Oral Health and Pregnancy Part 2
(courtesy of NZDA)
Pregnancy is a time when women have special health needs. Oral health needs also change during pregnancy when teeth and gums need special care. There is an old wive's tale that says "A tooth lost for every child". While it may be far fetched, it actually was based loosely on fact. Your teeth and gums may be affected by your pregnancy, just as other tissues in your body are. If your gums are in good health before you get pregnant and you clean your teeth well, you are less likely to have problems.
Oral tissues may show an exaggerated response to bacterial plaque during pregnancy due to increased levels of oestrogen and progesterone. These hormones may affect your immune response to bacteria and favour bacterial growth. Therefore you may feel more gum problems at this time.
Pregnant women may experience increased gingivitis (gum inflammation/bleeding gums). This may be more noticeable between the second and eighth months of pregnancy and tends to go away after delivery. It is called pregnancy gingivitis. Symptoms may include redness, bleeding and swelling of your gums. Pre-existing gum disease may worsen during pregnancy. However if you have healthy gum tissue before pregnancy, pregnancy gingivitis may be prevented with good oral hygiene. Unfortunately, pregnant women may find it difficult to maintain good oral hygiene due to morning sickness, which may cause nausea to the smell or taste of toothpaste, or even having a toothbrush in the mouth.
In pregnant women with poor oral hygiene, pregnancy gingivitis may progress into periodontitis, a more severe form of gum disease. If left untreated, periodontitis can cause destruction of the gums and bone surrounding your teeth, resulting in tissue (bone and gum) loss= loose wiggly teeth.
Severe Periodontitis may increase the risk of:
-Preterm birth, low birth weight and pre-eclampsia
The effects can be minimised with professional cleaning (Scaling and root planing) and a good homecare regimen (daily brushing and flossing). It is important during pregnancy to continue your regular dental examinations, so treatment can be provided if required. It may be beneficial to have more regular professional cleaning visits during your pregnancy.
Occasionally, a gum lump can occur during pregnancy called a pregnancy granuloma (or epulis). These are more common after the third month of pregnancy and are non-cancerous. It is caused by the inflammatory response of your gums to local irritants (i.e. bacterial plaque or calculus/tartar). The growth usually looks like a red nodule/lump on the gums between teeth, which may bleed easily and occasionally become ulcerated. The lump is usually painless, but it may become painful if it interferes with your bite or it accumulates food/debris. If a pregnancy granuloma forms, professional removal of plaque and calculus is required, along with good oral hygiene. Pregnancy Granulomas usually go away after your child is born, but it if needs removal- this can be performed by a dentist or specialist periodontist. This procedure is usually carried out after delivery as it may reoccur if removed during pregnancy.
If you experience gum problems during your pregnancy, it is important to visit your dentist. Any treatment you might need can be provided before or after delivery of the baby as required.
Dental caries (tooth decay)
Eating sugary foods and drinking acidic drinks may increase your risk for dental caries during pregnancy. Choose healthy, nutritious food and avoid eating sugary, sticky snacks. Brush your teeth twice daily with a fluoride toothpaste, soft toothbrush and floss every night.
Morning sickness may lead to vomiting during some stages of your pregnancy. Frequent vomiting during pregnancy can have an erosive (dissolving) effect on your tooth surface. Your tooth enamel may dissolve or become softened by gastric acids. Don't brush your teeth immediately after vomiting. Wait for about 30 minutes before brushing your teeth. Instead rinse your mouth immediately with water. Avoid drinking soft drinks or juices to help ease nausea as acidic drinks are highly erosive. The so-called "diet" drinks are also acidic, and if taken frequently can lead to erosion.
A dental exam before you plan to become pregnant will allow identification and treatment of teeth and gum problems beforehand. Otherwise a check up during pregnancy is advisable to help you to maintain good oral health, especially if you have any symptoms of gum disease. If treatment is required during pregnancy, this may be best performed during the second trimester. Emergency treatment can be done at any time with proper safety measures to keep you and your baby safe.