Pregnancy and dental care

Being pregnant doesn't mean missing regular dental checks and having great dental hygiene, in fact, it is even more important now.

How does pregnancy affect your dental health?

Pregnancy gingivitis (Swollen gums) is caused by significant increase in the levels of the hormones oestrogen and progesterone.  The hormones increase blood flow to the gums and this causes softness or swelling and increased sensitivity of the gums.  Pregnancy also changes the microbiome of the mouth and affects the way the body responds to plaque and infections, reducing the body's normal response to bacteria in the mouth leading to peritonitis.

The risk of gingivitis usually increases in the second trimester and stays high the postpartum.

Other things that can affect your teeth and gums is high sugar diets, not brushing and flossing (tricky when your gums are sore or if brushing makes you feel nauseated) and if you have experienced a lot of vomiting which can affect the enamel on your teeth.

The good and the bad

Let's start with the bad.  So, apart from sore bleeding gums, periodontitis (gum disease or infection) is associated with a number of diseases, such as pneumonia (especially in the elderly), diabetes and atherosclerosis and heart attack.  That might be surprising and the connection may not be obvious initially.  There are a couple of theories about how this happens but the main one is bacteria from the periodontitis enters the blood and travels to other areas, for example, causing arterial plaques in atherosclerosis.

In pregnancy, the infection and inflammation may affect the placenta and is associated with preterm birth, pre-eclampsia, smaller babies and gestational diabetes melllitus (GDM).  A couple of recent meta-analyses, where researchers review all the studies done to date found that periodontitis was associated with an 66% increased risk of GDM!  Note - that is periodontitis, not gingivitis which more than half of all pregnant women experience at some point. And if a pregnant woman had periodontitis and cavities, then this affects her baby's teeth later in life.

Ok, let's get onto the good!  The scarier risks are associated with more advanced periodontitis, so you can reduce your risk by having good dental hygiene and if you have milder conditions, you can treat it before it progresses.  Plus, if you do have more advanced periodontitis, having it treated reduces your risk of preterm birth, pre-eclampsia and GDM.

What you can do

Get regular dental checkups before and during pregnancy - in the second trimester ideally.  Let your dentist know if you have any pregnancy-related conditions or are considered a high-risk pregnancy.

Brush your teeth 2-3 times a day and floss daily.

Using a soft-bristled toothbrush can help reduce tooth and gum sensitivity.  Minimising very cold or very hot food can also reduce tooth sensitivity.

Check you gums and teeth: be on the look out for gingivitis which is the first stage - stop it here and it doesn't progress to being periodontitis. Signs and symptoms include:

• Redness and swelling
• Tenderness in the gums
• Bleeding of the gums, even when you brush your teeth gently
• Shiny gums

Other dental problems to look out for, and to see your dentist about include:

• Bad breath
• Loose teeth
• Mouth sores or lumps on the gums
• New spaces between your teeth
• Receding gums (when your gums pull away from your teeth so you can see roots of your teeth) or pus along your gumline (where your gums meet your teeth)
• Toothache or other pain

Avoid having a lots of sweets and sugary foods and soft drinks.

There is also some research to show that omega 3 fatty acids can help prevent pregnancy complications from periodontitis, probiotics may support a healthy oral microbiome and the CoQ10 applied to the gums can reduce inflammation and support healing.

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