Dental MythBuster #6 – My baby stole the calcium from my teeth!

As a general dentist practicing in Orange, CT, I have the privilege of treating patients of all ages, including both expecting and postpartum mothers.  The number one dental myth I hear from these patients is the following:

Drawing of baby who stole the calcium from his mother's teeth leading to dental cavities

“I didn’t have any cavities until I became pregnant. Then my baby sucked the calcium out of my teeth which is why I have all these new cavities now!”

This is always a difficult dental myth to “bust.” First, the concept of losing calcium from bones is well established and patients frequently assume bones and teeth are similar.   Secondly, this dental myth is so widely circulated among pregnant and new mothers that many don’t want to believe me when I try to “bust” it!

About Calcium, Teeth, and Bone

Teeth, like bone, are comprised of hard minerals, with calcium being one of the key components. Tooth enamel is harder than bone and is actually the hardest substance in the body!  Adult teeth begin to develop at a very young age and continue to mature until approximately age 16 (except for wisdom teeth).  By age 16, your teeth are no longer developing and the strong enamel layer no longer requires nutrients from your bloodstream.   So at this point a deficiency of calcium in your diet will not affect your teeth, because your teeth are no longer forming.

Picture of Bone in Thigh. Unlike teeth, bones are constantly being broken down for calicum.

Bone is used as a source of calcium.

This is in direct contrast to bone which is constantly being reformed in response to dietary, hormonal, and other factors. Every single day, small parts of your bones are naturally dissolved and then re-formed.  Calcium is needed for this process and a deficiency of calcium can lead to weaker bones.  This is one of the main reasons why older patients frequently take Vitamin D and Calcium – it is to enhance the strength of their bones.

So, many patients assume that because bones constantly require a source of calcium, then teeth must as well. And with a growing baby in utero and/or nursing baby taking nutrients from the mother, people assume their teeth are having nutrients taken away. Not true!

New Mothers and Tooth Cavities

So this brings up the question: do new mothers have greater amounts of tooth decay? And if so, why?  Well, the answer to the first question is Yes! New mothers do have higher rates of dental decay.

Tooth with a cavity or decay in a new mother, not because the baby stole her calcium

Photo of a tooth from one of my patients with an 8 month-old little one. The cavity is NOT because the baby “stole” calcium from her teeth!

There are several reasons for why new mothers have more cavities. I have observed all 4 of these personally in my private practice.

  1. Morning Sickness: not all pregnant patients experience this. However, even occasional vomiting in the morning brings up very acidic stomach contents which can quickly erode your teeth, leading to decay.
  2. Acid Reflux: pregnant women are more likely to experience acid reflux due to the pressure on their stomach from the growing baby. This can also lead to stomach acid entering the mouth to erode the teeth.
  3. Changes in Oral Hygiene: let’s face it, being a Mom is hard work! Many new mothers spend so much time focusing on their new child that they neglect to brush and floss consistently. This can easily lead to new cavities.
  4. Changes in Diet: with pregnancy and nursing, some women will start eating sugary foods they did not typically consume before.  Increased sugar intake can lead to increased decay.

In addition to dental decay, pregnant and nursing mothers are also at risk for Pregnancy Gingivitis which will be covered in a future post.

Comments

  1. Jennifer says:

    I asked the hygienist about this after my second child and she didn’t know. So I assumed the teeth got soft because of the pregnancy. Thanks for setting this straight.

    • Jennifer,
      I am glad you were able to find this post on the internet. There are many Moms out there who have been led to believe their teeth are soft because of their baby. Now you know the real reasons. Keep up with good oral hygiene and you should be fine.

  2. I averaged 1-2 cavities a year until I got pregnant. I eat pretty well when I’m not pregnant, and I upped the ante during. Beans, fish, produce, fruit, avoiding almost all sweeteners…and brushing/flossing with more dedication than I did before. Average was about 2 times brushing and 1 time flossing. I drank literally over a gallon of water a day toward the end of my pregnancy, rinsing out my mouth plenty. I ate tums, I avoided soda, I ate cheese and drank milk trying to expose my teeth to basic foods as opposed to acidic. And you want to know how many cavities I ended up with? Not 10, not 20, but 50 cavities. I need 3 root canals, and only three of my teeth don’t have cavities in them. I had my blood tested for magnesium, potassium, phosphorus, vitamin D…no one can tell what it was other than to tell me to use better hygiene. Now, I know I am not a religious brusher and flosser the way my mom is; doing both 4+ times a day, but my habits certainly don’t cause the same effect in other people.

    So what do I make of this? Pregnancy sapping calcium? Higher acidity in my mouth caused by hormones, morning sickness, reflux, etc? Increased susceptibility to infection?

  3. Rachel,

    First off let me sympathize with you because of all the dental procedures you’ve had to endure, especially with a little one to look after!

