“There are so many risks to the baby if I go for dental work, right?” “What about x-rays?” “I don’t like going to the dentist anyway, so I’ll probably just wait until my baby is born. That should be fine, right?” Worries, excuses, we’ve heard it all at MotherToBaby when it comes to dental procedures during pregnancy. We often receive questions from women wondering whether dental care is safe. In short, the answer is….yes! What better time to talk about the reasons why it’s ok than during June – typically the month the American Dental Association dubs as “Oral Health Month.”

Routine dental care is low risk, and most emergency procedures can be done as well.
Good oral health improves your overall health, and increases your chances of a good pregnancy outcome. However, when you are scheduling a dental appointment and are pregnant (or trying to get pregnant), let the office know so that they can be prepared to make decisions about which procedures are safe for your baby. In some cases, you or your dentist may want to wait until after delivery for elective (non-necessary) procedures.

Here are some commonly asked questions we get from pregnant women:

• When I brush my teeth, my gums have started to bleed. Is this normal? What should I do?

Bleeding gums is a common problem during pregnancy. Pregnant women have hormonal changes that can increase their chances of getting gum problems such as gingivitis (puffy and tender red gums that bleed easily). Your dentist will want to monitor this so that it does not progress to a more serious gum disease. Periodontal disease is a bacterial infection of the gums and jaw bones that support the teeth, and can increase your chances of having a smaller baby, delivering early, and having other pregnancy complications. Dentists recommend that you floss daily, and get your teeth cleaned on a regular basis during pregnancy (consider having it done more frequently, if you are having pregnancy gingivitis).

• It seems like pregnancy is causing me to get more cavities in my teeth…am I right?

Pregnancy can contribute to women having more cavities. This is in part due to changes in diet such as frequent snacks including sugary foods. To prevent cavities, eat a healthy diet and brush your teeth after eating sweets. In addition, if you have morning sickness, the acid from your stomach can affect your tooth enamel and make cavities more likely. Rinse your mouth with water or mouthwash after morning sickness episodes. If your toothpaste is making your morning sickness worse, ask your dentist for the name of a bland-tasting toothpaste.

• What if I need to get a cavity filled or a tooth pulled? Can I have a local anesthetic?

Agents like lidocaine which are injected into your gums are low risk for your baby. In one study, researchers compared pregnant women who received lidocaine injections as part of dental treatment with women who did not, and found no significant increase in risk for miscarriage, prematurity, or birth defects. If you need a pain medication, your dentist will take into account where you are in your pregnancy so as to make a choice that is safest for your baby.

• Are dental x-rays safe in pregnancy?

You may choose to have routine X-rays done prior to pregnancy, or to delay them until after you deliver – talk to your dentist about the best options for you. However, if you have a dental emergency and need to have them done, don’t hesitate. Advances in technology have made dental X-rays safer, and they do not involve as much radiation or may not involve radiation at all. Your dental office will cover your neck and abdomen with a lead apron, which lessens the exposure to your baby even more.

• What else can I do to ensure dental health?

Schedule a visit to your dentist before you are pregnant. Get teeth cleaned, gums examined, and any dental issues addressed prior to pregnancy.

Brush your teeth at least twice a day and floss once a day. This helps reduce plaque, the sticky film that covers your teeth and can make gums inflamed and increase your risk for periodontal disease.

I hope I’ve given you a few good tips to chew on – Your teeth and baby will thank you. Have a healthy pregnancy!

Beth Conover, APRN, CGC, is a genetic counselor and pediatric nurse practitioner. She established the Nebraska Teratogen Information Service in 1986, also known as MotherToBaby Nebraska. She was also a founding board member of the Organization of Teratology Information Specialists (OTIS). In her clinical practice, Beth sees patients in Pharmacogenetics Clinic and Genetics Clinic at the University of Nebraska Medical Center. Beth has provided consultation to the FDA and CDC.

About MotherToBaby
MotherToBaby is a service of the Organization of Teratology Information Specialists (OTIS), suggested resources by many agencies including the Centers for Disease Control and Prevention (CDC). If you have questions about exposures during pregnancy and breastfeeding, please call MotherToBaby toll-FREE at 866-626-6847 or try out MotherToBaby’s new text information service by texting questions to (855) 999-3525. You can also visit MotherToBaby.org to browse a library of fact sheets about dozens of viruses, medications, vaccines, alcohol, diseases, or other exposures during pregnancy and breastfeeding or connect with all of our resources by downloading the new MotherToBaby free app, available on Android and iOS markets.

The post Don’t Fight It Tooth and Nail: Your Dentist is on Your Side during Pregnancy! appeared first on MotherToBaby.

