ACOG Recommends Routine Oral Health Assessment at First Prenatal Visit

Teeth cleanings and dental X-rays are safe for pregnant women, according to new recommendations issued by The American College of Obstetricians and Gynecologists. Ob/Gyns are now being advised to perform routine oral health assessments at the first prenatal visit and encourage their patients to see a dentist during pregnancy.

"These new recommendations address the questions and concerns that many Ob/Gyns, dentists, and our patients have about whether it is safe to have dental work during pregnancy," said Diana Cheng, MD, vice chair of The College's Committee on Health Care for Underserved Women, which issued the guidelines. According to The College, oral health problems are associated with other diseases, including heart disease, diabetes, and respiratory infections. "We want Ob/Gyns to routinely counsel all of their patients, including pregnant women, about the importance of oral health to their overall health," said Dr. Cheng.

More than a third (35%) of all women report they haven't been to the dentist within the past year. Approximately 40% of pregnant women in the US have some form of periodontal disease, including gingivitis (inflammation of the gums), cavities (tooth decay), and periodontitis (inflammation of ligaments and bones that support the teeth). The physical changes caused by pregnancy can result in changes in the gums and teeth. Periodontal disease during pregnancy is most prevalent among black women, smokers, and women on public assistance.

In many states, women who use Medicaid insurance for prenatal care may also have dental services covered. However, access to dentists remains a problem in many states, especially for low-income women.

"We can all reassure our patients that routine teeth cleanings, dental X-rays, and local anesthesia are safe during pregnancy," said Dr. Cheng. "Pregnancy is not a reason to delay root canals or filling cavities if they are needed because putting off treatment may lead to further complications." One potential benefit of improving a woman's oral health: It may decrease the transmission of cavity-causing bacteria from mother to baby. This can help lessen the future risk of cavities in children.

Ob/Gyns are encouraged to reinforce practical advice for their patients: Limit sugary foods and drinks, brush teeth twice daily with a fluoridated toothpaste, floss once daily, and visit the dentist twice a year. Pregnant women with severe vomiting (hyperemesis) or gastric reflux can help avoid damage to their teeth from stomach acid by using an antacid or by rinsing with a teaspoon of baking soda in a cup of water after vomiting.

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