    Based upon your history, it appears to me that you were at high risk for decay BEFORE you got pregnant. 1-2 new areas of decay per year is not typical. If I have a patient who is averaging 1-2 new cavities per year then I sit down with him/her to really analyze what is going on!

    And it looks like the pregnancy just exacerbated your situation. You list morning sickness and reflux as factors which are true. The pregnancy taking calcium is a myth, so that is not a factor. It is a combination of factors. And remember that milk actually contains sugar so if you are constantly drinking milk you are at higher risk.

    I would talk to your dentist ASAP about getting a high fluoride toothpaste (Prevident) or a special toothpaste to help rebuild the enamel (called MI Paste).

    Good luck.

    • Dr. Calcaterra, While pregnant could the salivary mineral constituents change and therefore be less calcium and phosphorus to aid in remineralization of the dentition? Thanks, Tom

    • Sorry I saw the answer given later. I believe that the salivary change does effect the caries rate during pregnancy. Just as dry mouth effects it. Also throwing fluoride into the mix without the mineral building blocks for remineralization will have a significantly less effect at lowering the caries rate in that case. Novamin was my choice for a remin product, too bad GSK pulled it from the U.S. market. Hoping to see it available OTC again soon here.

      • Tom,

        Based on your response I suspect you’re a dental professional.

        Research posted on this article have confirmed that the composition of saliva does change during pregnancy. And that change affects remineralization of teeth.

        But a change in remineralization secondary to changes in salivary composition does not mean that the fetus is actively “harvesting” or “stealing” calcium from the teeth. This effect (changes in saliva) along with the points I posted are responsible for the increase in decay, not a fetus that is directly harvesting calcium from the enamel or dentin.

  4. This doesn’t make sense to me. No, I’m not a dentist, but I HAVE done as much research as possible. And I’m not getting my information from shady websites. I stuck to peer-reviewed sources and doctors that referenced peer-reviewed sources (which I notice you haven’t done here!).

    I HAD to do all this research because my teeth were falling out in spite of religiously doing everything my dentist told me to do (and by this, I mean: all wisdom teeth pulled, two molars pulled, fillings in every tooth, several root canals, six or seven crowns….) Even my dentist was flummoxed, and eventually just shrugged and said “Some people are just prone to cavities.”

    I wasn’t satisfied with this explanation, so I decided to investigate for myself to figure out what was going wrong in my body. What I found after investigating the literature was that there IS a mechanism by which your body remineralizes weak spots in your enamel. It just won’t refill cavities once they form. (Though there seems to be SOME controversy regarding whether extremely small cavities can heal, since there have been studies showing that they can, under the right circumstances.)

    Calcium is present in your saliva, where it is used to remineralize your enamel. (I don’t pretend to understand how this works.) From what I understand, there are two problems that can develop: Either your saliva is not available in the first place (dry mouth), or it doesn’t have enough calcium or other minerals in it to be used for repairing weak spots.

    Learning this was a HUGE epiphany to me. My cavity explosion happened directly after I moved to the part of the country that is extremely dry. In addition to the dryness of the air, this region is terrible for my allergies, and this combined with my very narrow nose meant that my nose was nearly always clogged, so I was always breathing through my mouth. The cumulative effect being that I had been experiencing terrible dry mouth, particularly at night.

    I still wasn’t sure if this was my “silver bullet”, but I figured it couldn’t hurt to try doing something about it. I treated my allergies, then treated the lingering dry mouth using OTC toothpaste, sipping water frequently, changing my evening ritual to avoid any kind of mouthwash directly before bed, tried to make sure I wasn’t mouth-breathing while biking, and otherwise tried to be “mindful” (that is, I tried to pay attention to whether my mouth was dry, and then make my mouth water by thinking of food!)

    I made NO other changes to my diet or brushing routine during this time. (In fact, I continued to drink the occasional soda, though I had already cut back at this point… I suspect that cutting back might have helped, since the phosphorous can contribute to a lack of calcium, based on certain sources I read.)

    I saw my dentist for a routine cleaning this week, and she was thrilled by the improvement in my teeth. In fact, she enthusiastically announced, “I can tell you must have quit the sodas! Your teeth look fantastic!”

    I didn’t bother correcting her. I just smiled and agreed. 🙂

    So yes, calcium in your body DOES have a mechanism to affect your likelihood of developing cavities, and it’s irresponsible to suggest otherwise as a medical professional.

    If you feel like I’m missing something here, I would love to hear your counter argument, or see some peer-reviewed sources supporting your argument that a lack of calcium can’t cause cavities, since my personal experience was completely different!

