Pregnancy and Dentistry

Prevention

Visiting a dentist while pregnant is highly recommended for your own wellbeing and that of your unborn child. Routine dental treatment is safe during pregnancy, although some procedures or medication should be avoided in the first 3 months, so be sure to tell your dentist you are pregnant. Many treatments are elective (tooth whitening etc.) and postponed until after pregnancy, there is care that a pregnant woman needs and sometimes treatment cannot wait, but can be done with minimal risk. .

Myths

There is a long-standing myth that a woman looses a tooth for every child she has. Of course this is not the case, but circumstances and changes in the mouth make it appear so. The myth goes on to claim that the foetus draws calcium directly from the mother’s teeth and results in weakened teeth that decay and may be lost. In fact the mother’s diet (and nutritional supplements) give the developing foetus all the calcium he or she needs to develop. Increased cavities are the result of many factors such as an increase in snacking and poor oral hygiene.

Intraoral Changes

Starting about the second month of and continuing for the rest of the pregnancy, hormone changes affect the gums or gingivae. The gingivae are far more susceptible to irritation from plaque (soft) or calculus (hard) deposits on the teeth. An exaggerated inflammatory response can result in mild redness or gingivitis, to swelling of the gingivae between the teeth. These swellings are painless, but do bleed easily. Most pregnant women experience some form of inflamed gums even with good dental hygiene. Additionally, looseness of the teeth may be noticed, especially in the third trimester. These gingival changes usually reverse after the baby is born.

Pregnancy and Dentistry Information from Tooth Dental. (source: @suchajka via Unsplash.com)

Gum disease and pregnancy

If gum disease becomes severe, the infection can affect an unborn baby’s development.  Severe gum disease in an expectant mother can increase the risk of premature birth and of delivering a low birth weight baby. Signs of gum disease include:

  • bleeding gums
  • red gums (instead of pink)
  • swollen gums
  • bad breath.

Prevention:

  • Brush twice a day and floss before you go to bed to avoid plaque build-up. Gingivitis is most common during the second to eighth months of pregnancy.

Morning sickness, vomiting and acid reflux

Pregnant women who experience morning sickness with vomiting and/or acid reflux are at high risk of tooth erosion*.

To reduce risk of tooth erosion and damage to your teeth after vomiting/reflux you can: 

  • Rinse your mouth immediately with water or a mouth rinse. (e.g. Add a teaspoon of baking soda (sodium bicarbonate) to a cup of water to rinse and spit after vomiting)
  • Chew sugar free gum to stimulate saliva to neutralise and wash away acid.
  • Smear a little bit of toothpaste over your teeth with your finger.
  • Wait at least 30 minutes before brushing to avoid damaging softened enamel surface.

For further advice, speak to your dentist or an oral health professional.

* Tooth erosion is the gradual wearing away or dissolving of the outer enamel layer of your teeth.

Could gingivitis affect my baby’s health?

New research suggests a link between pre-term, low birth weight babies and gingivitis. Excessive bacteria, which causes gingivitis, can enter the blood stream through your mouth (gums). If this happens, the bacteria can travel to the uterus, triggering the production of chemicals called ‘prostaglandin’, which are suspected to induce premature labour.

FAQ ON PREGNANCY AND DENTISTRY

Will pregnancy affect my oral health?

Expectant mothers (and women who take some oral contraceptives) experience-elevated levels of the hormones estrogen and progesterone. This causes the gums to react differently to the bacteria found in plaque, and in many cases can cause a condition known as ‘pregnancy gingivitis’ 65 to 70% of all pregnant women developed gingivitis during this time! Symptoms including swollen, red gums and bleeding of the gums when you brush.

Pregnancy gingivitis usually starts around the second month of pregnancy and decreases during the ninth month. If you already have gingivitis, it will most likely get worse during pregnancy. Remember that the bacteria in plaque (not hormones) are what cause gingivitis. Brush twice a day and floss before you go to bed to avoid plaque build-up. Gingivitis is most common during the second to eighth months of pregnancy.

