You may listen to the podcast here
Host- Janet Sibanda (JS)
Interviewee Dr Farai Maisva (FM)
JS: Hello. To our subscribers, our readers. We want to welcome you to a special edition of our weekly blog post. Today, we're not going to be doing our usual written work. We're going to be having a podcast. And we are so, so excited to have this one person that all of us have wondered, at the back of our minds, how do we access these services, if at all it's safe to access them.
JS So here we are with Dr. Farai Maisva. He's a dentist and he's going to tell us all the things we need to know, all the things we need to worry about, all the things we need to do, concerning our teeth and pregnancy. So welcome, Dr. Farai.
FM Thank you so much. It's an honour to be here.
JS We are thrilled to have you here, because I'll tell you this, through my two pregnancies, the one thing I always wondered was, is there a relationship between my teeth and these babies? Am I going to end up toothless because of bringing humans into the world? So does that mean I should stop? Please help us. Dr. Farai, answer the biggest question, the biggest elephant in the room, is there a relationship between our teeth and pregnancy?
FM There is a relationship between pregnancy and certain conditions within the oral cavity. OK, and this relationship is predominantly based on the fact that during pregnancy you have excess hormones that you typically don't have when you're not pregnant. And these hormones then make the gums very sensitive to plaque. Plaque is the ordinary debris that builds up on our teeth after we eat and plaque is soft. OK, but the gums become highly sensitive to the presence of plaque that normally would not have been a problem and you have pregnant ladies developing predominantly gum disease or what we typically call periodontitis.
JS OK
FM Ok. This is typically seen more so in the second trimester of pregnancy. OK, we also find that there may be an increase in dental decay and typically this is more related to the cravings that somebody has got. You start eating all sorts of things. Some people are craving chocolate, some are craving sugars, they're drinking tea. And all this additional sugar and things that you don't typically eat can lead to an increase, in acids, that then attack the teeth.
JS Wow. So even those of us who eat soil.
FM I've not heard of soil causing decay, but typically you're probably craving more than just soil, you eat other things that you won't confess in public that you're eating them.
JS Not at all. I had some very weird cravings. But I think also another thing I'd want to ask is my particular issue was I used to I couldn't brush my teeth a lot when I was pregnant because whenever I tried to do that, it would induce vomiting. And then I just said to myself, you know what, I'm not doing this. And my husband had issues with it. And I said, you know what guy, you loved me, bad breath and oh, so deal. Is there a relationship there?
FM I wish you had consulted because then if it was the toothpaste that was irritating you, you could still brush your teeth and try and remove as much plaque as you can without toothpaste, you could use other things, you could use, bicarbonate of soda or salt, even anything just to brush away that plaque...
JS Oh, so it's all in the plaque?
FM It's all in the plaque that your gums that reacting to plaque due to the hormonal onslaught that's going on during pregnancy.
JS OK,
FM the other thing that also happens is that, thank you for bringing up the vomitting issues, that a lot of women then start suffering from morning sickness. So they're vomiting and bringing up stomach acids that typically would not have access to teeth and it’s the acids that help break down the enamel layer of the teeth. Hence we see an increase in tooth decay as well.
JS OK, that's quite interesting and I had a lot of that. So tell me, what then should we do to avoid. Well, essentially, what oral hygiene practices should we get into in order to have good, healthy teeth and gums?
FM Well, typically, your usual that we normally recommend try and brush your teeth after every meal. If you cannot use toothpaste, use bicarb soda that some people will say use salt, use whatever you can that you can tolerate during pregnancy to scrub away at the teeth. Let me not use the word scrub to brush away at the teeth so that you can remove that plaque layer that causes the irritation of the gums whenever you've had an episode of vomiting. It's imperative that you wash your mouth and try and rinse out that extra acid with water, salt water, whatever you can, whatever you can tolerate to reduce that acid, the time that the acid is exposed to your teeth.
JS OK. And the plaque as well.
FM Yeah. And typically you can visit the dentist. Remember, it's only certain procedures that we try and avoid during pregnancy. But preventative procedures have no effect on the developing child.
JS Oh, they have none?
FM No
JS We've always heard the myths about visiting the dentist and how it might have an impact on you, on your pregnancy. And I think one of the biggest issues is, you know, a lot of the times you'll have to take X-rays of the mouth. And as you're pregnant, they say that x rays and things like that are strictly forbidden. So what does that mean?
FM X-rays, X-rays have the potential of interfering with the developing baby's genetic makeup, and we might end up with babies being born with certain x-ray induced deformities.
JS OK
FM So that is primarily critical in the first trimester of pregnancy when the fetus is rapidly growing and organs and systems and limbs are developing. But as we move into the second trimester, it's not recommended, but not as critical. And then what we also tend to find is a lot of the dental X-rays are very focused.
