OB-GYNs: Dental Care OK During Pregnancy

Approximately 4 months ago, we published a blog post describing a relationship between tooth loss and pregnancy. The theory was that pregnant women avoided dental care due to fears over the possible impact of dental treatment on their pregnancy.  The findings of the study confirmed a greater incidence of tooth loss in women with children .

American College of Obstetricians and Gynecologists Logo OK for dentist visit during pregnancy

New Guidelines

In a recent issue of Obstetrics and Gynecology, the American College of Obstetricians and Gynecologists (ACOG) published recommendations regarding dental care during pregnancy. These recommendations were based upon years of research on the impact of oral health on pregnant and post-partum individuals.

Key findings from the committee included:

Pregnant Woman Photo - OK to see the dentist

Routine dental care is important

  • OB/Gyns should discuss oral health with all patients, especially those who are pregnant.
  • Pregnant women should be advised by their OB that by improving her oral health, she is less likely to transmit the cavity producing bacteria to her infant.
  • OBs should inform patients that diagnosis of oral conditions, including dental x-rays, are safe during pregnancy.
  • OBs should inform their pregnant patients that certain conditions (dental abscesses, dental caries, pericoronitis, etc.)  may require treatment during the pregnancy. In general, delaying treatment may result in more complex problems.
  • Patients who experience morning sickness are at a greater risk for dental decay.

The Committee writes:

“Oral health is an important component of general health and should be maintained during pregnancy and through a woman’s lifetime. Maintaining good oral health may have a positive effect on cardiovascular disease, diabetes, and other disorders.”

Our clinical team at Calcaterra Family Dentistry

Our dedicated clinical team

We have had the privilege of caring for hundreds of pregnant and post-partum women over the years.

In most cases, we simply perform a routine cleaning and inform the patient of our findings. By doing so, we have been able to educate on the importance of oral health as well as help prevent future  tooth loss.

If you are expecting and have a dental question, feel free to call us for an appointment.


New Study Demonstrates Relationship Between Teeth Defects and Celiac Disease

Celiac Disease and effects on teeth for the dentist to identify

Symptoms of Celiac Disease. Image courtesy celiac.org

A new study has been published which has highlighted an increasingly common finding in the dental office: a correlation between certain teeth defects and celiac disease. The study showed 85% of adults with celiac disease had specific tooth enamel defects attributable to gluten consumption while the adult teeth were forming.

Unfortunately, very few dentists are aware of this correlation and the steps necessary to help dental patients with celiac disease. Drs. Nicholas and Carla Calcaterra in our Orange, CT dental office are committed to informing and educating patients about this link.

What is Celiac Disease?

Celiac disease is an inherited condition which affects an individual’s ability to digest gluten. Gluten is the common name given to proteins found in all types of wheat. When a person with this condition consumes gluten, the immune system creates a toxic reaction that damages the small intestine. In the United States, nearly 1 in 100 whites have celiac disease.

Celiac Disease gastrointestinal symptoms and stomach pain

Stomach Pain is a common finding. Image courtesy Celiac.org

There are many non-dental symptoms of celiac disease. These include:

  • Bloating of the Stomach
  • Chronic Constipation and/or diarrhea
  • Anemia
  • Fatigue or lack of energy
  • Osteopenia and then Osteoporosis
  • And many others…

Dental Findings in Patients with Celiac Disease

Patients with Celiac Disease will frequently have several common findings identifiable by a dentist:

  • Problems or defects in dental enamel (enamel is the outermost layer of the tooth).
  • Apthous ulcers (also called canker sores or mouth sores).
  • Delayed tooth eruption.

Defects in dental enamel are the most troubling for patients, as they weaken the teeth and make them more susceptible to dental decay (also referred to as cavities). In order for the defects to occur, you must have consumed gluten while the permanent teeth were developing, which is from birth to age 7 to 8.

