks and pop (soda). Frequent consumption of foods containing sugar increases the risk for tooth decay. Many foods contain one or more types of sugar, and all types of sugar can promote tooth decay. To help choose foods low in sugar, read food labels.
• For snacks, choosing foods with no added sugar, such as fruits, vegetables, cheese, and unsweetened yogurt.
• Drinking water or milk instead of juice, fruit-flavored drinks, or pop (soda).
• Drinking water throughout the day, especially between meals and snacks. Drinking fluoridated water (via a community fluoridated water source) or bottled water that contains fluoride.
• If having problems with nausea, try to eat small amounts of healthy foods throughout the day. And if vomiting, rinse the mouth with a teaspoon of baking soda in a cup of water to stop acid from attacking the teeth.
• To reduce the risk for birth defects, throughout pregnancy, getting 600 micrograms of folic acid each day by taking a dietary supplement of folic acid and eating foods high in folate and foods fortified with folic acid. Examples of these foods include
  • Asparagus, broccoli, and green leafy vegetables, such as lettuce and spinach
  • Legumes (beans, peas, lentils)
  • Papayas, oranges, strawberries, cantaloupe, and bananas
  • Grain products fortified with folic acid (breads, cereals, cornmeal, flour, pasta, white rice)
• Once the infant is born, avoiding testing the temperature of the bottle with the mouth, sharing utensils (e.g., spoons), or orally cleaning a pacifier or a bottle nipple. These practices help prevent transmission of bacteria that cause tooth decay from the parent, especially the mother, to the child via saliva.

Injury Prevention

• Wearing a seat belt while riding in or driving a vehicle. If you are driving, insist that passengers also wear seat belts.
• Wearing protective gear (e.g., mouth guard, face protector, helmet) when participating in physical activities or sports that could result in injuries to the mouth, such as biking or playing baseball or soccer.
• Not getting oral piercings, which can damage teeth and gums.

Substance Use

• Not smoking cigarettes (cigarettes or e-cigarettes) or using chewing tobacco. Avoiding secondhand smoke.
• Not using recreational drugs.
• Stopping consumption of alcoholic beverages.

Outcomes

• Pregnant and postpartum women are under the care of an oral health professional.
• Pregnant and postpartum women are informed of and understand the need for oral health care.
• Pregnant and postpartum women understand and practice good oral hygiene, eating and feeding behaviors, and other healthy behaviors.
• Pregnant and postpartum women have no oral disease or injury.

 

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