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‘I couldn’t believe it when I found out that there was a charity that deals with HG. I actually broke down, at last what I had seemed valid.’ - a hyperemesis gravidarum sufferer

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Oral Hygiene and Pregnancy Sickness

Pregnancy sickness can pose a problem for maintaining oral hygiene as many women, particularly those suffering hyperemesis gravidarum find that brushing their teeth and the foaming toothpaste can trigger retching and vomiting. On top of that, the acid in vomit can cause enamel errosion and sores in your mouth. So, what can you do?

When you can, brush your teeth twice a day with a fluoride toothpaste and floss once a day. Don't rinse after brushing, just spit excess toothpaste out.
Information about Oral Hygiene during hyperemesis gravidarum

Don't brush immediately after vomiting because the acid from your stomach softens the enamel on your
teeth. If you then brush you wear this vital layer away. Instead rinse your mouth out with water or a fluoride mouth rinse. Supermarket own brands are great for this as they're generally milder in flavour and cheap so you can have a bottle at home, work, in the car and anywhere else you might need. Wait at least 20 minutes between vomiting and tooth brushing for your tooth enamel to re-harden.

As far as toothbrushes go use a medium hardness brush with a head roughly the size of a pound coin. Experiment if a normal or electric toothbrush is going to be easier for you to tolerate. A battery powered disposable brush may give less vibration than a rechargeable electric one making it easier for you to brush.

When you do manage to brush start by cleaning your back teeth first. This delays toothpaste coming into contact with the taste buds and potentially triggering vomiting.

Choose a sensitive toothpaste as they tend to have less flavour and no foaming agents (SLS) but still contain vital fluoride. Dentists frequently get sent free samples so do ask your dentist for some so you can see what is going to be easiest for you to tolerate.

If you are very prone to decay ask your dentist if the prescription toothpaste Duraphat 5000 and/or prescription mouth rinse might be appropriate for you. NHS dental prescriptions are also free during pregnancy and for 12 months after the birth of your baby.

If you can't tolerate any toothpaste try brushing without any, this will still remove plaque effectively. If you can't manage that you could use a flannel to gently rub your teeth to remove plaque. You could follow either of these by rubbing a thin smear of toothpaste over your teeth with your finger.

Frequent sugary or carbohydrate based snacks can lead to tooth decay but tend to be necessary whilst suffering from HG. If you can, chew sugar free gum containing xylitol after each snack. Xylitol has been shown to stop plaque forming on your teeth. Also if you're struggling to brush it can be helpful to use instead. If you're having frequent sugary or fizzy drinks use a straw so the acid and sugar bypasses your teeth.

Research has shown that there's possibly a link between gum disease (periodontal disease) and premature birth. If you have periodontal disease and are struggling to keep your usual oral hygiene routine talk to your dentist for a personalised management plan.

Make sure you take advantage of the free NHS treatment all women are entitled to whilst pregnant and for 12 months following the birth of their child to get your oral health back on track.

References

Attin T, Knofel S, Buchalla W, Tutuncu R. (2001) In situ evaluation of different remineralization periods to decrease brushing abrasion of demineralised enamel. Caries Res. 35:216-222


Chestnutt IG, Schafer F, Jacobson AP, Stephen KW. (1998) The influence of tooth brushing frequency and post-brushing rinsing on caries in a caries clinical trial. Community Dent Oral Epidemiol. 26(6):406-411


Crowther CA, Thomas N, Middleton P, Chua MC, Esposito M. (2005) Treating periodontal disease for preventing preterm birth in pregnant women (Protocol) Chochrane Database of Systematic Reviews, Issue 2


Johansson AK, Lingstrom P, Imfeld T et al. (2004) Influence of drinking method on tooth-surface pH in relation to dental erosion. Eur J Oral Sci 112: 484-489


Keukenmeester RS, Slot, DE, Rosena NAM, Van Loveren C, Van der Weijden GA. (2014) Effects of sugar-free chewing gum sweetened with xylitol or mantitol on the development of gingivitis and plaque: a randomized clinicaltrail. International journal of Dental Hygiene 12:238-244


Paice EM, Vowles RW, West NX et al. (2011) The erosive effects of saliva following chewing gum on enamel and dentine: an ex vivo study. Br Dent J 210(3):E3


Royal College of Surgeons, England. (2013) Clinical guideline on Dental Erosion – Diagnosis, Prevention and management of dental erosion. www.rcseng.ac.uk/fds/publications-clinical-

guidelines/clinical_guidelines/documents/diagnosis-prevention-and-management-of-dental-erosion
Steinberg BJ, Hilton I, Iada H, Samelson R. (2013) Oral health and dental care during pregnancy. Dent Clin N Am 57:195-210

 

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