Often, yes. Occasionally, no.  Sensitivity to sweets in children (and adults) can mean that there is a cavity lurking.  The presence of sugar in the sweets will cause a chemical reaction within a decaying tooth. This reaction causes that “twinging nerve pain” or sensitivity, which may or may not linger for a little while after the sweet treat.   It is best to take your child to the dentist and let them examine the tooth and take an x-ray if needed to see if a cavity is causing the sensation.

Sensitivity to hot or cold in a child’s tooth (baby teeth or permanent teeth) can be of concern.  A cavity can also cause sensitivity to hot and cold, however if it is, this is usually a sign that the cavity is already large. This can also be a sign of the nerve dying and/or and abscess of a tooth.  Again, the appropriate treatment would be to see your dentist immediately and let them take an x-ray if needed.  If an x-ray is taken and other tests done confirm that the nerve is dying or that an abscess is present, your dentist will discuss options with you.

Options for treatment of cavities or abscesses (dead/dying nerve) may include procedures such as extraction (with or without a space maintainer to hold the space open for the future permanent tooth), baby tooth root canal, filling or stainless steel crown.  The decision for treatment options is made based on the amount of damage/decay in the baby tooth, the length of time until it would normally fall out and position of the underlying permanent tooth.   Of course, we want to do our best to try to save baby teeth, particularly if it will help the child avoid braces in the future.  But all of these things must be taken into consideration in order to make the best decision for the child.

Occasionally in children, but most often in adults, this sensitivity can be caused by an area where the gum has receded away from the tooth.  You don’t see this too often with children, simply because the baby teeth are actively changing form each day, and they don’t have the sensitive roots that adult teeth have.  It is quite uncommon for gums to recede in children or even in teenagers (unless they have braces).  So, the bad news is that it is likely a cavity causing the pain.

These sensations can also be normal and transient.  Your dentist will likely use a combination of diagnostic procedures to evaluate the offending tooth.  If nothing obvious can be found that explains the source of the pain, they  may opt to “watch” the tooth.  What this means is, they will ask for your help in monitoring your child’s symptoms at home and call if things change (for better or for worse).  Either way, your dentist may decide to take a new x-ray in a few weeks to see if there are any changes.

Teeth are strange in that sometimes they give symptoms disproportionate to their experienced “trauma.”  For example, when eating a chip or popcorn or some crunchy food item, occasionally a piece may break off and get lodged beneath the gum without you or your child even noticing.  The area may then become tender and feel like a toothache, hot and cold sensitive or become painful on chewing.  A trip to the dentist may show nothing and then the sensitivity goes away in a few weeks.

A tooth can also be traumatized by biting into something hard which can cause the ligament which holds the tooth in to be “bruised.”  This may cause biting sensitivity for a week or two which may also go away on its own.  There are many examples of these situations but most commonly, symptoms are actually due to the presence of a cavity or an abscess.  So, always have your dentist check the area rather than assuming there is nothing really wrong.

There have been many scientific developments in the field of oral health in the last decade. One of the most important studies has to do with the link between gum disease and several other health conditions. I won’t go into depth here about the other health conditions, as they don’t relate pregnancy but I will briefly mention them due to their extreme importance. There has been a proven relationship of gum disease to diabetic complications, stroke and heart disease. The oral bacteria which causes gum disease (which is different from those causing cavities) has been found in the heart and brain tissue of those who have had a fatal encounter with a stroke or heart attack. Diabetics with gum disease also experience more uncontrolled blood sugars. I would suggest a Google search the internet if you are interested in finding out more on the details of this relationship.

So, what does this have to do with pregnancy? Well, let me first give you a quick lesson on gum disease, since most of the population really doesn’t understand what it is. What it typically means to most people is the dreaded “you have to floss more” lecture from your dental hygienist. Basically, flossing your gums (notice I did not say teeth here) allows you to clean out the debris below the surface of your gums-in the area where popcorn kernels get caught. If that debris is not removed, it can turn into a concrete-like, bodily substance called “tartar” or “calculus” from the minerals in your saliva. This tartar can then become strongly adhered to the tooth root beneath the gums, causing inflammation which may be called gingivitis or gum disease.

Once tartar is present, it is not possible to be removed by flossing any longer. It will only come off with those dreaded scrapers we all hate at your dental cleaning appointment. Everyone gets tartar, but some people get it more abundantly than others either due to genetics, nutritional habits and/or mineral composition of saliva. This is why a dental cleaning or “prophylaxis” is needed every six months. It takes about six months for the body to develop enough tartar to elicit the start of the gum disease process.

If you don’t have your teeth cleaned, the tartar stays on the tooth root and allows more tartar to continue building on top of the existing tartar layer. This causes an even more inflammation of the gums. Eventually, the body “sees” this tartar layer as a “foreign object” and tries to get rid of through chemical and biologic means. So, this is good, right? Well, I have only told you part of the story. While the body is trying to help, it also releases special mediators that unfortunately destroy the bone around the teeth in an effort to get rid of the tartar.

If left untreated, the cycle of tartar deposited and more bone destroyed continues, causing the teeth to become loose. I always use the analogy of a “For Sale” sign in the yard-if you keep taking away the dirt around the big wooden post, eventually it becomes loose and falls out. Teeth are really as simple as that analogy. Eventually the teeth either fall out on their own, or have to be pulled because they cause a choking hazard.

In addition to this, pregnancy causes a huge hormonal shift which causes a lot more than tears, weight gain and cravings. An increase in the hormone progesterone during this time causes the gums to become more sensitive and prone to gum disease if plaque and tartar are not controlled. Signs of gum disease may be as follows: Sore, sensitive, swollen, red gums which may bleed spontaneously or especially while brushing or flossing. You may notice a black, yellow or brown, rough-appearing, grainy-looking substance along the gum-line of your teeth. You may also notice an increase in bad breath or a bad taste in your mouth.

You may hear your dentist call this process “gum disease” or “periodontal disease” (they mean the same thing) and they may tell you that you have “pockets” around your gums. These “pockets” are the popcorn-kernel-catching areas I was referring to earlier and get deeper with the deposition of more tartar over time. Certain ethnicities, such as African Americans and Hispanics are more genetically prone to getting gum disease. If you are of either of these descents, I strongly encourage you to see a dentist regularly and be sure that they are actually checking your gums every 6 months. Especially if your gums bleed when you floss or are highly sensitive.

So, of course we can see that one implication of gum disease as it relates to pregnancy would be the loss of teeth and therefore inadequate nutrition due to the inability to chew. While this is a huge concern, the primary concern is actually systemic in nature. Scientists have linked the presence of gum disease to increased incidence of pre-term delivery and low birth weight.

As mentioned earlier, the body’s attempts to resolve gum disease result in the release of bodily chemicals. These chemicals can cause the early onset of contractions, leading to pre-mature birth. Premature birth can cause a myriad of problems for the baby including, breathing difficulties (due to immature lung development), seizures and bleeding in the brain, difficulties in feeding and thus slow weight gain and poor nutrition. There are many other problems which can arise from pre-term labor and if you have concerns regarding this link with gum disease, talk to your physician and dentist. The best protection against this is to brush and floss regularly and to see your dentist regularly for a check-up and cleaning before, during and after pregnancy.

I know most people hate flossing (myself included) and despise going to the dentist. I know too that food is one of life’s greatest pleasures, especially during pregnancy. However, as parents, something in us changes and causes us to care for our children (event the unborn ones) and allows us to do the best for our children. Modification of routines and following a few simple guidelines will only eliminate one more thing to have to worry about during pregnancy. They are factors which we can control when so many other things during this amazing time are out of our control.