Labour of Love

Media item: feature article

Date published: 7 January 2017

This page records the media item. The original article is the property of its publisher and is not reproduced here.

The archive preserves the headline and the date. What follows is general information on dental care in pregnancy — a subject surrounded by more misinformation than almost any other in dentistry, and one where the misinformation causes real harm. The articles on the same subject are Oral health care while pregnant, Protecting your teeth in pregnancy, Is it safe to visit the dentist in pregnancy? and A dental check-up when pregnant.

Nothing here is advice for your pregnancy. Discuss your own care with your dentist, your GP, your midwife or your obstetrician.

The single most important point

Dental care during pregnancy is safe, and it should not be deferred.

This is the settled position of Australian and international health authorities, and it needs saying plainly because the folk belief runs the other way. Very large numbers of people avoid the dentist entirely while pregnant, on the assumption that treatment is risky.

The avoidance is measurable at the other end of the timeline too. The Australian Dental Association's consumer research found that 75% of women did not have a dental check-up before conception, and the ADA's stated reason for treating that as a problem is that ‘poor oral health in pregnant mothers is associated with poorer pregnancy outcomes like low birthweight babies'. Note the ADA's own word: associated. That is the honest form of the claim and this page keeps to it.

The risk runs the other direction. Pregnancy makes several dental problems more likely, and an untreated dental infection during pregnancy is a genuine hazard — to the person who has it, and potentially to the pregnancy. Deferring is the risk, not treating. See Can a dental abscess affect your general health?.

On that point the general clinical principle is blunt, and it is not pregnancy-specific: the RACGP states that ‘antibiotic treatment without dental treatment to remove the cause always fails', and that where an abscess has spread beyond the tooth ‘it requires dental treatment and will not respond to antibiotics alone'. The same source names the trap in the symptom pattern — ‘when pulp necrosis finally occurs, there is no pain' — so pain stopping is not evidence that the problem has. For scale, the AIHW records 88,600 potentially preventable hospital admissions due to dental conditions in Australia in 2023–24, about 3 in every 1,000 people; that is an all-ages figure and not a pregnancy statistic, but it is the size of the avoidable harm from leaving dental disease alone.

Tell your practitioner you are pregnant, or might be. It changes some choices; it does not close the surgery door.

What actually changes in pregnancy

Pregnancy gingivitis. Hormonal changes exaggerate the gum's inflammatory response to plaque, so gums that were mildly inflamed become markedly so — red, swollen, and bleeding on brushing. It is very common, it typically appears from the second month and peaks in the second trimester, and it is a response to plaque, not to hormones alone. The plaque is what you can control. See Bleeding Gums and What is gum disease?. Why are women especially prone to oral health problems? puts pregnancy in the context of the other hormonal stages.

Pregnancy epulis (pyogenic granuloma). A localised lump on the gum, usually between teeth. Alarming to find, almost always benign, and it typically resolves after the birth. It should still be examined — because ‘almost always' is not ‘always'. On when a lump or ulcer warrants closer attention, see The cause of mouth ulcers and their usual treatments and Oral cancer: how a dentist can help with early detection.

Erosion from morning sickness. This is the one that causes lasting damage. Repeated vomiting exposes teeth to stomach acid, which is far stronger than anything in a drink, and the wear pattern is characteristic — typically the inner surfaces of the upper front teeth. See What is acid wear and how can I avoid it? and How is dental erosion addressed?.

Critically: do not brush immediately after vomiting. The enamel is acid-softened and brushing removes it. Rinse with water, or with water and a little bicarbonate of soda, and wait at least 30 minutes. The same timing rule is explained in Brushing teeth before or after breakfast and Over-brushing.

Diet changes. Frequent small meals, nausea managed by grazing, and cravings all raise the number of acid exposures per day. Frequency matters more than quantity. The Australian Dental Association's position on diet and caries puts it as ‘the form, frequency, timing and total amount of sugar intake are significant in the initiation of the caries process', with particular emphasis on snacking on sugary drinks and sugar-rich foods of limited nutritional value. See How does acidic food affect your teeth? and How does your diet affect your teeth?.

Reflux, which is common in later pregnancy, adds acid exposure independent of diet.

Dry mouth in some people, which reduces the saliva that would otherwise buffer all of the above — see My mouth is always dry.

What is safe, specifically

Examinations and cleans — yes, at any stage. Actively recommended. See Dental Cleans and Hygienists.

Fillings and other routine treatment — yes. The second trimester is generally the most comfortable time for elective work, simply because nausea has usually settled and lying back is easier than it becomes later. That is a comfort consideration, not a safety one. See Tooth Fillings.

Local anaesthetic — yes. The agents used in dentistry are used in pregnancy. Adequate anaesthesia is better than a painful procedure, and pain and stress are not benign.

Radiographs — dental radiography is very low dose and the beam is directed away from the abdomen. The International Atomic Energy Agency's published typical effective doses give the scale: intraoral dental imaging 1–8 μSv, panoramic examinations 4–30 μSv, cephalometric examinations 2–3 μSv, and CBCT 50 μSv or below for small or medium scanning volumes and around 100 μSv for large volumes. Where imaging is needed for diagnosis, it can be taken, with appropriate shielding. Non-urgent imaging is commonly deferred as a precaution, which is a reasonable default rather than a statement that it would be harmful. See How safe are dental X-rays?.