    • Misty,
      Several points on your comments:
      1. Where are all the peer reviewed research articles you’ve reviewed? You are quick to criticize me for not supplying them yet you fail to include them!
      2. Please note that one person’s experience cannot then be used to generalize. There is a reason why well designed research studies are double-blind, placebo controlled, and include hundreds if not thousands of research participants.
      I recently noted a change in one of my moles on my skin after drinking Kefir (a pasteurized yogurt drink) for the first time. It was biopsied and had slight cytologic atypia. I guess I can conclude that Kefir causes cancer and should be banned? All because of MY experience?
      3. You did not propose a mechanism for how a baby will cause enamel to be depleted of calcium. Please do.
      4. Lastly, and most importantly, in your “research”, you did not distinguish the difference between topically applied calcium and systemic calcium. I’ll sum it up for you:

      Topically applied minerals, be it calcium or fluoride or others, can remineralize the outermost surface of the teeth (called enamel). This is the basis for the use of high fluoride toothpastes in adults. When used appropriately, these toothpastes, applied TOPICALLY, can remineralize or heal cavities in enamel.

      Systemic consumption of minerals will not affect the outermost layer of teeth – enamel – as it is completely formed (except in wisdom teeth) – by mid to late teens. There is simply no physiologic mechanism by which a calcium deficiency (or nursing) can “suck” calcium out of enamel. Enamel is completely avascular – which means it has no blood supply.

      Perhaps I wasn’t this clear in my article. Or perhaps you had your own agenda and elected to gloss over the points of my post you did not agree with.

      5. Your assertion that I am irresponsible is insulting in light of the fact that you have provided no evidence to the contrary. I certainly hope you don’t treat the health care providers who actually treat you like this!

      • Spenser Cammack says:

        I just found your website and found it interesting. I especially liked the article on the novocaine myth. I am a practicing dentist and I have to disagree with you on some level here. Everything you said in your article is correct but you left out some important other factors. This lead me to doing a little research also.

        First is the role of salivia, glorious salivia. It is the miricle fluid of the mouth. Along with carrying important elements of the immune system (I do not know of any affects in pregnancy) they also carry Calcium and phosphate into the oral cavity. I will explain a few things in terms potential readers will understand, trust me , I respect you and am not talking down to you, just want others to understand.

        As you know our teeth are losing minerals daily, all the time. These are replaced by the salivia. If this were not true, than our teeth would never last a lifetime. Think about what happens if you over etch a tooth for sealant placement, if you go back a few weeks later the enamel will not be frosty, due to remineralization of the enamel. So if the content of the salivia is altered, than caries (cavity) rates can potentially change due to this. If a women is not getting enough calcium and phosphate in their diet during pregnancy than what might have been just enough prior to pregnancy may well be too little during. Here is a paper on this:

        http://www.academicjournals.org/article/article1380896913_Bakhshi%20et%20al.pdf

        And here:
        http://onlinelibrary.wiley.com/store/10.1111/j.1471-0528.1998.tb10181.x/asset/j.1471-0528.1998.tb10181.x.pdf;jsessionid=B88BDE908A74FA8652CA0226E8A96CEC.f01t02?v=1&t=ic45jr0p&s=d39608052e1f5957bdaac54954dc56964751a28c

        So the baby isn’t stealing the calcium from the teeth, you are right, but it MAY be preventing sufficient Calcium (and phosphate) from being available in the salivia to remineralize the teeth. I’m not sure this is the biggest role, but I always advise my pregnant patients to make sure they have sufficient Ca+ in their diet.

        Also, changes in hormone levels during pregnancy play a major role. These can cause gingival (gums) overgrowth and inflamed gingiva. This I think plays a role in reduced hygiene and therefore higher caries rates.

        One paper discussed a decreased perception to sucrose, which also can play a role.
        http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4253273/ si pregnant women may be also eating more sugar, even without realizing it.

        Again, I really like your blog, just wanted to add my two cents in this subject.

        Sincerely,

        Spenser Cammack DDS
        Lacey, WA

        • Spenser,

          Thanks for the insightful commentary. I think your post gives new information while also helping to bust the myth (in my opinion).

          Approximately 1 week ago, one reader commented about the role of calcium and saliva – and made many accurate statement about it – but then incorrectly concluded that babies pull or suck calcium from the teeth. I will admit my explanation back to her may not have been succinct as yours.

          And I do agree 100% with your comment that a baby in utero MAY affect the amount of calcium in saliva available to help remineralize the teeth. But we should all remember that this is only a topical effect – and that this does not in any way mean that your teeth are being actively broken down by your body to provide calcium to the baby. This is why I made the distinction between teeth and bones – because bone is broken down by your body and used as a source of calcium.

          The myth – as I have heard dozens of times – is that the in utero baby’s nutritional needs literally cause your body to “attack” (not my words – but words of a patient I saw in residency) your teeth and break them down to give calcium to the baby. And I believe your posting help to bust that myth.