The New Year often brings thoughts of finding a new job. Even those happy in their current occupations often use the New Year to jump start career advancements. If you are thinking about a pregnancy, or you are already pregnant or breastfeeding, chances are you have also started to think more about potential exposures that might be of concern.

As a prenatal genetic counselor, I have noticed a common trend among working women. Many women do not worry very much about potential work hazards when first starting their careers. However, once they start to plan a pregnancy or find out that they are pregnant, many women call to ask about job safety. With a new life is on their minds, many women start to view their environment more critically.

For those of you planning a pregnancy, now is a great time to ask your questions about workplace safety with your healthcare providers or to contact a MotherToBaby specialist. Researching possible occupational exposures prior to pregnancy can allow time to decide if extra safety measures should be considered. Don’t forget to think about occupational exposures that your partner might be facing.

Occupational hazards can include:

• chemicals,
• metals,
• anesthetic gases,
• ionizing radiation,
• loud noise,
• extreme heat or extreme cold,
• strenuous physical exertion,
• repetitive movements,
• whole body vibration,
• infectious agents (viruses, diseases),
• injury,
• emotional stress and
• changing shift rotations.

In general, exposures can happen through: inhaling substances (e.g., breathing a gas, powder, dust or vapor into your lungs), absorption through skin, or ingestion (i.e., eating or drinking).

Sometimes, workers carry hazardous substances (dust, powder, chemicals, metal flakes) home on their shoes or clothing. This is one of the reasons that it is also important talk to your partner or other adults living in your home about their workplace.

While the list of potential hazards looks long, we should remember that just because we work around a potential hazard, it does not mean that we are actually exposed to the hazard. More importantly, employment has generally been considered beneficial for maternal health and birth outcomes. This is due to the financial and social benefits of working, and some call it the “healthy worker effect”. Most of the health problems that have been associated with workplace exposures do not affect our ability to get pregnant or to carry a healthy pregnancy to term.

The United States Department of Labor’s Occupational Safety and Health Administration (OSHA) requires employers (your bosses) to make the workplace safe for their workers. But, workplace safety measures were mainly created with adults (men and non-pregnant women) in mind; not a developing baby. In addition, workplace hazards that might affect a pregnancy are difficult to research. Therefore, your healthcare providers might not always know how a true exposure could affect a pregnancy. However, by following proper safety procedures, workplace exposures will likely be kept below levels that would affect your health or a pregnancy.

What should I be ready to discuss if I am worried about possible exposures at my workplace?

1. Employer/Job title
2. How long you’ve been working there
3. Description of job tasks, during and prior to pregnancy
4. Exposures that you are worried about
5. Personal protective equipment used (such as gloves, gowns, masks, or eyewear)
6. Ventilation at the work site (e.g., are there Hoods? Air Handlers? Fans? Windows that can open?)
7. Eating or drinking at the work site (e.g., do you store your food in an area that is designated only for that purpose?)
8. Any health symptoms in you or coworkers
9. Any reports available, such as blood lead levels, air quality reports, or water report.
   1. Sometimes an industrial hygienist will come to a work site to visually look at the work place or to take test samples (air, water, surfaces) for contamination.
10. For those who work around chemicals, they may ask about Safety Data Sheets (more on these below).
11. Other jobs/hobbies during pregnancy

What are Safety Data Sheets?

The best way to find out what chemicals are in the product(s) you use at work, or products that are used around you, is to get a copy of the Safety Data Sheets (SDS) (previously called Material Safety Data Sheets, or MSDS). SDS are prepared by chemical manufacturers and outline information on the product. Your workplace is required to have the SDS readily available to workers for all hazardous chemicals used at a worksite. Most SDS / MSDS can also be downloaded from the internet.

Along with listing hazardous ingredients, the SDS will talk about how to handle and store the product. The sheet should also talk about any specific recommendations for PPE and how to clean a spill or how to apply immediate first aid in case of accidental exposure.

Sometimes, a hazardous ingredient may be listed as “trade secret” or “proprietary formulation”. One can try to learn more about the chemicals in the proprietary formulation by contacting the manufacturer at the address or telephone number listed on the SDS. If a product contains no hazardous ingredients, it will be listed as such.

Along with a list of ingredients considered hazardous, the SDS may also discuss allowable levels of exposure. You may have heard of these limits by the terms: the Threshold Limit Value (TLV) or Permissible Exposure Limit (PEL). TLVs and PELs are limits for the maximum exposure allowed in the workplace. Industrial hygienists can perform workplace assessments to determine if there are exposures that are above allowable levels. These limits are designed to minimize health effects in nonpregnant workers. So it cannot be assumed that exposure levels below the TLV or PEL will be safe for a pregnant woman and/or her fetus.