What are “pregnancy tumours”?

Pregnancy tumours (pyogenic granuloma) are inflammatory, benign growths that develop on the gums as part of an exaggerated response to the irritants that cause periodontal disease. These ‘tumours’ are rare, usually painless and develop on your gums in response to plaque. Although they are not cancerous, they should be treated. Pregnancy tumours usually subside shortly after childbirth.

Should I receive dental treatment while I’m pregnant?

Dentists recommend that major dental treatments that aren’t urgent be postponed until after your child is born. The first trimester, the stage of pregnancy in which most of the baby’’ organs are formed, is the most crucial to your baby’’ development, so it is best to have procedures performed during the second trimester to minimise any potential risk.

If I do need treatment, what drugs are safe?

If you need to have dental work done during your pregnancy, research has shown that some acceptable antibiotics include penicillin, amoxicillin and clindamycin but avoid tetracycline, which can cause discoloration of your child’s temporary and permanent teeth.

What if I’m hungry between meals?

During pregnancy, many women have the desire to eat between meals. While this is a normal urge, frequent snacking on carbohydrate-containing foods can be an invitation to tooth decay. The decay process begins with plaque, an invisible sticky layer of harmful bacteria that constantly forms on the teeth. The bacteria convert sugar and starch that remain in the mouth to acid that attacks tooth enamel. The longer sugars are retained in your mouth, the longer the acids attack. After repeated attacks, tooth decay can result.

Eat nutritious, well-balanced meals made up of foods from the five major food groups: bread cereals and other grains; fruits; vegetables; meat; fish; poultry and protein alternatives and more yoghurt and cheese. Try to resist the urge to snack constantly. When you need a snack, choose foods that are nutritious for you and your baby such as raw fruits and vegetables and dairy products.

(source: via @realkayls at Unsplash.com)

What can I do to keep my mouth healthy during pregnancy?

To help prevent tooth decay and periodontal disease, brush your teeth thoroughly twice a day with fluoride toothpaste to remove plaque. Be sure to clean between your teeth daily with dental floss or interdental cleaners.

What if I’m pregnant and need a dental x-ray?

As a general rule we attempt to avoid x-rays and treatment requiring x-rays until after the baby is born. However, an x-ray may be needed for dental treatment or a dental emergency that can’t wait until after the baby is born. Untreated dental infections can pose a risk to the foetus, and dental treatment may be necessary to maintain the health of the mother and child. Radiation from dental x-rays is extremely low. However, every precaution is taken to minimise radiation exposure. A lead apron minimises exposure to the abdomen and should be used when any dental x-ray is taken.

What is Temporomandibular Disorder (TMD)?

What is Temporomandibular Disorder (TMD)?

Temporomandibular disorder relates to pain and dysfunction as a result of a problem with the jaw, jaw joint and/ or surrounding facial muscles that control chewing and jaw movement. TMD results in a large range of symptoms that vary for each individual and can include:

  • Significant face and neck pain
  • Headaches
  • Damaged teeth and tooth pain
  • Stiff/sore jaw muscles
  • Limited mouth opening
  • Neck and shoulder pain
  • Ear pain and ringing in the ears (tinnitus)
  • Painful clicking
  • Popping, clicking or grating of the jaw

In many cases, the exact cause of TMD is not clear, but Dentists often believe that symptoms often arise from problems with muscles of the jaw or parts of the jaw itself. Other contributing factors can include:

  • Injury to the jaw, TMJ, nerves or muscles of the head and neck e.g heavy blow, whiplash
  • Day and night grinding or clenching the teeth resulting in a lot of pressure on the joint (Bruxism)
  • Presence of osteo or rheumatoid arthritis in the TMJ
  • Emotional/ psychological stress
  • Sleep disorders and breathing difficulties
  • Dislocation of the soft cushion or disc between the ball and socket of the jaw

How can TMD be treated?

