Oral health & Pregnancy

Pregnancy is a time when women have special health needs. Oral health needs also change during pregnancy when teeth and gums meed extra care.

During pregnancy your teeth and gums may be affected by your pregnancy, just as other issues 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. 

Gum disease

Oral tissues may show an exaggerated response to bacterial plaque during pregnancy due to increased levels of estrogen and progesterone. These hormones may affect your immune response to bacteria and favor bacterial growth. Therefore you may experience more gum problems at this time. 

Gingivitis

Pregnant women may experience increased gingivitis (gum inflammation). This may be more noticeable between the second and eighth months of pregnancy and tends to subside 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 due to morning sickness, which may cause aversion to the smell or taste of toothpaste, or even having a toothbrush in the mouth. 

Periodontitis

In pregnant women with poor oral hygiene, pregnancy gingivitis may progress into periodontitis, a more severe form of gum disease. Periodontitis is chronic and usually not a rapidly progressing disease. Hence, the destruction during nine months is mostly not severe. However, if left untreated, periodontitis can cause destruction of the gums and bone surrounding your teeth, resulting in tissue (bone and gum) loss. 

Severe periodontitis (usually pre-existing) may increase the risk of:

• Preterm birth, low birth weight and pre-eclampsia

• Pregnancy diabetes

The effects can be minimized with professional cleaning (scaling and root planning) and a good home-care regimen (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. 

Pregnancy Granuloma

Occasionally, a gum growth may occur during pregnancy called a pregnancy granuloma (or epulis). Pregnancy granulomas are more common after the third month of pregnancy and are non-cancerous. A pregnancy granuloma is caused by the inflammatory response of your gums to local irritants. (i.e.bacterial plaque or calculus/tartar).

The growth usually presents as a red nodule on the gums between the teeth, which may bleed easily and occasionally became ulcerated. The lump is usually painless, however, it may become painful if it interferes with your bite or it accumulates debris. If a pregnancy granuloma forms,professional removal of plaque and calculus is required supported by good oral hygiene. 

If you experience gum problems during your pregnancy, it is important to visit your dentist. Any treatment you might need can be provided before of after delivery as required. 

Dental caries (tooth decay)

Eating sugary foods and drinking acidic 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 fluoride toothpaste and a soft toothbrush. 

Dental Erosion

Morning sickness may lead to vomiting during some stages of your pregnancy. Frequent vomiting during pregnancy can have 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. 

Dental Visits

A dental examination 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 maintain good oral health, particularly 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 undertaken at any time with proper safety measures.