Urgent treatment — infection, abscess, severe pain — at any stage. An untreated infection is the greater risk, without qualification. See Emergency Dentistry and How is a tooth abscess treated?.

What is usually deferred: elective cosmetic treatment, including whitening, for which there is simply no safety data in pregnancy and no reason to take an unquantified risk for an appearance outcome — see Teeth Whitening and Why should I go to a dentist for whitening?. Elective procedures under sedation or general anaesthetic are also normally postponed — see Sleep Dentistry.

Medicines: some analgesics and antibiotics are avoided in pregnancy and some are not. This is a prescribing decision for your practitioner in consultation with your medical team — do not self-medicate, and do not stop anything you have been prescribed. On the specific case of toothache, see Should I see a GP for antibiotics for toothache?.

Positioning and comfort

Practical, and rarely mentioned:

Lying flat in later pregnancy can be genuinely uncomfortable, and can cause light-headedness through pressure on major blood vessels. Say so. The chair can be tilted less far, a wedge or cushion used under the right hip, and breaks taken.
A gag reflex worsened by nausea is common. Shorter appointments, sitting more upright, and morning or afternoon slots to suit when you feel best all help.
Ask for a longer appointment if you need to stop frequently. It is an ordinary request — see Dental Anxiety for how those adjustments are usually arranged.

The evidence on gum disease and pregnancy outcomes, stated honestly

There is a well-documented association between periodontal disease and adverse pregnancy outcomes, including preterm birth and low birth weight. See What is periodontal disease? and Health problems linked to poor oral hygiene.

What is less settled is whether treating gum disease during pregnancy changes those outcomes. Trials have not consistently shown that it does. It is worth saying that the independent Australian material we can point to goes no further than the word associated — the ADA's own phrasing above — and that no source we can find claims a treatment effect on birth outcomes.

So the honest framing is this: treat gum disease in pregnancy because inflamed, bleeding gums are a problem worth treating in their own right, and because periodontitis is the leading cause of adult tooth loss. That reason is sufficient and it is certain. See Periodontists and Do I need a deeper cleaning?. Do not let anyone tell you a dental treatment will prevent a preterm birth — that claim runs ahead of the evidence.

Afterwards, and the baby

Decay-causing bacteria are transmissible, and a child's oral flora is substantially acquired from close carers. Reducing your own decay activity is genuinely protective for the child — see Can you catch dental decay from someone else's toothbrush?.
Do not share spoons, dummies, or clean a dummy in your own mouth.
No bottle in bed with anything but water.
Start cleaning the first tooth when it arrives, with a smear of fluoride toothpaste — see The benefits of fluoride and Children's Dentistry.
Eligible children may be covered under the Child Dental Benefits Schedule — Services Australia sets the benefit at up to $1,158 for each eligible child over two consecutive calendar years for basic dental services, indexed on 1 January each year. See Child Dental Benefit Schedule.
Book your own check-up too. Postnatal dental care is skipped almost universally, and the erosion and gingivitis of pregnancy do not resolve on their own — see How often should I go to the dentist?.

And if cost is the barrier, say so. Public dental care in Victoria is available through community dental agencies and the Royal Dental Hospital of Melbourne for eligible people, and pregnancy is a priority category in some public dental services — worth asking about directly. The practice's own fees are set out in the Price Guide.

Common questions

When should my baby's first dental visit be, and what actually happens at it?

Much earlier than most people think, and much less happens than most people fear.

On timing, the Australian Dental Association is specific: ‘Dentists recommend taking a child for their first dental visit when their first tooth comes through or by the age of one – whichever comes first.’ Its 2025 survey of 25,000 Australian adults found that expectation is not widely shared — 40% think around two years old is acceptable, 20% believe three, and 10% believe four or older, with only 25% answering age one or younger.

On what happens, the ADA's own framing is reassuring and worth quoting because it removes the main reason people delay: the first visit ‘helps introduce the infant to the sights, sounds and sensations of the dentist, as well as helping to spot any issues early – though it's unusual for much to be done at the first few visits.’ The purpose is to make the next visit ordinary: ‘That way subsequent visits when perhaps an x-ray, scale and clean or filling is needed, won't be so confronting for the child.’

The reason to do it on time rather than when something goes wrong is in the same survey. Of children who had been, 46% of first visits were for a check-up and 33% for pain or a problem — and the ADA's comment on that is the practical argument: ‘It's best not to wait for the child to be experiencing any pain or have an issue because then their first time may be more challenging for them, and the parent, in a new environment.’ First visit to the dentist and When should a child first visit the dentist?

Do I really need to floss baby teeth? They are going to fall out.

Yes, and the reasoning people use to skip it is exactly the one the ADA identifies. Its 2025 survey found 76% of children never floss themselves, nor have their parents do it, and reports the explanation directly: ‘many survey respondents thought it not worthwhile while baby teeth are in place.’

