Keeping your pearly whites in tip-top condition may seem like a straightforward task pre-pregnancy, but everything is complicated once you’re suffering from HG. For instance, the taste, or even the smell of toothpaste, can make brushing impossible, and repeated vomiting can have a detrimental effect on the oral environmental. These tips have been prepared for Hyperemesis Australia by dentist and HG survivor Dr Shu’An Hu BDSC (MELB) (HONS).

Dental Erosion

Dental erosion poses a real problem if you’re throwing up multiple times a day. The acid from your stomach erodes the enamel/outermost layer in your teeth, resulting in unpleasant sensitivity when eating something hot and/or cold. If the erosion is severe and progresses past the enamel, the deeper layers of the teeth including the nerves can also be damaged.

One way to limit the effects of repeated vomiting is to rinse your mouth out with water after each time you throw up. This will help to neutralise the acidity and limit the damage to your teeth. If the taste of baking soda can be tolerated, rinsing with a teaspoon of bicarbonate in the water can help to neutralise the acidity in your mouth more effectively.

It is also very important to ensure that you do not brush your teeth for at least 30 minutes after throwing up otherwise the act of brushing can actually wear away the weakened enamel, further exacerbating the effects of dental erosion.

Snacking

For some sufferers of HG, snacking constantly can alleviate nausea. If that’s you, try snacking on things such as carrot and cucumber sticks rather than crackers if possible, as high carbohydrate snacks can lead to an increased risk of decay. But, remember - eating anything is better than eating nothing so don’t beat yourself up if you can’t manage the healthier alternative. Otherwise, try to limit the frequency of snacking, and always rinse your mouth with water every time you snack. Chewing with sugar-free gum after every snack can also be helpful as it stimulates the production of saliva, which helps to neutralise acids and sugars in the oral environment. Additionally, consider talking to your dentist about using a high fluoride toothpaste as that can further reduce the chances of dental decay and erosion.

Toothpaste + Brushes

Unfortunately, HG and toothbrushing seldom go hand-in-hand. If the taste of your usual toothpaste worsens your nausea, give other brands a go until you find one that works. An SLS-free toothpaste will not foam up, like traditional toothpaste, which can be helpful if you have trouble with the foamy texture. If toothpaste is completely intolerable, remember that brushing without toothpaste is better than not brushing at all. Even the act of running a damp face washer over your teeth can help remove some plaque. You may find that using a child or even toddler-sized toothbrush can help reduce the unpleasantness of brushing.

It may be helpful to limit your brushing session to times of the day when the nausea is not as severe. If possible, try to ensure that your teeth are cleaned before going to bed at night - your mouth gets dry when you sleep, and without the protective effects of saliva, decay is more likely to set in. So, if brushing can only be managed once a day, try to do it before going to bed.

Going to the dentist

Making certain changes to your lifestyle and habits can mean that your HG pregnancy will not necessarily lead to a deterioration in oral health. It can be helpful to get a dental check-up while you’re pregnant if you can manage it, but if it’s not possible, consider booking in for a check-up once your baby arrives and HG becomes a thing of the past. Early detection of any issues and a professional application of a concentrated fluoride varnish, can be beneficial in restoring dental health or even reversing early dental disease.

And if you have doubts that your dentist may not understand the effects of HG, fear not - dentists are trained to be familiar with the adverse effects of repeated vomiting and periods of dental neglect on teeth. However, if you feel that your dentist is unfamiliar with HG mentioning that you suffered from extremely severe nausea and vomiting during your pregnancy will already raise several dentally relevant red flags in their minds. There’s no need to be embarrassed about the state of your teeth and gums - dentists are health professionals who are passionate about restoring your dental health and function. Together, they want to work with you and be on your team to help you to eat, speak and smile confidently again.