怀孕与牙齿                           

译注：梁明                      

大家好，我是梁醫生。近來碰到幾個懷孕準媽媽和產後的媽媽，都有不同程度的牙科問題，覺得懷孕前，看看維洲政府網站betterhealth.vic.gov.au裡面的關於牙齒和懷孕的文章，會有幫助，所以翻譯出來，自己也加了一些註解和英文原文希望能幫助閱讀，如有分歧或疑問，以betterhealth.vic.gov.au的英文版為正確，也請諮詢你的牙醫和醫生。如有翻譯錯誤，敬請指出，多謝.

https://www.betterhealth.vic.gov.au/health/HealthyLiving/pregnancy-and-teeth

懷孕不意味你的牙齒會變壞（懷孕不會自動損害你的牙齒-這麼直譯挺擰的：  ）。 “老人們的傳言說：女人每生一個孩子會掉一顆牙齒的說法是不對的。在懷孕期間，如果母親的鈣攝入量是不夠，那麼提供鈣她嬰兒需求的鈣的是她的骨頭- 而不是她的牙齒。這種鈣的流失哺乳後停止後迅速補充。（我註明一下，這是有前提的，產婦得到充足的鈣的攝入，最好是牛奶，燉骨頭湯的安慰意義大大大於實際效果。也看看是否需要補充維他命D3，關於補充維他命D3這點請質詢你的醫生，本人是dentist不是Medical  Doctor。）


Pregnancy does not automatically damage your teeth. The old wives' tale that warns a woman to expect a lost tooth for every baby is false. If the mother's intake of calcium is inadequate during pregnancy, her bones – not her teeth – will provide the calcium her growing baby needs. This calcium loss is quickly made up after breastfeeding is stopped.



不過，對於某些些婦女，懷孕可導致牙科問題，包括牙周病和蛀牙的風險增加。在家裡正確的口腔衛生清潔和專業人員的幫助將確保你的牙齒在整個孕期的健康。牙周疾病是一種牙齦的慢性感染，可能引發早產。


您的牙齒健康可以影響你的寶寶。


研究發現孕婦的牙齦疾病和早產兒合併有低出生體重之間有聯繫。早產嬰兒可能的風險範圍包括腦癱和視力和聽力問題的健康狀況。

估計數字顯示，大約18%早產可能由牙周疾病引起，（牙周疾病是一種牙齦的慢性感染。）根據一項研究，得到適當的牙科治療的準媽媽能減少超過80％的早產風險。


Your dental health can affect your baby

Research has found a link between gum disease in pregnant women and premature birth with low birth weight. Babies who are born prematurely may risk a range of health conditions including cerebral palsy and problems with eyesight and hearing.

Estimates suggest that about 18 out of every 100 premature births may be triggered by periodontal disease, which is a chronic infection of the gums. Appropriate dental treatment for the expectant mother can reduce the risk of premature birth by more than 80 per cent, according to one study.




懷孕前的牙齒健康

如果你已經有了良好的口腔衛生習慣，那麼你不太可能在懷孕期間有牙科問題。建議包括：
 1。每天兩次刷牙，使用含氟牙膏。 （最少2-3分鐘）
 2。使用牙線。 （註明一下：對於某些人可能需要牙間刷，具體請諮詢你的牙醫）
 3。定期看牙醫檢查牙齒
如果你計劃懷孕，請告訴你的牙醫。這樣，在懷孕前，會更方便去做選擇性的治療（或者一些治療會用到X光）。例如，新的銀汞合金補牙或者等到懷孕頭三個月過後再補牙。 （補充一下，現在澳洲越來越多的牙科診所包括我們Auburn Dental已經不用銀汞合金了，因為新的材料更好，也減少各種安全或環境的擔心。大家如果不確定的話可以問一下的牙醫用什麼材料給你補牙。）

Pre-pregnancy dental health

You are less likely to have dental problems during pregnancy if you already have good oral hygiene habits. Suggestions include:
Brush your teeth at least twice daily with fluoridated toothpaste.
Floss between your teeth.
Visit your dentist regularly.
If you are planning on getting pregnant, see your dentist. It may be more convenient to have elective procedures (or procedures that involve the use of x-r​​ays) done before you conceive. For example, new dental amalgam fillings or the replacement of old fillings may need to wait until after the first trimester.