JS OK
FM You have a cone that is going to come and specifically take an X-ray on the tooth itself. And at that time, it is highly recommended that you have a lead apron covering your stomach so that any scatter of dental X-rays, the baby does not get exposed to that scatter. But again, I would still say if you can avoid the dental X-ray, there's no need to have it during pregnancy.
JS OK, so is there something that we should change in our diet as well in order to in order to have strengthened teeth? Because I also understand that they say when the baby needs whatever it needs, calcium or whatever it draws from the mom. So what does it mean in relation to our diet? Are there specific things we should focus on in order to have strengthened gums and teeth as well?
FM Remember, a lot of our dietary calcium we can actually get from vegetables
JS OK?
FM Right! People will tell you drink milk, they take cheese, take calcium supplements. I have no problems with people taking calcium supplements. But I think that a lot of us forget that the milk, that the cow that makes the milk is eating grass and getting its calcium from the grass.
So why don't we just go straight to source and then a diet high in vegetables, no a diet high in vegetables. also will lead to additional cleaning of plaque over your teeth because of the fibrous nature of the diet. You get it ?
JS Oh yeah
FM Yes. Watch your diet. Try and eat as many vegetables as you can. Brush your teeth as regularly as you can to remove plaque and so forth. And all the normal preventative measures, avoid sugars, avoid sodas, Chocolate. Soil is quite OK as far as I know.
JS Thank you. Another thing that just popped into my mind, you know how pregnant women typically, zvinonzi akupfira pfira, we salivate a lot. Is that also, does that also have the same impact, although our saliva is more alkaline than our stomach acids, but does that also have an impact on our teeth?
FM A good impact. Saliva, keep in mind that saliva has got salivary salts that actually fight off that cavity, causing bacteria within your mouth. So saliva is a protective mechanism to the teeth
JS And yet we spit it out!
FM Well, it depends on how much is being produced and I never be pregnant myself. No, I can't.
God forbid that.
FM Exactly. The other thing that I wanted to just highlight, is the question I was hoping you would ask me, do these dental conditions affect the baby? Yes, there is a link between severe periodontal disease, which is diseases of the supporting structures of the teeth; your gums, the bone that the tooth sits in, the periodontal ligament that holds the tooth and attaches it to the bone. diseases affecting that when it becomes severe during pregnancy can, has been associated with, um, preterm babies and babies being born with low birth weight.
JS Okay. Okay.
FM Okay. So it is very critical that a pregnant mother makes sure that she does not have periodontal diseases. Cause we never know when it's going to affect the baby.
JS Okay. So, so I'm just using my deductive reasoning here. Does it then mean that when she's suffering all of these things, it probably also affects the way she eats and probably then we'll have subsequent impact on the growing foetus.
FM Yes. And also, also, also keeping in mind that whatever is happening in the mouth, there might be a breach and you will get some bacteria circulating within our blood. We actually don't know the link as to how much what it is exactly. But there has been found a link between. Uh, preterm babies and low birth weight babies in mothers with severe periodontal, uh, with, with, with a higher incidence of periodontal disease in their mouth.
JS That is really good information to have, you know, thank you so much for that. So I wanted to finally, well, not really, as we're drawing to the end of our interview, is there a specific doctor, a specific dentist you can visit or any dentist is okay, when you're pregnant?
FM No, you're your, your, your, your, your normal, the family dentist is fine, but when you start getting, uh, um, more aggressive periodontal disease, then you should move and see a specialist, um, who deals in oral health issues. And that's a. That specialist is called a Periodontist. Okay. Remember it's periodontal disease. So there's a Periodontist and fortunately we have one in Zimbabwe, in Harare, there is one in Harare. Um, yeah. And should you need his name; I would be more than happy to share with the people who need it. His name is Dr. Ronald Kumbawa.
JS Okay. Oh, yes, I know him. Um, so what, what I'm going to do after this, and I'm going to transcribe our conversation and put details at the very bottom so that people are able to, to reach out and access. Um, then I think in conclusion,
FM : wait, you had asked one other question. What else you should do? And we had talked about eating vegetables to increase your vitamin C also. So vitamin D
JS Oh, yes. That's sitting in the sun, right?
FM Sitting in the sun, just sitting in the sun, your vitamin D that will also just help. Um, it's, it's actually amazing the benefits that making sure we have adequate vitamin supply does for our health.
JS Definitely. Definitely. And I've seen a lot of within this time that we are, we really need to be strengthened and primed up when our immunity and all of that. Um, then I wanted to ask, are there any particular questions or information we need to give our dentists when we visit them?
