Should you have your teeth whitened during pregnancy?
How pregnancy affects your dental health
The law on teeth whitening
As far as the law in the UK stands, since 2012 teeth whitening as a procedure can only be performed by a registered dentist, or a dental hygienist or dental therapist on prescription.
No one else is lawfully allowed to undertake this work.
Teeth whitening and pregnancy
Teeth whitening itself is a safe and dependable procedure with manageable results, however, in the case of when the patient is pregnant the jury is still somewhat on the fence as to whether it is a good idea or not.
Though small, the risks are there and it is important you are fully informed before making this decision.
What are the risks?
All cosmetic dental procedures have an element of risk, these risks span from just not working and you losing your money to actual threats to both your dental and sometimes, overall health.
In the case of teeth whitening we can be fairly specific about the main risks because of the chemicals and processes involved.
Risk 1. Bleaching agents
This first risk does apply to everyone but it is of particular importance to those who are pregnant.
Professional teeth whitening uses hydrogen peroxide as a covering on the teeth, which is then stimulated by laser-based light to ‘bleach the teeth’ permanently. This procedure will be repeated as many times as is required dependent on the level of staining.
Bleaching agents have the capacity to trigger tooth sensitivity due to the bleach penetrating the enamel. This then gets into the gums and stimulates irritation.
During pregnancy, you are especially vulnerable to this due to heightened sensitivity and the likelihood of infection due to physical and hormonal changes. We delve further into this in the following sections.
Risk 2. Teeth whitening chemicals and morning sickness.
Morning sickness is an unpleasant and common condition during pregnancy and there is a chance it can contribute to the erosion of tooth enamel.
So when we mix enamel erosion due to morning sickness with tooth sensitivity from a bleaching agent, this increases sensitivity and exacerbates any tooth or gum problems.
Another potential result of teeth whitening during pregnancy is tissue damage.
The increased hormone fluctuations are pivotal to foetal development and health but they also often have the downside of causing gum tenderness, and this in turn creates a suitable breeding ground for gum disease and inflammation, applying bleaching agents into this environment can cause significant discomfort and can cause gum damage.
Risk 3. Pregnancy may loosen Teeth
The teeth may also become looser during pregnancy due to increased levels of oestrogen, which stimulates an increase in blood volume and flow and is the key element in placenta development.
Another hormone that can impact gum sensitivity and strength is the hormone progesterone, which aids to prevent the uterine muscles from premature contraction during pregnancy.
The fluctuations of both of these hormones are significant in keeping the gums and teeth rigid and stable. It’s a myth that these conditions will inevitably lead to the loss of teeth during pregnancy, but you do need to make sure that care is taken of your teeth, through regular dental care and visits to your dentist.
Risk 4. Pyogenic Granuloma
These are round growths which can emerge on the gums as a result of the body’s hormonal adjustments. They are non-cancerous tumours on either the skin or the mucous membrane and often appear during pregnancy.
The lesions themselves contain abnormal blood vessels that can break and bleed easily and cause issues to damage to both teeth and gums. The increased potential for these to occur does add an additional risk to having your teeth whitened.
Should you notice anything that displays these characteristics, there is no need to panic, but a prompt visit to your GP or your dentist would be advised.
Of all the possible risks, the most concerning ones during pregnancy are, of course, the potential dangers to the baby.
Is it worth it?
The biggest concern regarding teeth-whitening during pregnancy is the potential harm to the unborn baby. Testing of any suitable level has not been done on the effects of ingested hydrogen peroxide on an unborn child, and on this basis, the medical viewpoint is that during pregnancy tooth whitening is just simply not worth the risk.
What about at-home whitening kits?
At-home whitening is becoming ever more popular, and ‘do it yourself’ whitening systems are now being made to a much more professional quality these days than would have been possible previously.
That said, all whitening kits will contain hydrogen peroxide in varying amounts and some of the at-home solutions actually have higher levels than those in the dentist’s chair.