通知您的牙醫


如果你懷孕了，告訴你的牙醫。懷孕會影響你的牙齒護理。例如，牙醫可能會推遲X光的運用。如果牙科X射線是不可避免，牙醫可以採取額外的預防措施，以確保寶寶的安全。如果您的牙齒狀況需要全身麻醉或藥物，那要質詢你的產科醫生的意見。 （補充：澳洲牙科協會也有關於藥物對胎兒影響的信息給到我們牙醫。）



在懷孕期間的牙齒健康問題的常見原因包括：

    牙齦問題
    嘔吐
    很想吃甜食
    乾嘔而刷牙。

牙齦問題

與懷孕有關的激素可以使一些女性易患牙齦問題，包括：

牙齦炎（牙齦發炎） - 這是更可能發生在孕中期（3-6月）。症狀包括牙齦腫脹，出血，特別是在刷牙和用牙線時。
未確診或治療牙周疾病- 懷孕可能會加劇這種慢性牙齦感染，牙齦疾病是由未經治療的牙齦炎引起，可導致牙齒脫落。 Undiagnosed or untreated periodontal disease – pregnancy may exacerbate this chronic gum infection, which is caused by untreated gingivitis and can lead to tooth loss. 這可以表現為牙齦腫脹腫大，也稱之為妊娠性牙齦瘤，寶寶出生後可能會消退。 （注：如果不消退的話，需要手術去除。）

在懷孕期間，牙齦出現的問題不是由於菌斑的增加，而是由於母親體內激素水平的增加而導致對菌斑的加重反映。 an exacerbated response to plaque as a consequence of the increased hormone levels.

告訴你的牙醫所有關於牙齦的問題。換用較軟的牙刷，（注：超市裡的牙刷包裝上標明：Soft）並定期刷牙，每天至少兩次（注，早上是早餐後刷牙，原因和洗澡是在運動後而不是運動前是一樣的，那些起床刷牙的牙膏廣告誤導害了不少人啊）。使用含氟牙膏，（如果現在你沒有用含氟牙膏的話），以幫助加強你的牙齒抵抗蛀牙。

During pregnancy, the gum problems that occur are not due to increased plaque but an exacerbated response to plaque as a consequence of the increased hormone levels.

Tell your dentist about any gum problems that you might have. Switch to a softer toothbrush and brush your teeth regularly, at least twice every day. ​​Use toothpaste that contains fluoride (if you're not already) to help strengthen your teeth against decay.


如果在懷孕期間曾有有牙齦問題，那麼，重要的是在生完孩子後，去牙醫那裡檢查牙齦。雖然出生後，大多數的受孕激素引起的牙齦問題會消退，但少數婦女牙齦疾病會發展到更深的水平，需要治療來解決。

If you had gum problems during pregnancy, it is important to get your gums checked by a dentist after you have given birth. While most types of gum problems caused by pregnancy hormones resolve after birth, a small number of women may have developed a deeper level of gum disease that will need treatment to resolve.


嘔吐

受孕激素影響，胃部賁門的肌肉環變軟了，不能有效關住胃裡面的食物。胃反酸（regurgitating食物或飲料），或者早上噁心而來的嘔吐會帶來強烈的胃酸。反复胃反酸，嘔吐，可能會損壞牙齒釉質（琺瑯質），增加蛀牙的風險。
                

建議：


    嘔吐後不要馬上刷牙。當胃酸覆蓋牙齒時，用力刷牙會磨損牙齒釉質（琺瑯質）。
    用普通自來水徹底漱口。
    接著用含氟漱口水漱口。
如果你沒有含氟漱口水，把你的手指把含氟牙膏塗到牙齒上。 （幾分鐘後）用清水徹底漱口。
    至少在嘔吐後一個小時刷牙。

Suggestions include:
Don't brush your teeth immediately after vomiting. While the teeth are covered in stomach acids, the vigorous action of the toothbrush may scratch the tooth enamel.
Rinse your mouth thoroughly with plain tap water.
Follow up with a fluoridated mouthwash.
If you don't have a fluoridated mouthwash, put a dab of fluoridated toothpaste on your finger and smear it over your teeth. Rinse thoroughly with water.
Brush your teeth at least an hour after vomiting.



