Dr. Roja Ramani

See your dentist every six months. Your teeth may not look dirty from the outside, but bacteria and plaque lurks in places you cannot see in the mirror.

Some women have dental problems such as gum disease and tooth decay, during pregnancy. The increase of hormones during pregnancy can affect the response of the body to plaque, which is the layer of germs on the teeth.

It is not true that the teeth are automatically damaged due to pregnancy. In case the calcium intake of the mother during pregnancy is not enough, the bones provide the growing baby with the calcium that it needs. When the breastfeeding is stopped, the calcium is replenished quickly. Nonetheless, the high demands of pregnancy can prompt specific dental issues in a few females. With professional help and appropriate cleanliness at home from your dental specialist, your teeth ought to stay healthy during pregnancy.

It is possible that a dental disease might affect a developing baby. Premature births have a risk of developing health problems such as cerebral palsy and issues with hearing and eyesight. Research has shown that around 20% of all premature births might be caused due to periodontal disease. It is an infection of the gums which is chronic in nature. The risk of premature birth can be reduced by providing the expectant mother with the required dental treatment.

Some of the common causes of dental problems which occur during pregnancy include:

1. Gum Problems: Women become vulnerable to gum problems due to hormones which are associated with pregnancy. These include gingivitis, pyogenic granuloma or pregnancy epulis and untreated or undiagnosed periodontal disease.

2. Vomiting: The ring of muscles which are used for keeping the food inside the stomach are softened due to vomiting. Vomiting or gastric reflux, which is associated with morning sickness, causes the teeth to be coated with strong acids.

3. Retching: Provocation of retching is caused in pregnant women while they brush their teeth, especially the molars. Not brushing the teeth regularly can cause tooth decay.

Things to remember:

• The demands of pregnancy can lead to particular dental problems in some women.
• You are less likely to have dental problems during pregnancy if you already have good oral hygiene habits.
• With proper dental hygiene at home and professional help from your dentist, your teeth should stay healthy during pregnancy.

Teeth are one of the most precious parts of the human body.  By playing a significant functional and structural role in aesthetics, facial appearance, and food habits, digestion and chewing, all efforts at maintaining them should be undertaken. As we all know, we have two sets of teeth, primary or deciduous and the permanent set. Let us discuss tooth removal in these two sets separately.

Primary Teeth
In the primary teeth, the main indication would be dental decay.  If the tooth is severely damaged beyond repair with fillings, then removal could be an option, with two things considered. The primary successor will erupt within the next 6 months; if not, a space maintainer would be put in place.

Another reason would be if the tooth is beyond its lifecycle and is blocking the eruption of the successor, then it requires removal.

The permanent teeth, however, are a set that are meant to last for a lifetime and removal should be considered only as a last resort. With advances in dental treatment methods, gone are the days when removal would be an option for severe decay. 

Some of the absolute indications for removal would be:

1. Wisdom teeth: if it is erupting in abnormal position (flattened or crooked), then removing them to avoid infection and impingement on other teeth needs to be considered. Wisdom teeth infection is one of the most common causes requiring tooth removal. 
2. Recurrent infections: If a tooth has been root canal treated, but continues to have ongoing chronic infection, it could be a case for removal.
3. Malformed or supernumerary teeth: These may also block eruption of other teeth into the mouth. 
4. Orthodontic treatment: In cases where the jaw size is really not sufficient to realign the mal-positioned or crooked teeth, the first premolar is often sacrificed, and this space is used to align the other teeth. 
5. Injuries: In case of accidents or injuries with jaw fractures, teeth in the line of fracture may need to be removed. 
6. Preparation for dentures: In cases of severe periodontal disease, where the mobility of the teeth is high and complete dentures are being considered as an option, teeth removal may be planned.  Also, if there are teeth which are in the line of fixed partial dentures, again removal might be planned
7. Radiation therapy: For head and neck cancer patients, if there are teeth in the line of radiation, then removal might be planned.

Unlike in the earlier years, the absolute indications for removing tooth have changed.  A thorough examination, both oral and radiological, should be done before zeroing on extraction.