Dentist advice for HG
Veteran hyperemesis women know only too well what a nightmare trying to brush your teeth while trying not to spew up is! The brushing action, the foam, the whole process is utterly vomiting inducing and is not only a dreaded event but avoiding it is a source of massive guilt! There can be no denying that hyperemesis gravidarum can take a massive toll on your oral health... from the acid vomit damaging the enamel multiple times a day, to the poor diet and the days, weeks or months of avoiding brushing. It's an issue I get asked all the time about and we cover it in the book Hyperemesis Gravidarum - The Definitive Guide also.
At the Pregnancy Sickness Support annual conference in October I was delighted to meet a highly experienced dental surgeon who is also a hyperemesis survivor! She's joining our team of volunteers, but in the meantime has written up some evidenced based information for those women out there suffering now and feeling utterly guilty and miserable about the seemingly impossible task of protecting your teeth... in addition to your health, your baby, your sanity, your family and all the other things hyperemesis takes a chunk out of!
Over to Dentist Gina Harrap:
We all know we should be brushing our teeth twice a day and limiting sugar snacks to keep our mouths healthy; but what do you do when you can't due to nausea and vomiting in pregnancy?
As a NHS dentist and veteran of a hyperemesis pregnancy this is a problem I've dealt with both professionally and personally.
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.
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.
About the author
Gina qualified as a dentist from the University of Leeds in 2004. She subsequently undertook further training posts in Acute Dental Care at Leeds Dental Institute, and Oral and Maxillofacial Surgery at Pinderfields Hospital, Wakefield. She was awarded membership of the Faculty of Dental Surgery of the Royal College of Surgeons, England in 2008. She currently works in a large family mixed NHS and private practice in West Yorkshire. She is a registered volunteer with Pregnancy Sickness Support. She has one daughter and in her spare time is a member of a vintage style synchronized swimming group, The Bramley Mermaids.