The recommendation is more specific than ‘when they are older’, and it is easy to apply: ‘once a child has two or more baby teeth side-by-side, dentists recommend parents floss daily.’ That is the moment two surfaces start touching, which is the moment a toothbrush stops reaching between them. In practice most families start far later — the ADA found 61% introduced it between ages six and 13.

The reason it matters even in teeth that will be lost: decay between baby molars is painful, it is the commonest reason small children end up having treatment under general anaesthetic, and an early extraction changes the space the permanent tooth has to come into. Is flossing really that important? and Kids' teeth cleaning tips

They will not stand still at the basin, and some nights we manage only once. Does that matter?

It is extremely common — the ADA's 2025 survey found 68% of children brush twice a day and 21% only once, and it attributes the once-a-day group specifically to ‘parents of kids under three, who either thought once was appropriate or because of issues around the child co-operating at the basin.’ So you are not failing at something everyone else manages.

Of the two brushes, the one before bed is the one to defend. Saliva flow falls during sleep, so fluoride left on the teeth overnight is working through the hours when the mouth's own defence is at its weakest. If only one happens, make it that one, and do not give anything but water afterwards.

The ADA's list of main strategies is the target rather than the minimum: ‘brushing for two minutes twice a day; using an age-appropriate fluoride toothpaste; clean between teeth once a day using floss or interdental brushes; and visit a dental professional for regular check-ups and professional cleaning.’ On the amount of toothpaste, the NHMRC's guidance for young children is to ‘use only a small pea-sized amount’ and to ‘encourage children not to swallow toothpaste’ — a smear for the very young. You do the brushing, not the child, until they can do it properly; a child who resists brushing may also have a tooth that genuinely hurts to brush, which is worth mentioning at the next visit. How do I get my child to brush their teeth?

After the first visit, how often — and what does the Child Dental Benefits Schedule actually pay for?

The ADA's advice is a visit ‘at least every 12 months’ after the first, with the interval then set by the child's risk. Actual practice in its 2025 survey ran later: 29% had a check-up in the last 12 months, 58% every 12 to 24 months, and 9% only when there was a problem.

On the CDBS, two things are worth knowing because they explain why the scheme is under-claimed.

You do not apply. Services Australia states it plainly: ‘You don't need to apply or register for CDBS. If your child is eligible we'll send you a letter.’ Eligibility runs where the child is ‘eligible for Medicare’, is ‘0 to 17 years old for at least one day that calendar year’, and you or they ‘get an eligible payment at least once that calendar year’.

It covers more than a check-up. The listed services are ‘check-ups, X-rays, cleaning, fissure sealing, fillings, root canals, extractions’ — fissure sealing in particular, which is one of the best-evidenced preventive measures there is. What it does not cover: ‘orthodontic dental work, cosmetic dental work, any dental services in a hospital.’ Services Australia also warns that ‘There are some restrictions for basic dental services. You should check with your dentist if there are any item or time restrictions before starting your service.’

And the trap: the benefit is up to $1,158 per eligible child across two consecutive calendar years, and ‘If you don't use the full amount within the 2 calendar years, you can't use the remaining funds.’ An unclaimed balance is simply lost. Child Dental Benefit Schedule and how the scheme operates.

How is the decision to take a dental X-ray actually made?

By whether the image would change what is done next — not by a timetable, and not by age. The published guidance on prescribing radiographs in children, which sets out the principle most explicitly, states that ‘A justified radiograph should make a substantial contribution to distinguishing between treatment options’, and that routine screening has been abandoned: ‘Today, X-ray screenings are no longer recommended.’ The American Academy of Pediatric Dentistry's position is quoted in the same literature: ‘the timing of the radiographic examination should not be based upon the patient's age, but upon each child's individual circumstances’, while the European Association of Paediatric Dentistry recommends ‘an individualized and patient-specific justification’ as best practice.

The dose principle has been rewritten to match. The familiar ALARA — as low as reasonably achievable — has been ‘modified to As Low As Diagnostically Acceptable (ALADA)’, and further to ALADAIP, ‘being indication-oriented and patient-specific’: the lowest dose that still answers the specific question in that specific person. In practice that means the machine settings, the beam size and the receptor all matter, and that ‘protective devices such as rectangular collimation, fast image receptor speeds and thyroid shielding are able to reduce radiation exposure’.

The conclusion is the part worth carrying into an appointment, and it cuts both ways: ‘There is a certain health risk associated with every X-ray. It is our duty to keep this risk as low as possible. However, no X-ray should be withheld from the patient that is necessary for appropriate medical or dental care.’ So it is entirely reasonable to ask what a proposed radiograph will change — and equally reasonable to accept one when the answer is a real one. The typical doses are in the section above. How safe are dental X-rays?

Practical details

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This page records a published article and its date, with general information. It is not a diagnosis, a treatment plan, or advice about your pregnancy, and it does not replace advice from your dentist, GP, midwife or obstetrician. No medication should be started or stopped on the basis of this page. CDBS caps and eligibility rules are set by Services Australia and change; the cap is indexed each January, so confirm the current figure with them. Third-party published content is not reproduced.

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