There are several options to consider when discussing with your dentist. Your dentist will assess all aspects of your condition and help you determine the most appropriate choice for your individual condition. Available treatment options address different aspects of the condition depending on the case and they vary in cost, complexity and the expected results, including how long results last and potential complications. While no single treatment has proved universally effective for all patients, our aim is to treat patients holistically. Current treatment options include:

  • Relaxation/ Anti-inflammatory medication
  • Oral appliances called splints or bite guards
  • Massage/ Manipulation/ Exercise of the TMJ and associated muscles
  • Muscle relaxant injections (also known as Botox, Dysport) into the muscles of mastication
  • Orthodontics (braces) and dental work/ adjustment
  • TMJ surgery

Dentists strongly recommend using the most conservative, revisable treatments possible so to not further contribute to the problem.

Any questions about TMD or TMJ? Please contact the friendly team at Tooth Dental by calling 07 3366 1737 or click here to enquire online – we’d love to help! 

 

Which dental treatments are safe when you’re pregnant?

Pregnancy Dental Treatment

Congratulations, there is so much to organise over the next 9 months. Between doctor’s visits, setting up the nursery and cooing over tiny shoes – it is important to schedule a trip to the dentist, ideally in the second trimester. Which dental treatments are safe when you’re pregnant? Read on to learn more. 

Is it safe for expecting mums to see a dentist?

Absolutely – and there are many excellent reasons to schedule a trip to the dentist before bub arrives. We can help with some pregnancy-related symptoms you may be experiencing, and get your mouth in tip-top shape before bub arrives. Research suggests that a mother with a healthy, decay free mouth is far more likely to have a baby with a healthy mouth. There are also dental conditions such a periodontal disease which can affect the developing baby, and need to be treated fairly urgently. Cosmetic procedures, such as whitening, should be postponed until after baby arrives.

Which dental treatments are safe when you’re pregnant?

Please let us know if you think you are pregnant and how far along you are. Dentistry is very safe in pregnant women, but there are some procedures which should be postponed.

Does being pregnant affect my mouth?

There are many strange and unique symptoms that come with being pregnant, and the mouth is certainly not immune to this.

  • Pregnancy Gingivitis: 4 in 10 women will experience bleeding gums during their pregnancy, although the number could be much higher. The hormones that lead to the development of the placenta will increase the leakiness of the delicate blood vessels in the gingiva. You may notice that the gums bleed more when you brush or floss, and can lead on to more serious conditions if left untreated. Gingivitis is caused by plaque build up and can generally be resolved easily with professional dental cleaning and oral hygiene techniques.
  • Periodontal disease: Periodontal disease is a more serious form of gum disease, and can result in permanent bone loss and gum recession as well as being linked to preterm and low birthweight babies. Premature delivery is associated with a whole raft of lifelong problems for your baby. The symptoms of periodontal disease include bleeding when brushing or flossing, bad breath or loose teeth.
  • Pregnancy Tumours: 1 in 10 women may experience pregnancy tumours, which are localised swellings in the gingiva which are an extreme inflammatory reaction to plaque and may appear like a small raspberry. They tend to resolve spontaneously after birth, and generally don’t need to be treated, unless they interfere with your bite, or are painful, or persist after birth.
  • Increased Decay Risk: Pregnant women are at a higher risk of dental decay. This may be due to increased snacking, cravings for sweet or carbohydrate-based food, morning sickness eroding away enamel, and difficulty with brushing and flossing brought on by an overreactive gag reflex. There is evidence that the bacteria in mum’s mouth will colonise baby’s mouth through kissing and tasting of food. If mum has a high decay rate, there is a good chance that baby could get cavities when the teeth come through. It is important to have any cavities treated before baby is born. Modifications to oral hygiene and diet can also help in reducing cavity-causing bacteria.

Can I have X-rays when I am pregnant?

Which dental treatments are safe when you’re pregnant? How about x-rays?

