Healthy teeth & gums

A study at the University of Carolina showed that serious gum (periodontal) disease during pregnancy increases the risk of premature birth and/or low birth weight in babies by seven times. One of the main reasons for this is that the oral bacteria that cause periodontal disease release a chemical called prostaglandin, which is labour-inducing and may cause premature birth.

More commonly found is something called “pregnancy gingivitis”, an aggravated response to the bacterial film, or plaque, that builds up on teeth. This causes inflammation and bleeding gums. In fact, between 50 to 75 per cent of pregnant women experience this condition. It is a natural consequence of an increase in the concentrations of the hormones oestrogen and progesterone in the body during pregnancy and can be prevented through good oral hygiene.

One of the best things you can do early on in your pregnancy is to have a professional cleaning of your teeth, which will help to prevent most dental problems. During pregnancy you may anyway experience red, puffy or irritated and tender gums that bleed easily, particularly during the second and early third trimester.

The puffiness is often due to the fact that during pregnancy the kidneys retain more water in order to increase the blood volume and provide the placenta with nourishment. The extra blood flow in the body means that even the gum tissues retain more fluid and swell, making them susceptible to bacteria.

Remember that even though pain or sensitivity when brushing may lead you to be tempted to neglect your oral hygiene, this is the last thing you must do, especially if during the first trimester morning sickness caused increased vomiting. You need to eliminate plaque bacteria daily to prevent gingivitis leading to gum disease.

Unfortunately, pregnancy generally worsens existing gum conditions, particulary as the resistance of the gingival tissue in the gums to bacterial infection is reduced and at the same time the increase in progesterone tends to promote the growth of bacteria. The increase in hormone levels can cause the gums to react differently to the bacteria found in plaque. Excess plaque may then harden into a thick deposit called tartar which, if neglected, can cause periodontal disease. This is a serious infection of the gums and bone under the teeth, which destroys the attachment fibres and the bone that supports them, causing irreversible damage to gums and teeth.

Periodontal disease can also cause non-cancerous ”pregnancy tumours“ or swellings on the gums between the teeth. They may need to be removed after birth if they don’t disappear spontaneously. These look like a large lump on the gumline, with deep red markings and are caused by excess plaque. They can be very uncomfortable and can make eating and talking painful.

Treatment of both gingivitis and gum disease requires meticulous oral hygiene and routine professional cleaning.

Signs of periodontal disease

What to look out for:

• Red, swollen, shiny and tender gums
• Frequent bleeding while brushing, flossing or eating
• Mouth sores or ulcers
  
• Bad breath
  
• A bad taste in the mouth
  
• Gums that recede or pull up from the teeth
  
• Changes in how the teeth fit together on biting
  
• Loose teeth
  
• Pus between gums and teeth
  

can I have dental X-rays while pregnant?
Any routine dental work should be delayed, however, limited emergency X-rays are possible in consultation with your obstetrician. If an X-ray is needed in order to determine treatment that will affect your (and your baby’s) health, have the testing done.

what pain medication is suitable during pregnancy?
As most medications pass through the placenta to some degree and enter your baby’s bloodstream, it is best to be cautious as his metabolism can’t yet process them. Up until 32 weeks (the third trimester) anti-pain medication such as paracetamol is considered safe.

can I take antibiotics?
Most antibiotics administered to prevent or treat infection can be taken during pregnancy, for example penicillin. However, tetracycline should be avoided as it may affect your baby’s developing teeth.

what happens if I have a dental emergency?
Seek appropriate treatment but be sure to alert your dentist to your pregnancy if you’re not yet showing. Your dentist will know which local anaesthetic is safest for your baby.

Tips for maintaining good oral health:

• Always remember to brush twice daily with a soft-bristle brush to remove plaque.
  
• Remove food debris from in between teeth by flossing daily.
  
• The use of a recommended anti-bacterial mouthwash is also useful as it can help to prevent gingivitis.
  
• Visit your dentist for regular check-ups and cleanings – pregnant women should have at least two dental cleanings.
  
• Brush or scrape your tongue daily to help remove bacteria.
  
• Avoid sugars and eat nutritious meals and healthy snacks.