Despite any claims made by manufacturers about these products and how safe they are, any cosmetic change to teeth should always be done with professional supervision.
These products seem innocuous and we all want to believe what is said on the box, but one mistake with gels or pastes can be extremely damaging to either yourself, your baby, or both.
The European regulations governing the UK state that tooth whitening products containing between 0.1% and 6% hydrogen peroxide can specifically and only be used by a registered dental practitioner.
Any product containing more than 6% is completely banned throughout the UK.
When it comes to a do it yourself ‘at home’ kit only kits containing 0.1% or less are legally allowed to be sold.
This sets a distinct red flag against purchasing these products abroad or from an online source as they may well contain significantly higher levels and less strict guidelines in their production.
The research is currently inconclusive as to whether small amounts of hydrogen peroxide can harm an unborn child, but higher levels combined with badly fitting mouth trays have been shown to cause:
Thinner enamel on teeth
A greater chance of gum recession
Burning of the soft gum tissues
What about Whitening Toothpaste?
Many toothpastes of course claim to whiten teeth and some of these don’t contain hydrogen peroxide but there is always a trade-off and your dentist should always be consulted when switching to something with extra chemicals, this is especially the case when pregnant.
The good news is that while deferring any teeth whitening until after the baby is born, there are plenty of things you can do to keep the teeth healthy, bright and white while retaining excellent oral and gum health.
Regular dental check-ups and cleaning is always important especially as you age, and even more critically when you are expecting.
The previously mentioned hormonal changes will affect your body’s chemical composition and this will in turn affect your gum's resilience to bacteria.
Tooth and gum cleaning when performed by a registered and qualified dentist will also have the added benefit of removing some of the mild stains that we develop every day, and a well-structured oral hygiene routine will help them stay that way.
This said, any cleaning routine no matter how good will struggle when faced with a diet full of sugars and harmful bacterial elements, many of which go straight into the gums and will begin to bed down immediately, so please be sure to limit your intake of gum-damaging foods.
Do Hydrogen Peroxide Free D.I.Y whitening methods actually work?
Unfortunately, there is no clear answer to this question. Products such as baking soda, known to have many cleaning uses, have long been touted as a successful teeth whitener, and though there may be some chemical reasoning behind this claim, there is also a definitive downside, while baking soda is widely used as a cleaning product this does not mean it is harmless to the body or the sensitive areas of the gum and teeth.
Baking soda-based products may well whiten but also have a very good chance of weakening your tooth enamel, and this over time can lead to tooth erosion.
Other tooth-whitening solutions
Other suggested remedies include more natural approaches such as using coconut oil, charcoal and even vinegar, there is in truth, little evidence to support any of these methods and often they can have unpleasant side effects on other body mechanisms such as your gut bacterial levels and dysbiosis.
Fruit, as well as being one of the cornerstones of a healthy diet, has also been found to have a mild tooth-whitening effect, especially acidic fruits like lemon and strawberries, but once again too much of these types of acids will start to damage teeth and gums so be careful not to consume too much.
Less is more
From the evidence available today, the smarter approach would be one of cutting out certain things, rather than adding others.
Coffee, tea, and darker fruit juices such as cherry juice and other ‘black’ juices all stain the teeth badly and simple avoidance is often the best preventative measure.
Smoking of course is another major cause of not just overall health, but also poor oral health and staining. Many ante-natal services are available for help quit smoking during pregnancy.
Other potential issues regarding teeth and gums during pregnancy
As well as the dangers of cosmetic tooth procedures, there are other potential pregnancy-related tooth and gum considerations.
Among the problems that may occur are excess bleeding, vulnerability to cavities, erosion of enamel, gingivitis, and gum tumours.
These are all possibilities due to the way in which pregnancy affects the body, and will often clear once the baby is born.
Speak to your dentist for further information on this.
After the baby is born
If you’re breastfeeding, the official advice remains to avoid teeth-whitening using hydrogen peroxide. Again there just isn’t sufficient data about any potential harm that could be caused, and while it’s unlikely that it could be a problem, the official advice is “better safe than sorry” considering the non-vital nature of the procedure.