While we tend to postpone routine x-rays during pregnancy, they may be needed for treatment (root canal for example) and are quite safe. Digital Dental x-rays have the lowest radiation of any medical x-ray, and the risk can be further reduced by use of a lead apron. It is far better to get a correct diagnosis and treatment by taking an x-ray, than leave an expecting mother with painful infection in her mouth. An infection may have a greater effect on bubs development than an xray.

Can I have local anaesthetic when I am pregnant?

Local anaesthetic is totally safe to use in pregnant women. If you need any fillings, extractions, or root canals, you can feel assured that the procedure will be pain free and the numbing will not have a negative effect on bub. There is no link between local anaesthetic and premature birth, miscarriage or birth defects.
What about medications prescribed by the dentist?
Please tell us if you are on any medications, including over the counter. If we need to give you an antibiotic or pain killer, we will ensure that we prescribe the medication with the lowest risk. Please talk to us if you are concerned.

Lou’s Top Tips for Pregnant Ladies:

Try rinsing your mouth out with water if you have been sick. Add a teaspoon of bicarb soda to water which will neutralise any acid in your mouth. You shouldn’t brush immediately after vomiting, as the enamel is softened and may be brushed away- Become the best brusher and flosser you have ever been. Now is the time to try an electric toothbrush. My floss lives in the shower on my conditioner bottle, try flossing while you condition your hair! If you are retching when you brush, an electric toothbrush or a child’s tooth brush with a smaller head may help. Try switching toothpaste brands if certain flavours aren’t agreeing with you.

  • You will be eating far more often and may not have a toothbrush handy – try rinsing your mouth with water and chewing sugar-free gum if you aren’t near the tooth brush
  • Book your continuing care recall appointment with tooth dental – we can’t wait to hear your exciting news and look forward to welcoming a new patient (baby) to the practice.

Please contact the friendly team at Tooth Dental by calling 07 3366 1737 or click here to enquire online – we’d love to help! 

Wisdom Tooth Removal in Ashgrove

Wisdom Tooth Removal in AshgroveWisdom tooth removal – they are the most common teeth to become impacted or positioned sideways and often have the most problems coming through safely and easily. Often this is due to a lack of space in the back of the mouth. They don’t live up to their name of being wise.

What are wisdom teeth?

Wisdom teeth are the third set of molars, developing and coming through sometimes in late teens and early twenties for most people. Historically diets consisted of course grains, seeds and nuts which wore down teeth and created tooth loss, so a third set of molars was required. With improved preventive dental care and a softer modern diet our teeth do not wear and therefore we have a complete set of healthy teeth often not requiring the addition of wisdom teeth.

When do we recommend wisdom tooth removal?

Wisdom tooth removal is recommended when the teeth are impacted and have insufficient space to erupt through the gums in a straight upright position which is easily cleaned. If the teeth are left in a sideways or remain partially submerged beneath the gums often food and plaque collects under the gums leading to painful swelling, inflammation and infection of the gums surrounding the wisdom tooth, decay of the wisdom tooth and can cause decay of the tooth in front, the second molar.

Wisdom teeth if often recommended following orthodontic treatment as well to reduce the risk of re-crowding of teeth following braces or Invisalign.

Is the wisdom tooth removal process difficult?

Wisdom teeth require thorough assessment by your dentist with visual examination and xray radiographs to assess the number, position and development stage of the wisdom teeth. Ideally if the teeth require removal, the removal should be done prior to full development of the roots and hooking around nerves, blood vessels and sinuses.

If the wisdom teeth are through in the mouth, straight and have uncomplicated roots, they can be removed very simply. If the wisdom teeth are impacted or buried beneath the gums they often require surgery to remove the tooth. This can be done in the dental chair with local anaesthetic and happy gas with a general dentist, or under general anaesthetic while you are asleep with a dental specialist.

Often there is some minor discomfort and swelling following the procedure, and your dentist will let you know how long that would be expected to last for your mouth.