          Thanks

          • Hi Nicholas,

            Nice blog, interesting post. I hear this all the time myself and am also quite reluctant to believe there is any merit to this myth. But allow me to play devils advocate for a moment.

            The enamel may not be actively broken down by the baby in utero to extract neccesary calcium. It is, however, in a constant state of demin and remin. It is the relative concentration of calcium and phosphate ions (and fluoride applied topically) within the saliva that hopefully allows for the demin/remin balance to remain neutral or even shift toward remin and produce calculus.

            If the concentration within saliva is decreased, let’s say by means of a child in utero, then the subsequent lack of minerals will promote a shift toward demin in enamel and subsequent cavitation. Of course, this isn’t concrete it’s just a reason why this theory is plausible and there is a physiological mechanism that could explain such a phenomenon.

          • Michael,

            Thank you for the well thought out comment. It is refreshing to see a comment like this as opposed to ones that are based purely on speculation or when N = 1.

            Your points make sense and the mechanism you propose, which was just mentioned by another poster recently, has some support in the literature.

            However, as I look at the mechanism, and compare it to how I interpret “the myth”, the myth is still busted.

            I interpret the myth as employing a mechanism similar to how bones are constantly being formed and re-formed in response to hormonal signals driven by blood calcium levels. Bone is harvested directly via the bloodstream for calcium, when needed. Calcium is liberated from bone, the calcium enters the bloodstream, and then is shuffled off to other areas of the body requiring that calcium. When blood calcium levels increase, the hormonal signals then decrease, and the bone is no longer broken down. This is Homeostasis 101.

            There is no such mechanism for teeth.

            Enamel is avascular and its mineralization (except by topical influences) is complete shortly after the teeth erupt. This is/was confirmed by every Oral Histology textbook out there. There is no way any hormonal signal (not that there even is one) could cause the enamel to be DIRECTLY broken down and have the calcium DIRECTLY enter the bloodstream to then be used by the in utero baby.

            The myth, as I have heard it many times over, suggests that the calcium is removed directly from the teeth and goes directly to the baby, presumably via the bloodstream. This simply does not happen.

            And, allow me to play devil’s advocate as well. Teeth are in constant states of demin/remin, regardless of whether you are pregnant or not. You pointed that out. There is no “special force” present that is directly attacking the teeth of a pregnant woman… just the same mechanism that is present in every human out there. The baby is not attacking the teeth… the teeth are being attacked by the same forces that everyone else experiences. When you look at it from this perspective… that decay in pregnant woman occurs via the exact same mechanism as non-pregnant woman… that also lends support to the busting of the myth.

            Thanks again for your comment.

  5. When I became pregnant I had zero cavities and I read and heard horror stories about what pregnancy does to your teeth so I became anal with brushing/flossing/mouth wash 5x a day litterally. I was slightly paranoid. I never got reflux nor morning sickness. I was nauseated all the time but never actually got sick. I also took Calcium/D/magnesium in high doses from 8 weeks up to build calcium levels up. I ate healthy my entire pregnancy worried I would develop GD or gain way too much weight and I didn’t but ate healthy as an ox. Well I did start having gum pain and the dentist of course said its normal. Then shortly after that my teeth would ache and throb. I found out that I was grinding and it was hard to believe I was doing that in my sleep because I didn’t know. My SO didn’t even hear it or know either. I was not under any stress, it was hormone related to pregnancy which I’ve read is very common to clinch/grind . I upped my dose of Calcium/magnesium/D and it became about 50% better miraculously. Not a placebo affect but my teeth didn’t ache near as bad. This could be do to the muscle relaxing effect of magnesium but I don’t know. I still end up getting cavities on high dose mineral supplements. I’m positive it’s all related to hormone changes. I just know it to be true, it’s the only explanation and maybe the grinding had some effect. But a friend of mine never had cavities and started having a bunch of random symptoms including cavities in a short period of time, come to find out her hormones were out of whack. This makes 100% since to me. Hormones play a big role in your teeth. I don’t believe it’s related to Calcium deficiencies for most people from my experience because I was taking high doses plus getting calcium from lots of food sources. I am on a large pregnancy group and I’ve seen two women this month say “OMG my tooth is loose, what’s going on?!”.. (Good tooth) I never had a loose tooth so I’m not sure what that indicates. However I just know for most people it’s hormone related.

Trackbacks

  1. […] lady knows, Twilight was just a teensy exaggeration of the ‘real’ McCoy! So goodbye, hair and dental health! Hello, varicose veins and […]

  2. […] the baby draws calcium away from the mother’s teeth–it does so from the mother’s bones–but because of the surge in hormones that affects a pregnant woman’s entire body. To learn […]

Speak Your Mind

*