Treating pregnant patients: What every dental hygienist should know | Ask the Expert

Pregnant patients are often told to delay dental care—but current evidence tells a different story. In this Ask the Expert episode, Katrina Sanders, RDH, shares practical, evidence-based guidance to help dental hygienists confidently and safely care for pregnant patients. From periodontal considerations and positioning to anesthesia, erosion, and breastfeeding concerns, this episode breaks down what hygienists need to know to support both maternal and fetal health.

Transcript

Katrina Sanders:

Welcome back to Ask the Expert. I’m your host, Katrina Sanders. As I recorded this episode at eight months pregnant, I’m diving into a topic currently close to my heart: how to treat pregnant patients safely, confidently, and collaboratively.

Here’s a surprising statistic: 77% of OB-GYNs report that their pregnant patients are declined routine dental care.That sends a troubling message to our patients—and to our medical colleagues—that oral health is somehow optional or should be delayed during pregnancy.

So let’s rewrite that narrative.

Since I’m eight months pregnant, I’m going to drop for you eight important tips for treating pregnant patients.

Tip #1: Routine dental care is safe and necessary in all trimesters

Preventive, diagnostic, and restorative care are safe throughout pregnancy. The outdated “second trimester only” rule no longer applies. In fact, untreated oral inflammation or infection poses a far greater risk to both maternal and fetal health than appropriate dental treatment ever could.

Tip #2: Be proactive about periodontal health

Hormonal changes will heighten the vascularity of the gingiva as well as immune reactivity, which will be seen oftentimes in bleeding and inflammation.

Many pregnant patients are now advised to take one—or sometimes two—daily aspirin to reduce preeclampsia risk. So if you’re seeing more bleeding than expected, that may simply reflect the addition of that mild blood thinner, and not necessarily poor oral hygiene.

We know that frequent maintenance visits will help keep that inflammation controlled, and both reassure the patient and the provider that the patient is receiving optimal care.

Tip #3: Manage morning sickness and erosion carefully

I don’t know why they call it morning sickness, when many of us experience it all throughout the day.

Encourage patients to rinse with a baking soda solution after purging to neutralize acids and protect the enamel before brushing.

Tip #4: Support nutrition and hydration

Encourage open discussion about prenatal vitamins and mineral supplementation—particularly calcium, vitamin D, and folate—which are essential for fetal development and maternal bone stability.

Because pregnant women filter blood faster, hydration is critical. Electrolyte powders or sodium hydration aids can help maintain fluid and sodium balance safely.

Tip #5: Watch for oral manifestations unique to pregnancy

Look for things like pregnancy gingivitis or the presence of a pyogenic granuloma—both common and typically self-limiting, but worth monitoring.

If lesions are traumatized or interfere with function, gentle debridement or smoothing may be indicated.

Tip #6: Address systemic implications and partner transmission

Get this: elevated Porphyromonas gingivalis counts have been linked to delayed conception in women, and reduced sperm motility and erectile dysfunction in men.

And yes—this pathogen can be transmitted via saliva. So partner oral health matters too.

Tip #7: Consider positioning and comfort

They matter.

If you’re seeing a pregnant patient late in pregnancy, you want to avoid the supine position. Instead, tilt the patient slightly to the left. Rolling onto her left side will prevent supine hypotensive syndrome.

You can also offer short breaks, hydration, and gradual chair movements for comfort if necessary.

Tip #8: Postpartum and breastfeeding considerations

If your patient chooses to breastfeed, reassure her that the “pump and dump” method is no longer necessary for things like routine dental anesthetics.

Agents like lidocaine with epi are considered compatible with breastfeeding, per the current pharmacologic evidence.

Encourage your patient to continue hygiene care postpartum, as inflammation can oftentimes persist during the recovery period.

Katrina Sanders:

Pregnancy is not a contraindication. Rather, it’s an opportunity for prevention by confidently caring for pregnant patients. We reinforce trust, support systemic health, and strengthen our connection with GYN colleagues.

I’m Katrina Sanders, and this has been Ask the Expert. Until next time, keep smiling and keep protecting that next generation before they even take their first breath.

Please feel free to reach me on Instagram at The Dental Wine Genist, or on my website: Katrinasanders.com. Cheers.