刷牙時干嘔

有的孕婦發現，刷牙，尤其是磨牙（後牙），會引起乾嘔。然而，如果你不經常刷牙又可能會蛀牙。
建議：

用小頭牙刷刷牙，例如兒童或幼兒用的牙刷。
花多些時間，（不要急），減慢刷牙。
閉上眼睛，集中註意力在呼吸上，可能有幫助。
嘗試其他的可以分神的事，如聽音樂。
如果牙膏的味道，可能引起乾嘔反射，換其他牌子的牙膏（或其他味道的牙膏）。另一種方法是，用水刷牙然後用含氟漱口水（漱口）。如果不嘔吐了，盡快再使用含氟牙膏刷牙。


Retching while brushing teeth

Some pregnant women find that brushing their teeth, particularly the molars, provokes retching. However, you risk tooth decay if you don't brush regularly. Suggestions include:

Use a brush with a small head, such as a brush made for toddlers.
Take your time. Slow down your brushing action.
It may help to close your eyes and concentrate on your breathing.
Try other distractions, such as listening to music.
If the taste of the toothpaste seems to provoke your gag reflex, switch to another brand. Alternatively, brush your teeth with water and follow up with a fluoridated mouthwash. Go back to brushing with fluoridated toothpaste as soon as you can.


很想吃東西

因為懷孕，有些女性懷孕時會經歷不尋常的很想吃東西（和食品反感）。經常性的想吃含糖零食可能會增加蛀牙的風險。可以試試含糖量少的食物。如果你只有吃含糖食物才能滿足，那麼有時選擇健康些的選擇，如新鮮水果。在吃完含糖零食後，用水或牛奶漱口，或刷牙。

Food cravings

Some women experience unusual food cravings (and food aversions) while they are pregnant. A regular desire for sugary snacks may increase your risk of tooth decay. Try to snack on low sugar foods instead. If nothing but sweetness will satisfy your craving, try to sometimes choose healthier options such as fresh fruits. Rinse your mouth with water or milk or brush your teeth after having sugary snacks.



增加鈣攝入量

你需要增加在懷孕期間每天的鈣攝入。充足的鈣會保護你的骨量和滿足您的發育中的胎兒的營養需要。膳食中良好鈣的來源包括低脂肪產品，如：

    牛奶
    奶酪
    酸奶
    加鈣豆漿。

Increase your intake of calcium

You need to increase your daily intake of calcium during pregnancy. Sufficient calcium will protect your bone mass and meet the nutritional needs of your developing baby. Good sources of dietary calcium include low fat versions of products s​​uch as:
Milk
Cheese
Yoghurt
Calcium-fortified soymilk.



增加您的維生素D攝入量

維生素D能幫助人體利用鈣。良好維生素D來源包括：

    奶酪
    強化人造奶油（ 具體請諮詢你的醫生，華人亞裔一般吃的少。）
    富含脂肪的魚類，如鮭魚
    雞蛋。

Increase your intake of vitamin D

Vitamin D ​​helps the body to utilise calcium. Good sources include:
Cheese
Margarine
Fatty fish, such as salmon
Eggs.
去哪裡尋求幫助？
你的牙醫，你的醫生，產科醫生，澳洲牙科協會，維洲分部Tel. (03) 8825-4600
Where to get help
Your dentist
Your doctor
Obstetrician
Australian Dental Association, Victorian Branch Tel. (03) 8825-4600（注：如果英文不好，可以打翻譯電話： 131 450。這是澳洲全國的翻譯服務，當地電話收費，記住，你要會說Chinese （中文）,接線員只會英文， 有時接線員也會再問Mandarin （國語） 還是Cantonese （粵語）。

需要記住的事情

懷孕的需求可能導致一些婦女有牙科問題。
估計數字顯示，大約每100名早產兒中有18個是因為牙周疾病引發的，牙周疾病是一種牙齦的慢性感染。
如果你已經有了良好的口腔衛生習慣，那你不太可能在懷孕期間出現牙科問題，。
Things to remember
The demands of pregnancy can lead to particular dental problems in some women.
Estimates suggest that about 18 out of every 100 premature births may be triggered by periodontal disease, which is a chronic infection of the gums.
You are less likely to have dental problems during pregnancy if you already have good oral hygiene habits.

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