Dental health in pregnancy

"A tooth lost for every child" is more than just an old wives' tale. Left untreated, poor oral health can affect both a woman and her developing baby

How does pregnancy affect teeth and gums?

Just as other tissues in the body are affected by pregnancy, your mouth also undergoes changes. Hormone levels are at an all-time high, making it easier for bacteria to grow on extra-sensitive teeth and gums.

About half of expectant mothers develop pregnancy gingivitis, a condition beginning in the second month of pregnancy and characterized by inflamed, swollen gums that bleed easily.

Periodontitis (or periodontal “gum” disease) is caused primarily by plaque, a sticky, colourless film that forms on the teeth and occurs when oral bacteria is so prevalent that in the late stages it penetrates the gum line and moves into the bone and tissue surrounding the teeth.

So-called “pregnancy tumours,” which are neither tumours nor cancerous, are growths on the gums that occur in a small percentage of women. The red nodules usually appear in the second trimester along the upper gum line as small tags of tissue that bleed easily. Most women with pregnancy tumours also have pregnancy gingivitis.

According to the Canadian Academy of Periodontology, there is some evidence to suggest that periodontal disease may put pregnant women at greater risk of preterm birth and having a low-birth-weight baby. Some researchers have suggested that early labour may be caused by an infection that is spread via the pregnant woman’s bloodstream to the placenta.

More research is needed to study the possible link between the disease and adverse pregnancy outcomes, but researchers agree that avoiding any kind of infection is important during pregnancy. “If things are not healthy in your mouth, then that is going to create problems for the rest of your health,” explains Michael Eggert, a professor of dentistry in the Faculty of Medicine and Dentistry at the University of Alberta in Edmonton.

What steps help ensure healthy teeth and gums?

Scrupulous attention to daily oral hygiene combined with regular professional cleanings and checkups are key to dental health. “You have to brush and floss,” advises Eggert.

Maintain regular checkups regardless of how far along you are in your pregnancy and tell your dentist if you are pregnant or trying to conceive.

X-rays should be avoided during pregnancy unless absolutely necessary.

Schedule an appointment immediately if you have bleeding or painful gums, have persistent bad breath, or you discover a lump or growth in your mouth. Losing a tooth or tooth pain also warrant a visit to your dentist.

Although early intervention and good oral hygiene habits can reverse gingivitis, periodontal disease requires more extensive treatment. Depending on how advanced the disease is, procedures like scaling and root planing (deep cleaning) may be recommended.

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