Your child’s first dental visit: creating a great first impression

first dental visitA visit to the dentist is a fun and important adventure where you will get your teeth counted and cleaned. Your child’s first dental visit is a milestone like your first words, your first haircut, or your first day of school. We are going to have a fun time which will set you up for a lifetime of excellent dental care and habits!

Your child’s first dental visit

At the dentist, you will be greeted by our front office girls who will be eagerly awaiting you and your family. While your parent fills out important information about you on our iPad, you can play on our duplo wall or read a book. Keep an eye out for the tooth fairy’s front door and letter box!

When we are ready, the dentist will take you through to their room. You get to sit in a special chair called the golden marshmallow and interact (play?) with some of our high tech equipment. We have an air and water pistol and a sucker. We will even use the air pistol to make you a balloon animal!

Just like a fireman wears a helmet, and a doctor wears a white coat and a stethoscope-the dentist has a uniform. We put on a mask, some gloves and glasses with small magnifiers on them. You get to wear a bib and some sunglasses.

With the push of a button, the chair lies back and becomes a bed. When you lie back, there is a TV on the roof playing a movie or a show on animals. Next we will count your teeth with a tiny mirror and counter. Did you know children have 20 teeth and adults have 32 teeth? Sometimes we take pictures or radiographs to check your teeth for cavities and see how your permanent teeth are growing in your jawbones.

We then clean your teeth with a special dentist toothbrush that spins around and around and tickles your mouth. After you sit up and rinse your mouth, we paint on some fluoride. Fluoride is a special foam that you swish around in your mouth-it makes your teeth very strong and protects you from cavities. It comes in a few yummy flavours that you get to choose from: mint, grape or even marshmallow!

We will have a chat about healthy foods that are good for your teeth, such as fresh fruit and vegetables, cheese and yoghurt. We will talk about which foods cause cavities like lollies, chocolate and soft drink.

The last thing that happens is that you get a goody-bag, which has a toothbrush, toothpaste and sometimes floss. We make sure you are an A+ expert at cleaning your teeth. High five! We can head back to the front office to make your next appointment.

Congratulations! You did really well. Wasn’t that fun? I can’t wait to see you again in 6 months!

Click here to learn more about our Children’s Dentistry service at Ashgrove. 

Tooth Whitening in Ashgrove

Tooth Whitening – How do I get whiter, brighter teeth? 

It’s hard these days to cut through the social media hype, with so many different options and opinions out there it seems like every fashion blogger is a specialist on tooth whitening! I wanted to take some time to talk about what’s right, what will work and more importantly, what is safe for you.

Why aren’t my teeth white?

There are some things we need to understand about teeth before we can figure out how to whiten them. There are two types of discolorations in teeth and they are internal and external. Basically, external staining comes from things like coffee, teas, red wine etc. Internal discolorations are a little more complex and are related to the development of the teeth and age related changes.

Is there a magic tooth paste I can use?

‘Whitening’ tooth pastes are a simple and easy way you can get some relatively immediate results. The difference between these pastes and regular pastes are the abrasive particles in them. Usually they encorporate something like silica (aka. sand) or other products. This is exactly how things like charcoal tooth pastes work – basically trying to scrub stains with sand paper! 

As you can imagine, if overused these products probably aren’t the best for our teeth as we can see enamel wear from heavy brushing – so be careful. If you’re thinking of using these make sure you have a soft brush and don’t brush half an hour after eating or drinking anything acidic like juice/soft drink. 

What about those mouth guard looking things that I saw on Instagram?

Tooth Whitening in Ashgrove

Products that will help whiten internal stains need to contain hydrogen or carbamide peroxide. If you’re wondering what these are – they are both bleach products and carbamide turns into hydrogen peroxide as it works… Basically the same thing. Both of these work equally as well, it’s the concentration that matters.

Online or over the counter strips/gels/mouth guards etc will generally use these peroxides, however I would be wary of products claiming to ‘whiten’ teeth without peroxides. The concentrations and risk of hurting yourself are usually low, but results are often also limited – especially with all the effort involved in daily and often prolonged use. 

