Morning sickness and oral health

Kia ora, I’m Tia, an oral health therapist working in Wellington, New Zealand. My role in a private dental clinic is to look after the prevention side of oral care. The bodies of expecting mums are going through many changes that can affect their oral health. Today I will go through the common issues mums experience, what to do, and what to use.

Repeated vomiting due to morning sickness has an erosive effect on the teeth surfaces. When the acidic level of saliva is below pH 5.5, the minerals in enamel begin to dissolve, which lead to sensitivity and eventually, cavities. Our stomach acid’s pH ranges from 1.5 to 2.5, hence after vomiting or nausea, we should never brush our teeth straight after. It is advised to rinse with water then leave at least 30 minutes before brushing. This is to avoid brushing off the top layer of enamel after exposure to acid, leading to more enamel loss.

Some products that can be helpful to battle the effect of vomiting such as tooth mousse, tooth mousse plus (with added fluoride), mint or chewing gum containing xylitol. Or you can try homemade baking soda mouth rinse after vomiting. I always advise my clients check product safety with their GP or midwives first.

It can be hard to do good oral cleaning when experiencing increased gag reflex. What I usually suggest to my patients is to brush when morning sickness is less. Perhaps once late morning, and once after dinner. Also, try flossing with tools like reach floss to help minimise discomfort. 

Pregnancy and gum health
I once had a patient tell me “I’ve lost one tooth during each pregnancy”. She was a mother of 4, a 40 something living with stage IV periodontitis (gum disease). Periodontitis is a condition where the supporting structure around teeth such as the bone, the gums breakdown due to chronic infection. Expecting mothers tend to have more gum health issues due to hormone changes and increased blood flow. It is essential to get proper dental hygiene treatment regularly throughout pregnancy, this may be as frequent as every three months. Patients usually experience regular bleeding, such as waking up with blood in the mouth, bad breath, swelling gums, and sore gums. The main cause of periodontitis is genetics, hygiene, diet and hormonal changes. If you are suspecting periodontitis, it is important to visit an oral health professional as soon as possible.

Recommended products and home remedies
For gum bleeding:
- Colgate peroxyl
- Solid Oxygenating mouthwash

Easy cleaning tools:
- Reach flosser
- Grin floss pick

Oral health supplement:
- Xylitol mint
- Tooth mousse
- Toothpaste (can choose SLS free to avoid foaming up)
- Sensodyne Sensitive Teeth Toothpaste Freshmint
- Solid oral care toothpastes (NZ made)

Baking soda mouthrinse:
- 1/4 teaspoon baking soda. 1/8 teaspoon salt. One cup of warm water.

What can be done at dental visits during pregnancy
- Routine exams
- Dental hygiene treatment
- Dental X-ray when necessary (some dentists may choose to only take them after first trimester)
- Dental fillings

Local injections are generally safe,  2% lidocaine with 1:200,000 epinephrine is considered a good balance with safety and effectiveness.

Tia is an oral health therapist in Wellington, New Zealand. You can reach her at @smilewithtia.