Periodontal disease and pregnancy
THE maintenance of healthy teeth and gums is an important and often overlooked aspect of our overall health. Many times when planning pregnancy, gums and teeth are not included in the discussion between women and their health care providers. The result is that some women have painful gum disease or tooth decay in pregnancy, which is more difficult to treat because of the risks to the pregnancy.
Pregnancy causes decreased immunity in the mother, which can increase the risk of dangerous gum disease from plaque on the teeth. Plaque is a sticky, colourless film of bacteria and sugars that constantly forms on our teeth. It is the main cause of cavities and gum disease. When plaque is not removed, it can cause gingivitis — red, swollen and tender gums that bleed easily. If gingivitis is already present, it is likely to get worse in pregnancy, and if left untreated, it can lead to periodontal disease.
Periodontal disease is a long-term inflammatory condition caused by bacteria that attack the gum tissue and, if severe, can affect the bone supporting the teeth. If it is not treated it can lead to tooth loss and may even increase the risk of diabetes and cardiovascular disease.
The problem with this, aside from the discomfort to mommy, is that periodontal disease increases the risk of delivering a baby prematurely or having a baby with low birth weight. Excessive bacteria from the gum disease can enter the bloodstream and travel to the uterus where it can cause a series of effects that trigger premature labour. Prematurity and low birth weight put babies at risk for long-term health issues that can even last into adulthood, including delayed motor skills, learning disabilities, lung issues, feeding problems, vision and hearing difficulties, and cardiovascular disease.
In light of this, it is most important to establish healthy oral hygiene habits before pregnancy and maintain them during all trimesters. If planning for pregnancy, get a thorough check-up by your dentist to map out a plan for your oral care. Prevent gingivitis by brushing at least twice daily with a soft bristle toothbrush, paying close attention to the gum line. Ensure the toothpaste has fluoride to strengthen teeth. Floss daily, especially before bed, getting down between teeth and the gum line. Maintain good nutrition with special attention to vitamins C and B12 (which are also found in prenatal supplements). Make sure to see your dentist/dental hygienist for cleanings every six months so that any early changes can be picked up and treated easily.
Routine dental exams and cleaning can be continued normally throughout pregnancy, but if a routine surgical/dental procedure is required, it is safest for the baby in the second trimester (middle part of pregnancy). Dental emergencies, however, (especially if causing severe pain), may be treated in any trimester after discussion with your obstetrician. X-rays should be done in emergency situations only, and always advise your dentist if you are pregnant or planning a pregnancy soon. Elective and cosmetic procedures should wait until after the birth of the baby.
Routine dental health by regular brushing and flossing and keeping regular appointments with the dentist decreases the chances of significant periodontal disease in pregnancy, and helps to ensure a safe pregnancy and healthy baby.
Dr Anna-Kay Taylor Christmas is a consultant obstetrician and gynaecologist at the Obs and Gynae Centre, Winchester Business Centre. She can be contacted at drtaylorchristmas@ gmail.com or 908-3263, 906-2265, 325-7362.
