Pregnancy is often framed as a symphony of ultrasounds, vitamin supplements, and obstetric visits. Dental care, meanwhile, is generally sidelined.

What Expectant Mothers Often Don’t Know About Oral Health

A cohort study conducted at a London maternity unit uncovered a consistent gap in oral-health awareness among pregnant women. While many expectant mothers recognized the benefits of fluoride toothpaste, flossing, and sugar-free chewing gum, far fewer identified everyday dietary exposures, such as milk, dried fruits, and fruit juices as contributors to early tooth decay in children.

Knowledge about preventive measures such as fluoride varnish, as well as the correct timing to initiate toothbrushing, was limited.

Does Experience Equal Awareness?

Interestingly, prior motherhood did not reliably translate into better preventive knowledge. First-time mothers and those with older children showed similar gaps in understanding dietary risks and caries prevention. Mothers with previous children were slightly more familiar with toothpaste quantities and brushing timelines, but the overall knowledge deficit remained.

What is Early Childhood Caries?

Early childhood caries (ECC) is the most prevalent chronic disease affecting young children worldwide and is defined as the presence of decay in any primary tooth during early life. ¹ Importantly, ECC does not appear suddenly, it develops gradually, shaped by feeding practices, dietary habits, and caregiver behaviors.

Maternal education, socioeconomic status, and food choices are all factors influencing the risk. Prolonged night-time milk feeding, frequent bottle use, unrestricted breastfeeding beyond infancy, and regular exposure to fruit juices or dried fruits between meals have all been linked to higher rates of ECC.²

Even well-intentioned dietary choices, often marketed as “healthy,” can quietly damage teeth when food labels fail to explain their dental impact.²

See also: Maternal Vitamin D in Pregnancy Linked to Lower Childhood Caries Risk

Pregnancy as a Window for Prevention

Pregnancy represents a rare and powerful window for health education. Expectant mothers are often more receptive to preventive guidance. ³ This makes pregnancy an ideal time to establish long-lasting oral-health behaviors.

Recognizing this opportunity, professional bodies such as the American College of Obstetricians and Gynecologists (ACOG) and the American Dental Association (ADA) issued joint guidance emphasizing that dental care during pregnancy is both safe and necessary.⁴

Their recommendations include:

• Oral-health screening

• Patient education

• Timely dental visits

• Not postponing dental treatment due to pregnancy

Hormones, Gums, and Pregnancy Outcomes

Pregnancy hormones alter metabolism and mood, along with affecting the oral cavity.

Rising progesterone levels increase gum sensitivity to plaque, making pregnant women particularly susceptible to gingivitis. In fact, mild gum inflammation affects the majority of expectant mothers.⁵

Can Gum Disease Affect the Baby?

Growing evidence suggests that untreated gum inflammation, may enter the bloodstream and potentially reach the placenta, increasing the risk of adverse pregnancy outcomes.⁶

Encouragingly, treating gingivitis during pregnancy has been associated with a significant reduction in preterm birth risk and improvements in birth weight.⁶ Even routine dental check-ups and professional cleanings have been shown to make a measurable difference.

Simple Oral Health Habits with Long-Term Impact

Maintaining oral health during pregnancy does not require complex interventions, only consistency:

• Twice-daily brushing with fluoride toothpaste

• Daily flossing

• Use of alcohol-free antimicrobial mouth rinses

• Balanced nutrition with adequate calcium intake

• Rinsing the mouth after episodes of morning sickness

• Open communication between the dentist and the obstetrician

After delivery, oral care remains important. Maternal oral health influences bacterial transmission to the infant, shaping a child’s future caries risk long before the first toothbrush is introduced.

The Bigger Picture

Dental health during pregnancy is not cosmetic. It is preventive pediatrics and prenatal care in disguise.

A healthy mouth supports a healthier pregnancy and lays the foundation for a child’s oral health long before the first tooth erupts.

The first dental visit, after all, does not begin in the clinic.

It begins with an informed mother.

References

1. Plonka KA, Pukallus ML, Barnett A, Holcombe TF, Walsh LJ, Seow WK. “A controlled, longitudinal study of home visits compared to telephone contacts to prevent early childhood caries.” International Journal of Paediatric Dentistry. 2013 Jan;23(1):23–31. https://pubmed.ncbi.nlm.nih.gov/22251427/

2. Correia PN, Alkhatrash A, Williams CE, Briley A, Carter J, Poston L, et al. “What do expectant mothers need to know about oral health? A cohort study from a London maternity unit.” BDJ Open. 2017 Mar 24;3:17004. https://pubmed.ncbi.nlm.nih.gov/29789770/

3. Rocha JS, Arima L, Chibinski AC, Werneck RI, Moysés SJ, Baldani MH. “Barriers and facilitators to dental care during pregnancy: a systematic review and meta-synthesis of qualitative studies.” Cad Saude Publica. 2018 Sept 6;34(8):e00130817. https://pubmed.ncbi.nlm.nih.gov/30208187/

4. Maryland Department of Health. “Oral health care during pregnancy: Practice Guidance for Maryland Prenatal and dental providers.” Baltimore MD: Maryland Department of Health, Office of Oral Health.; 2022. http://www.oralHealth4Better.com

5. Wu M, Chen SW, Jiang SY. “Relationship between Gingival Inflammation and Pregnancy.” Mediators Inflamm. 2015;2015:623427. https://pubmed.ncbi.nlm.nih.gov/25873767/

6. Tsikouras P, Oikonomou E, Nikolettos K, Andreou S, Kyriakou D, Damaskos C, et al. “The Impact of Periodontal Disease on Preterm Birth and Preeclampsia.” Journal of Personalized Medicine. 2024 Mar 26;14(4):345. https://pubmed.ncbi.nlm.nih.gov/38672972/