Best oral health practices while pregnant
The best oral health measures during pregnancy are generally the same practices that everyone should follow, with a few key pregnancy-specific additions.
Among the key ones are:
Brush twice a day for at least 2 minutes on each side
Floss thoroughly with dental floss and/or interdental and interspace brushes to get into all gaps between the teeth
Eat a balanced, non-staining diet
Ensure all dental appointments are attended
Limit foods and drinks that are high in acidic content
Limit sugars and sugar-based ingredients such as sucrose and dextrose
Consider rinsing with salted warm water for overall oral health protection
A good idea during pregnancy is to rinse with baking soda and warm water as this will neutralise stomach acid and has been shown to decrease morning sickness.
Always try to keep to a specific oral routine and where possible do this at the same times each day, this prevents bacteria from bedding in, the likelihood of which increases as we age and during pregnancy.
Visiting the dentist during pregnancy
It is essential to keep up with all dental appointments and this is even more important when expecting a baby.
Dental issues can cause serious complications such as preterm birth, so vigilance is key at this time.
Timing is also an important factor for any treatments or surgeries that must be performed and we would suggest having work completed by the end of the second trimester due to your own ability to reach certain positions such as lying down.
Once the third trimester begins it is advised to postpone all non-essential procedures until after the baby is born.
Dental medications and their effect on pregnancy
Lidocaine is a common medication used by dentists and this can enter the placenta, though it is currently unknown what effect this may have on the baby.
Anaesthesia is another common dental requirement and during pregnancy, the strength of the anaesthetic used may be important so we would advise as small a dose as possible for any procedures.
Antibiotic medications such as penicillin, amoxicillin and clindamycin are also commonly used and will be safe as long as strict medication guidelines are followed.
Other things to think about while pregnant
If you are reading this article there is a high possibility that you are expecting, or trying for a baby.
With this in mind, there are a few other key dentistry guidelines that help to keep both mum and baby healthy.
X-rays while pregnant
These days, part of your dental examination will often be an X-ray, when pregnant it may be sensible to defer any X-rays until after the baby is born.
That said, the radiation impact of a single x-ray is extremely small and should one be required for any serious implications then it should certainly be done.
If planning to have a baby
If you are not yet pregnant, it's best to visit your dentist before you are. This will confirm your state of oral health before any pregnancy discomfort begins.
Also, if there are any issues, it's wise to have them addressed beforehand so that your primary focus can be the baby’s health.
Once you are pregnant
Make sure to inform your dentist so that they can give you a good outline of what to expect and how to approach any dental work coming up.
When doing this please be sure to let them know of any medications you are currently taking, including any prenatal vitamins, and also to report any doctor's guidelines or advice, as this may affect the dental approach.
A final word on foods
It's easy to overlook but what we consume has a huge impact on dental health.
We know with today’s busy lives and so much temptation it's hard not to treat ourselves, but it's not enough to look after your teeth ‘sometimes’ and this is especially true when pregnant due to the increased vulnerabilities already mentioned.
Sweets and sugary snacks should be consumed extremely sparingly and this may be hard when specific pregnancy cravings kick in.
It is important to be resolute and to focus on healthy and balanced food groups for your own health and that of the baby too.
At about 3 months your baby’s own teeth and gums will begin to form and it's important to have adequate calcium and vitamin D in your diet to aid this process.
Yoghurt, cheese and milk are all great sources of dietary calcium but all of these foods can also be very high in harmful fats, so it's important to do a little research and to be well-informed and watchful of your dairy choices.
Here at Life Dental and Wellbeing we strive to be a leading source of advice and guidance as well as excelling in the field of dentistry.
Should you have any enquiries about any of the above, or indeed any dental health queries, our expert team will have the answer or point you in the right direction, so please call us on 01392 278843, or email us and we’ll get back to you with an answer as soon as we can.
Wishing you a good day and happy oral health.