FM Yes. When you, when you visit your dentist, it is imperative that you tell your dentist, if you're expecting that you're pregnant and how many weeks, or how many months down the line you are. Remember I said to you in the first trimester x-rays are a no, no.
JS Okay.
FM Okay.
JS Yeah
FM Right. Um, in the second trimester, a lot of procedures.Uh, can be done. Okay. In the third trimester again, even just maybe local anesthetic and, and stress and trauma might trigger off induced early labour.
JS Um, okay.
FM So it is very important when it's not visible to let your dentist know that you're expecting. And then for, just for you to also just have that information in case they want to take an x-ray. Query it. Is this really necessary at this stage of development of my baby? And are you going to cover me with the lead apron? Is it, um, um, a panoramic x-ray or an Intraoral x-ray?
• The panoramic x-ray, you have a lot more scatter
• The Intraoral x-ray is the one that is focused. It has a cone that actually comes in and, you know, the x-rays are within a cone and specific to a particular area.
JS It’s very localized?
FM As opposed to a general, um, Panoramic.
JS That is a lot of good information to have. And I think that the issue that we all struggle with is what are, what are our rights? What should we ask and what should or should not be done on us? Because there's not a lot of conversation that happens between, um, service provider and client, most of the times. So being informed is key.
FM Well information is one of those rights that you really need. And then always keep in mind, the dentist should not do anything in your mouth or on your body that you have not given consent. You have to give consent,
JS Exactly, So you should know to give consent.
FM And, uh, but having said that, uh, I had patients come to me and say they have a dental absess, and they're eight months pregnant. Then they say to me, can they wait until the baby is born? And I, and I find that weird because. The dental abscess is an infection. And why do you want to keep an infection? Sitting with toxins circulating in your body, that could damage the baby. You know, there's certain procedures that have to be taken care of. It's just the additional care that the dentist must exercise to make sure that he doesn't, it doesn't bring you into early labor or do something to damage the baby.
JS Yeah. So it goes back to that issue of being informed and knowing what your rights are. And I think all of this that we've been discussing, understanding the risks and understanding what it is we need to do to prevent some of these conditions from happening. This has been so, so amazing. I do have any last words. I am. I'm floored.
FM Last words, , for expectant mothers out there is PREVENTION PREVENTION, PREVENTION! If plaque is going to be a problem. If you are brushing your teeth 3 times a day, increase it to four or five, six times a day. Every time you eat, try and make sure you brush your teeth and there's no build-up of plaque on your teeth.
It's the hormones and the plaque um, additional plaque, normal plaque on your gums that triggers off a cascade of events that make,or can make your pregnancy quite traumatic. Uh, I'll tell you a little anecdote. I had a patient who came in to get braces and, um, she got a braces and a couple of months later, she fell pregnant.
JS Okay.
FM And braces by nature, trap food when you eat and no matter how hard she brushed, she developed a pregnancy epulis, which is just a boil on a gum that just, and sadly for her, it was at the front. So it was constantly visible. And so she would come in and would clean. Eventually we had to cut it off and it grew back on, but she didn't want to get her braces taken off.
JS Oh my gosh, she was strong.
FM You should see her now! She has a beautiful smile and a healthy baby
JS Oh, we thank God for that
FM Exactly, we thank God for that
JS Definitely. Definitely. Thank you so much, Dr Maisva.
FM You’re most welcome.
JS This was an amazing interview. I am so informed. I was thinking maybe, you know, not to have another because my teeth are going crazy. But now that I know that salt can do the brushing, I might try it,
FM You know? No, you should contemplate it. I know a certain Gogo, who'd be very happy to hear command that God gave to mankind. Multiply and fill the earth.
JS Definitely. So, we will have you back talking about Postnatal Oral Hygiene
FM Anytime, anytime.
JS Yes. So we're so thankful and to our listeners, we'll be sharing. Um, we'll be writing a whole transcript of this interview and then sharing the details within the blog.
Thank you so much, Doctor Farai, take care. Bye
FM You too, Bye
You may listen to the podcast here
Dr Farai Maisva- Specialist Orthodontist- Maisva Orthodontics
173 Fife Ave/8th
Harare
+263 (0242) 708686/7/9
+263 772220647
Dr. Kumbawa, Ron
Periodontist, Implantologist and Oral Medicine Specialist
8 Mold Crescent, Kensington, Harare, Zimbabwe
+263712797248, +263772754224
Thank you Doctor Maisva for the eye opening contribution. However I realize some things will never be learnt in dental school... The mystery of me puking every time I looked into ANY bathroom sink when I was pregnant 🤔... Praise God I lived to smile again😁