“BY CARING FOR THEIR GUMS AND THEIR DENTAL HEALTH, PREGNANT WOMEN ARE PROTECTING THEIR BABY’S HEALTH” 

Ever since childhood, Ainhoa Liaño has witnessed all aspects of motherhood first-hand, since she is a third-generation midwife. Now, after 14 years of professional involvement in midwifery, she combines her work in both the public and private health sectors in the area of dilation and delivery. In addition, she regularly works in maternal education and preparation for childbirth. 

Why is the figure of the midwife important during pregnancy? 

The midwife is the health professional of reference for pregnant women, and is directly responsible for them to prepare for pregnancy, delivery and postpartum as best as possible. 

What does the monitoring by midwives consist of during the nine months of pregnancy? 

The monitoring of pregnant women is determined by the physiological situation they are experiencing. During pregnancy, primary care guidelines are followed for the comprehensive health care of women, focussing on fostering prevention and on health education. 

There are screening criteria to identify women in early pregnancy with specific health risks and who need special care. Additionally, there is early enrolment in primary care of pregnant women for health examinations and maternal education carried out jointly with obstetricians, who make assessments, monitoring and ultrasound check-ups through to childbirth. 

What is your function during labour? 

Childbirth is the highlight of an important stage in life. The midwife is the professional that assists the pregnant woman during this process, helping make it a positive experience. During normal obstetric care, we carry out maternal-foetal monitoring and control the dilation process, and, if delivery transpires without any complication, we attend childbirth, we carry out the first neonatal care and go on to examine the newborn - always as a member of a multidisciplinary team. 

How can pregnancy affect the mother’s oral health? 

The first noticeable changes in pregnancy, caused by hormonal influence, are morning sickness and vomiting which may cause tooth erosion and favour conditions for the overgrowth of certain bacteria in the oral environment. This hormonal surge, in particular of progesterone and oestrogen, causes an increase in the general peripheral irrigation of the mucosa and a dilation of the capillaries in the gums, making it easier for the gums to bleed. 

What oral healthcare advice do you offer the pregnant women you treat? 

First, I recommend a visit to the dentist to assess the state of their teeth and gums, and then offer advice focussing on good oral hygiene and maintaining healthy gums. I recommend carrying a kit with a soft filament brush to prevent bleeding, a paste for teeth and gums, and a specific mouthwash, especially in case of morning sickness and vomiting, to prevent dental erosion and halitosis, while keeping their mouths feeling fresh. This way, even if you are away from home, good hygiene is guaranteed with proper brushing after meals or at least twice a day for two minutes. It is important to tell pregnant women to change their brushes after two or three months and to complete their hygiene with dental floss and interdental brushes. 

How can oral health problems be prevented during pregnancy? 

Our recommendations as midwives are always aimed at prevention. In addition to the previously mentioned oral care actions, smoking and drinking are also discouraged, not only because of their effects on oral health, but also because they cause direct harm on the foetus. You must keep cravings for sweets and other food in check—cravings are a myth in any case—and get regular check-ups at the dentist and, if there are any alterations to the gums, teeth or mucosa, these should not be ignored and you should visit a specialist. 

What relationship is there between oral health and general health during pregnancy? 

Oral healthcare should be part of a pregnant woman’s daily habits, along with application of stretch mark creams and sunscreens, and watching their weight and diet. Pregnant women know that they must go to a gynaecologist and a midwife for regular check-ups on their pregnancy, with analyses, monitoring and ultrasound. They should also be aware that going to the dentist is part and parcel of comprehensive care in pregnancy, not only for their own health but also for their baby’s. 

How are oral health problems treated during pregnancy and what dental treatment is there? 

The role of the dentist and the dental hygienist is fundamental. It is important that women realise that nothing will be done in the dental office that could harm their health or their baby's, and that they should not be afraid. It is normal to fear pain and any kind of medication or anaesthesia that may affect the foetus. 

The best time to get a check-up is before conception. However, any dental treatment can be safely performed during the second trimester of pregnancy, when the foetus is already formed. If considered necessary, x-rays at this stage of pregnancy are not a problem and are not a risk for their baby. No health professional will do anything to harm them or their child. 

What recommendations can pregnant women receive at the pharmacy? 

Pregnancy is a time at which women are very receptive, but at the same time very sensitive, so it is important to inform, guide, clear up any doubts and advise specifically, clearly, simply and, above all, without causing alarm and transmitting calm. It is important to make them aware and that they understand that by taking care of their gums and their oral health, they are protecting the health of their baby.