Dear Doctor, I'm so excited — I just found out that I'm pregnant with my first child! Since I had bad teeth as a child, I want to ensure that my baby will be healthy and have good teeth. Can you answer my questions? Expectant mother Dear Kylie, Congratulations on your pregnancy! Since you have so many questions, I've listed them below to make it easier for our readers. You are wise to already be thinking about your baby's dental health because his/her teeth have already started forming in the tiny jaw bones, by the fifth to sixth week after conception. By birth, all twenty primary (baby) teeth are almost completely formed. Here are some facts that you will need to know: The best thing you can do as an expectant mother is to nurture and maintain your own dental and general health. It's best to eat a balanced diet and avoid starchy and sugary snacks between meals. A healthy and balanced diet will provide you with the calcium, phosphorus and other vitamins and minerals needed for your baby's teeth and bones. Throughout your pregnancy, your physician will evaluate your specific needs and advise you accordingly. Does the calcium for the baby's teeth come from my teeth? No! It's important for us to dispel a common myth that the calcium needed for your baby's teeth comes from the mother's teeth. The truth is that it comes from your diet. What's the best way to care for my teeth? To help prevent tooth decay and periodontal (gum) disease, brush your teeth thoroughly twice a day. A fluoridated toothpaste that has the ADA seal of approval to remove plaque is recommended. Be sure to clean between your teeth daily with floss or inter-dental cleaners, and supplement with an anti-plaque/anti-gingivitis mouthrinse that has the ADA seal of approval. To learn how to brush and floss correctly, consult your dentist or hygienist. Gingivitis, inflammation of the gums, is especially common during the second through the eighth month of pregnancy. What about fluoride? For women who take fluoride supplements during pregnancy, the expectation is that the additional fluoride will help their children form strong teeth. This may sound appealing, but the benefits of prenatal fluoride supplementation remains poorly studied and therefore quite controversial. Fluoride supplements will not necessarily aid in the process of enamel formation because fluoride works best when the teeth have fully formed and have erupted in the mouth. Fluoride changes the chemical bonds in the enamel of the erupted teeth to make it more cavity-resistant. Due to the fact that prenatal fluoride supplementation remains poorly studied, there are many unanswered questions. Therefore, indications for prenatal fluoride supplementation have not been established. More research is needed to determine the advantages, if any, and the dosage levels for prenatal fluoride supplementation. Does pregnancy affect my gums? During pregnancy, your body's hormone levels rise considerably. Gingivitis, inflammation of the gums, is especially common during the second through the eighth month of pregnancy. This may cause red, puffy or tender gums that tend to bleed when you brush. This sensitivity is an exaggerated response to bacterial plaque and is caused by an increased level of the hormone progesterone in your system which is normal during pregnancy. Occasionally, overgrowths of gum tissue, called “pregnancy tumors,” appear on the gums during the second trimester. These non-cancerous localized growths or swellings are usually found between the teeth and are believed to be related to excess plaque. Hence, it's especially important to maintain a high level of oral hygiene during pregnancy. Studies have suggested that pregnant women who have severe periodontal (gum) disease may be at a higher risk for preterm birth and low birth weight. If you notice any changes in your mouth during your pregnancy, please consult your dentist. Hope you have a safe pregnancy and an easy delivery!