Photo and Picture of Tooth with enamel defect due to celiac disease

Upper canine tooth on an adult patient from Milford, CT with celiac disease. Photo Dr. Nicholas Calcaterra.

The exact mechanism of how the defects occur is unknown, but researchers in this paper believe it is an immune-mediated reaction.

The photograph here shows enamel defects in an upper canine in a patient from Milford, CT. She was seen by Dr. Nicholas Calcaterra in our office in Orange, CT. A thorough medical and dental history as well as a detailed clinical exam allowed for Dr. Calcaterra to determine the origin of the defects. To address this tooth and other ones with similar features, Dr. Calcaterra placed several all porcelain crowns.

Considerations for Dental Patients with Celiac Disease

Several pages could be written on this subject. But key points include:

  • If you have celiac disease, ask your dentist if she/he sees any clinical or radiographic enamel defects.
  • Be aware that if you have defects, you are at higher risk for dental decay. Ask your dentist for a high fluoride prescription toothpaste such as Prevident.
  • If you suffer from chronic apthous ulcers, ask your dentist for a prescription that can relieve the pain and potentially shorten the duration. Kenalog in Orabase is a common one.
  • If you have celiac disease, ask your dentist or hygienist to use gluten-free paste at your 6 month cleaning appointment.  We have this available for all patients upon request.
  • If you have not been diagnosed with Celiac disease, but have dental findings similar to what is described AND you have gastrointestinal symptoms, consult your physician.

If you live in Orange, Woodbridge, Milford, or other area towns and would like a consult or new patient appointment with Dr. Nicholas or Carla Calcaterra, call us at (203) 799 – 2929 or visit our appointment page.


NYU Study Confirms Link Between Tooth Loss and Pregnancy

Pregnant Woman Photo who will lose more teeth and have more dental problems

Expectant Mom. Will she expect to lose teeth?

A study out of New York University’s Dental program has given validity to the saying “for every child, the mother loses a tooth.”

In this research, Professor Stefanie Russell looked at women ages 18 to 64 who reported at least one pregnancy. After controlling for numerous variables, Russell demonstrated that women with more children were more likely to have more missing teeth.

In our experiences treating hundreds of present and future Moms in our Orange, CT dental office, we found the study results to be consistent with our observations. Changes in oral health in pregnant women are often times first detected in routine dental hygiene visits by our Hygienists Crystal and Toni. Then we end up observing dental problems during the later phases of the pregnancy and then after childbirth.

How Pregnancy Affects Teeth and Gums

As any mother would attest, pregnancy affects every part of the mom-to-be’s life.  The teeth and gums are no exception. We’ve made the following observations over the years:

Photo of tooth with dental decay on pregnant patient Woodbridge, CT

Cavity on a post-partum patient from Milford, CT

  • Hormonal changes cause the gum tissue to be more sensitive to plaque, leading to pregnancy gingivitis. Pregnancy Gingivitis is generalized inflammation of the gum tissue. Routine dental cleanings during pregnancy are needed to treat this.
  • Morning sickness can lead to nausea and vomiting. The acidity of the stomach contents is almost as bad as battery acid! The repeated acid attack on the teeth can lead to dental decay which can then lead to fillings or even more extensive treatment needs.
  • Many moms-to-be will neglect their own dental visits during the pregnancy. This is often due to a fear that a routine dental cleaning will impact their pregnancy (it will not!). As a result, dental problems go undetected and end up causing major problems post-partum, sometimes requiring a tooth extraction and then a dental implant.

Pregnancy and Tooth Loss

With the reasons cited above, one can reasonably understand the conclusions from the NYU Study. But it doesn’t have to be that way!

There is no reason to delay a dental appointment during your pregnancy. We have treated hundreds of pregnant patients over the years and we will be happy to see you. And if there are areas of concern, we will discuss it with you and your obstetrician to assess whether treatment should be done before childbirth or after. We are always a phone call away if you have questions.