Pregnancy and Oral Health

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Pregnant? Then you should be paying extra attention to those teeth! Many primary care physicians and expecting mothers overlook the importance of good oral health during pregnancy despite its potential impacts on the health of the newborn. More researchers are finding that gum inflammation and the resulting inflammatory markers that enter the bloodstream have an impact on low birth weight and preterm birth.

Unfortunately, only 22-34% of pregnant women visit their dentist. Ironically, a shocking 60-75% of pregnant women have gingivitis, i.e. inflammation of the gums. Gingivitis is caused by the accumulation of plaque, a sticky biofilm of bacteria, which covers the gums. During gestation, women experience a rise in estrogen and progesterone levels, increasing the gums susceptibility to the bacteria found in plaque. If untreated, the condition will escalate to periodontitis, an irreversible process whereby plaque migrates below the gum line, causing separation of the teeth and gums. The effect on the newborn is even more grave, as it results in premature birth, low birth weight, and increased dental caries during childhood. Studies show that gingivitis is quite common among pregnant women with 30% demonstrating some form of the disease.

Other studies have discovered that the infected pockets in the mouth, a result of periodontitis, create a favorable environment for the proliferation of oral bacteria. Naturally, the body’s immune system produces high-levels of inflammatory markers such as IL-6, IL-8, and PGE2 to fight off the foreign bacteria. As a result, higher levels of these markers are found in the amniotic fluid and placenta of pregnant women with periodontal disease. This inflammatory response alone prematurely initiates labor and consequently, a lower birth weight. Furthermore, the large presence of PGE2 restricts placental blood flow, causing placental necrosis and restricts intrauterine growth.

Additionally, morning sickness, a common side effect of pregnancy exposes the oral cavity to higher levels of gastric acid. As a result, the constant exposure to higher levels of acidity causes erosion of the dental enamel and consequently, increased sensitivity. Therefore, we advise pregnant women to avoid brushing their teeth immediately after vomiting. Instead, rinse the mouth with a teaspoon of baking soda in a cup of water to neutralize the acid. However when brushing the teeth, a toothbrush with soft bristles should be used to reduce the risk of enamel damage. In addition, a fluoride mouthwash should be used to protect eroded or sensitive teeth.

Now don’t go running to your dentist for a routine cleaning just yet! Dental procedures must be scheduled at particular times during gestation in order to ensure proper fetal development. A study suggests that dental appointments be made during the second trimester into early third trimester, as to avoid harm to the fetus and patient discomfort.

Here are some more tips for maintaining a healthy mouth when pregnant:

  • Think of your daily brushing routine as a marathon, not a sprint. Your gums are sensitive, so brush delicately twice a day for the full two minutes each time. Be sure to use a toothpaste containing fluoride.
  • Floss everyday
  • Visit your dental professional for routine cleanings but be sure to notify him or her about your pregnancy
  • If your pregnancy craving includes sugary snacks, be cautious. Sugar is fuel for the bacteria found in plaque.
  • Eat a balanced diet, full of nutrients, and minerals that will benefit both your health as well as the baby’s growth and development.

Again, oral health is seemingly overlooked by many expecting mothers despite the growing number of reports that demonstrate the significant role of dental on overall health. Conditions such as swelling and bleeding of the gum allow oral bacteria to enter the bloodstream and circulate throughout the body. These bacteria have been linked to several systemic diseases, including cardiovascular disease, stroke, diabetes, Alzheimer’s disease and various cancers. Therefore, the effects of oral health should be given particular attention during pregnancy.

Pregnancy is a time when women may be more motivated to make healthy changes.Visit your physician for an oral examination in order to address maternal oral issues, potentially reducing the risk of preterm birth and childhood caries through oral disease prevention, diagnosis, and early management.