What kind of safety protection can be used?

All work places should provide the proper personal protective equipment (PPE) for handling and working around hazardous situations. Some examples of PPE include gloves, shoes, aprons, gowns, ear protection, masks, and/or ventilation such as hoods and air filters.

• Use the PPE that is recommended for your job.
• Use PPE at all times, not just when pregnant.
• Keep your training on how to properly use the PPE up to date.
• Make sure hoods, respirators, and other equipment are working properly.
• If you wear PPE (such as a respirator), be sure it fits correctly. And keep in mind: as a woman’s body changes during pregnancy, PPE may need to be re-fitted.
• If you wear a respirator, remember that respirators are not a substitute for appropriate permanent exhaust ventilation (such as fume hoods, exhaust ducts and/or exhaust fans). Respirators are designed to be used only for a short period of time.
• If the right PPE is not currently at your worksite, ask your employer about getting it.

Consider talking with an occupational health specialist or industrial hygienist who may be able to provide information that is specific to your workplace.

How can I learn more about ways to reduce my exposure to potential hazards in my workplace?

MotherToBaby has a fact sheet that discusses general tips on working safely called Reproductive Hazards of the Workplace. There are some other fact sheets on specific occupational exposures, such as infectious diseases, lead, paint, and pesticides. There are also specific workplace sheets that look at working in a veterinary setting, in a nail salon, and for those who work with x-ray machines. Our entire library of fact sheets can be accessed by visiting https://mothertobaby.org/fact-sheets-parent/.

You can also contact an industrial hygienist or occupational medicine specialist. Try looking for them at a local medical university or through the American Industrial Hygiene Association: https://www.aiha.org/about-ih/Pages/Find-an-Industrial-Hygienist.aspx. Industrial hygienists should be able to provide an independent assessment on ways to improve the safety of your job, if needed, and may be able to give advice on how to work with employers in implementing these changes. The National Institute for Occupational Safety and Health (NIOSH) has a free service called Health Hazard Evaluation (HHE), which can provide you or your employer advice about health hazards that might be in your workplace and can offer tips on how to make your workplace safer. To learn more, visit the NIOSH website at: https://www.cdc.gov/niosh/hhe/.

Happy New Year, New Job, and New Baby.

Ginger Nichols is a licensed certified genetic counselor based in Farmington, Connecticut. She currently works for MotherToBaby CT, which is housed at UCONN Health in the Division of Human Genetics, Department of Genetics and Genome Sciences. She obtained her Bachelor of Science degree in Biology and Sociology from Juniata College and her Master’s Degree in Medical Genetics from the University of Cincinnati. She has a special interest in occupational and environmental exposures.

About MotherToBaby

MotherToBaby is a service of the Organization of Teratology Information Specialists (OTIS), suggested resources by many agencies including the Centers for Disease Control and Prevention (CDC). If you have questions about exposures during pregnancy and breastfeeding, please call MotherToBaby toll-FREE at 866-626-6847 or try out MotherToBaby’s new text information service by texting questions to (855) 999-3525. You can also visit MotherToBaby.org to browse a library of fact sheets about dozens of viruses, medications, vaccines, alcohol, diseases, or other exposures during pregnancy and breastfeeding or connect with all of our resources by downloading the new MotherToBaby free app, available on Android and iOS markets.

Selected References:

Feinberg JS & Kelley CR (1998) Pregnant Workers: A Physician’s Guide to Assessing Safe Employment; West J Med; 168(2): 86-92.

Frazier L & Hage M (1998) Reproductive Hazards of the Workplace. New York: Van Nostrand Reinhold.

Frazier L, Jones T (2000) Managing Patients with Concerns About Workplace Reproductive Hazards. JAMWA 55(2): 80-84.

The American College of Obstetrics and Gynecology (ACOG). 2017. Committee Opinion Number 313. The Importance of Preconception Care in the Continuum of Women’s Health Care. Available at: https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Gynecologic-Practice/The-Importance-of-Preconception-Care-in-the-Continuum-of-Womens-Health-Care

The Centers for Disease Control and Prevention (CDC) National Institute for Occupational Safety and Health (NIOSH). REPRODUCTIVE HEALTH AND THE WORKPLACE. https://www.cdc.gov/niosh/topics/repro/healthcare.html

The United States Department of Labor’s Occupational Safety and Health Administration (OSHA). Employer Responsibilities. Available at: https://www.osha.gov/as/opa/worker/employer-responsibility.html

The United States Department of Labor’s Occupational Safety and Health Administration (OSHA). Hazard Communication Safety Data Sheets: https://www.osha.gov/Publications/HazComm_QuickCard_SafetyData.html

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