ASK A RESEARCHER: Life changes can take a toll on your teeth, says researcher Ingvild Brusevold.
Cavities can develop quickly if you become a bit more lax when brushing your teeth while also eating more sweets, says researcher Ingvild Brusevold.(Photo: Anders Moen Kaste)
Some women find that their dental health suddenly deteriorates after pregnancy.
In a 2021 article in The Atlantic, Rosie Colosie wrote that she did not change her routines when she became pregnant. Still, several cavities showed up at her next check-up.
Her dentist told her he sees this often in new mothers: They get more cavities.
What's the explanation?
On the discussion forum Reddit, many encourage pregnant women not to blame themselves. Pregnancy is tough on teeth, they write. Some say it has to do with vomiting. Others point to hormones. And many believe it has to do with cravings and brushing routines.
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Researchers' views on the matter are somewhat divided. Biological factors may play a role. But a lot probably has to with changes that pregnant women themselves make without noticing, say two Norwegian odontologists.
Small cavities can stay stable for years – then worsen quickly
The generation that is pregnant now generally has few cavities and good dental health, says researcher Ingvild Brusevold at the University of Oslo's Faculty of Dentistry.
"But many of them have small cavities that have been there for many years. With good brushing and fluoride use, they stay that way," she says.
Brusevold believes habits matter more than biology when some women develop more cavities after pregnancy.
"When you become pregnant, your routine may change slightly," says Brusevold.
"Take a fluoride tablet"
Many pregnant women develop strong cravings for certain foods – often sweets.
"If you start eating sour candies or other sweets frequently, those small cavities can grow faster," she says.
Combined with slightly poorer oral hygiene, this can lead to more cavities.
"It can happen quickly," says Brusevold. "In a normal situation, with regular brushing routines, it generally takes a long time for cavities to develop."
She sometimes sees how quickly good routines fail.
"If you get tired in the evening and forget to brush your teeth, it's easy for that to continue," says Brusevold.
Use a bit more fluoride
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She recommends compensating with a bit more fluoride.
"Use a fluoride rinse, take a fluoride tablet, or chew fluoride gum. These are very small doses, so it's not dangerous for the foetus," says Brusevold.
She adds that it's not just pregnant women who can suddenly develop more cavities. Refugees can often have dental problems. People who have been hospitalised or have a chronic illness are also at risk, according to Brusevold.
"They may brush less, brush poorly, or develop dry mouth," she says.
Dry mouth increases the risk of cavities.
The issue isn't weaker teeth
Brusevold describes pregnancy as a special state for the body. Pregnant women also have a slightly higher risk mild gum inflammation.
"That can make brushing uncomfortable or painful, which may lead to poorer cleaning – and eventually cavities," she explains.
The researcher states that the problem does not lie in the strength of the teeth or the enamel.
"The enamel formed when the teeth were still in the jaw. It matures a bit after the teeth come out, but it doesn't change because you become pregnant," she says.
Her advice is not exactly surprising:
"If you maintain good habits and brush twice a day with fluoride toothpaste, there's no reason to believe you'll get more cavities," she says.
Pregnant women may have a slightly higher risk of both cavities and acid damage, says researcher Lars Martin Berg.(Photo: UiT The Arctic University of Norway)
Hormonal changes
Lars Martin Berg is a specialist in multidisciplinary dentistry.
He says it's a well-known phenomenon that pregnant women have an increased risk of cavities and gum inflammation, and that this is most often due to changes in habits.
"This includes, for example, poorer oral hygiene due to tiredness and nausea, along with a stronger desire to snack between meals and potentially consume more sweets and snack foods," he says.
But pregnancy itself can also contribute.
Berg explains that hormonal changes increase the risk of both mild and more serious gum inflammations, because these changes make the gums more sensitive to bacteria in plaque.
Hormones can also affect saliva production, which further raises the risk of cavities.
Lumps in the gums
Some pregnant women develop growths on their gums, Berg explains. They are called pregnancy epulis and are lumps that can appear in the third trimester.
The lumps are most often caused by a combination of poor oral hygiene and chronic irritation, according to the Great Norwegian Encyclopedia.
They disappear on their own in most cases, according to Berg. But for some, they need to be removed surgically.
"It's not the baby in the womb itself, but changes in hormones, saliva production, and the mother's behaviour related to pregnancy that increase the risk of oral health conditions," Berg asserts.
Not just cavities
"We know that vomiting, heartburn, and acid reflux become more common for many women during part or all of pregnancy. These are obvious reasons why acid damage can occur," says Berg.
When frequent snacking on acidic foods and drinks is added, it's not surprising that some people develop visible wear on their teeth after a pregnancy, he says.
Berg emphasises that it's difficult to say how many this affects, since acid damage can also occur both before and after pregnancy.