So what do dentists use to whiten their teeth?

At Tooth Dental, our most efficient option is using the ZOOM! in chair system with a high concentration hydrogen peroxide gel. This process involves us carefully protecting your gums and skin while carefully whitening your teeth. 

How long does it take?

You can have a whiter, brighter smile in just over one hour.

Do you have anything I can use at home?

We sure do. We custom make whitening trays to fit our patients and then carefully go through how they are used. We recommend using our trays initially for 15 minutes* per day for 5-7 days. Once you have achieved the results you are after you can save your trays to top up later.

Want to know more? 

Book an obligation free whitening consultation with us today 🙂

See you soon! 

Dr Alex and the team at Tooth Dental.

Dental implants in North Brisbane

Dental implants; what are they and how does it work?

Dental implants are used to replace a missing tooth or teeth, and are a mechanical tooth supported by a titanium implant. This is done over a number of stages with the final result of a natural looking tooth where there used to be a gap.

They have many advantages over other methods of replacing missing teeth as they stand independently to your other teeth and don’t place extra strain on your surrounding teeth. They allow full function and give a natural looking tooth or teeth in your gap.

Stage 1: Healing phase

Generally following removal of a tooth, a healing period of two to three months is needed for the gums and bone to heal and shrink into their new shape. If you have been missing a tooth or teeth for longer than three months already there is no need to wait, you can move straight to Stage 2.

During this healing phase, a temporary tooth replacement can be arranged which is especially useful in visible areas at the front of your mouth. This may be a removable denture/plate or a temporary bridge using your teeth either side for support.

Stage 2: Information gathering

Following the healing phase radiographic xrays, photos and moulds of your teeth and gums are required to check if you are suitable for an implant and if you have enough bone and gum to support a dental implant.

The moulds, photos and full mouth 2D xray are done first to have a general assessment of the area where the dental implant supported tooth or teeth are to be placed.

Once you are informed on what a dental implant is, a thin mouthguard with a mocked up tooth is then made to wear during a large CT xray to assess the jaw shape in three dimensions and plan your dental implant supported tooth.

Stage 3: Review of the dental implant planning

After we carefully plan your implant position using the 3D xray model of your jaw, we will go through the plan with you discussing the procedure in detail specifically for your mouth and implant supported tooth. You will have all the information on your planned procedure and a full quote.

If for any reason you are not suitable for a dental implant you will find out at this stage, and plans for an alternative replacement for your tooth can begin.

Stage 4: Placement of your dental implant

Dental Implants

Instructions will be given to you to take antibiotics and pain relievers immediately before your dental implant placement appointment. These are very useful to keep swelling, bruising and discomfort to a minimum.

The dental implant is usually placed under local anaesthetic at Tooth Dental and is generally a straightforward quick process. In some cases the dental implant will have a white healing cap poke

through to sculpt the gum shape, in others the dental implant will be covered with gum and uncovered at a later date.

Following dental implant placement, rest that day is recommended, although you can return to light duties at work if desired. Generally there is very minor swelling, bruising and discomfort for one or two days, with the minor swelling settling over a week.

One or two weeks later we will review the dental implant area and remove any sutures remaining.

Stage 4: Healing and integration phase

Following dental implant placement a healing phase of approximately three months is required to allow your titanium implant to integrate and bond to your bone. After three months the implant will be checked with radiofrequency to ensure the dental implant is integrated and ready to have your tooth placed, supported by your dental implant.

Stage 5: Moulds and placement of your tooth

Moulds and photos of your dental implant can now be taken and sent to a dental laboratory to make your tooth supported by your dental implant. Generally the laboratory requires two weeks to make your crown fit and match perfectly. Then your dentist can place your dental implant crown and you can smile widely, eat normally and enjoy your natural looking dental implant supported crown.

Your dental implant supported crown will require some maintenance and regular checks which are generally done as part of your six monthly examination and clean with your dentist.

Click here to learn more about the service and to make a booking.