Oral health is an important aspect of general health, even more so during pregnancy, when a lot of physiological changes occur in the body. Whereas most pregnant women know that they should keep a healthy and balanced diet during their...
The information below is from http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/Oral-Health-Care-During-Pregnancy-and-Through-the-Lifespan
Oral health is an important component of general health and should be maintained during pregnancy and through a woman’s lifespan. Maintaining good oral health may have a positive effect on cardiovascular disease, diabetes, and other disorders. In 2007–2009, 35% of U.S. women reported that they did not have a dental visit within the past year and 56% of women did not visit a dentist during pregnancy. Access to dental care is directly related to income level; the poorest women are least likely to have received dental care. Optimal maternal oral hygiene during the perinatal period may decrease the amount of caries-producing oral bacteria transmitted to the infant during common parenting behavior, such as sharing spoons. Although some studies have shown a possible association between periodontal infection and preterm birth, evidence has failed to show any improvement in outcomes after dental treatment during pregnancy. Nonetheless, these studies did not raise any concern about the safety of dental services during pregnancy. To potentiate general health and well-being, women should routinely be counseled about the maintenance of good oral health habits throughout their lives as well as the safety and importance of oral health care during pregnancy.
The 2000 Surgeon General’s report Oral Health in America, stated that a “silent epidemic of oral diseases is affecting our most vulnerable citizens,” including the poor and many members of racial and ethnic minority groups (1). Oral health, which includes health of the gums, teeth, and jawbone, is a “mirror for general health and well-being” (1). The World Health Organization Global Oral Health Programme emphasizes this interrelation and notes that oral health is a determining factor for quality of life (2). To prevent tooth decay, oral infections, and tooth loss, the American Dental Association recommends semiannual dental examinations and cleanings as well as daily brushing and flossing (3). The American Dental Association also affirms the importance of oral health care during pregnancy (4).
|Table 1. Common Oral Health Conditions During Pregnancy|
|Pregnancy gingivitis||An increased inflammatory response to dental plaque during pregnancy causes the gingivae to swell and bleed more easily in most women. Rinsing with saltwater (ie, 1 teaspoon of salt in 1 cup of warm water) may help with the irritation. Pregnancy gingivitis typically peaks during the third trimester. Women who have gingivitis before pregnancy are more prone to exacerbation during pregnancy.|
|Benign oral gingival lesions (known as pyogenic granuloma, granuloma gravidarum or epulis of pregnancy)||In approximately 5% of pregnancies, a highly vascularized, hyperplastic, and often pedunculated lesion up to 2 cm in diameter may appear, usually on the anterior gingiva. These lesions may result from a heightened inflammatory response to oral pathogens and usually regress after pregnancy. Excision is rarely necessary but may be needed if there is severe pain, bleeding, or interference with mastication.|
|Tooth mobility||Ligaments and bone that support the teeth may temporarily loosen during pregnancy, which results in increased tooth mobility. There is normally not any tooth loss unless other complications are present.|
|Tooth erosion||Erosion of tooth enamel may be more common because of increased exposure to gastric acid from vomiting secondary to morning sickness, hyperemesis gravidarum, or gastric reflux during late pregnancy. Rinsing with a baking soda solution (ie, a teaspoon of baking soda dissolved in a cup of water) may help neutralize the associated acid.|
|Dental caries||Pregnancy may result in dental caries due to the increased acidity in the mouth, greater intake of sugary snacks and drinks secondary to pregnancy cravings, and decreased attention to prenatal oral health maintenance.|
|Periodontitis||Untreated gingivitis can progress to periodontitis, an inflammatory response in which a film of bacteria, known as plaque, adheres to teeth and releases bacterial toxins that create pockets of destructive infection in the gums and bones. The teeth may loosen, bone may be lost, and a bacteremia may result.|
|Data from Silk H, Douglass AB, Douglass JM, Silk L. Oral health during pregnancy. Am Fam Physician 2008;77:1139–44; Pirie M, Cooke I, Linden G, Irwin C. Dental manifestations of pregnancy. The Obstetrician & Gynaecologist 2007;9:21–6; Boggess KA. Maternal oral health in pregnancy. Society for Maternal-Fetal Medicine. Obstet Gynecol 2008;111:976–86; and Polyzos NP, Polyzos IP, Zavos A, Valachis A, Mauri D, Papanikolaou EG, et al. Obstetric outcomes after treatment of periodontal disease during pregnancy: systematic review and meta-analysis. BMJ 2010;341:c7017.|
Oral health is an important aspect of general health, even more so during pregnancy, when a lot of physiological changes occur in the body. Whereas most pregnant women know that they should keep a healthy and balanced diet during their pregnancy, avoid any alcohol and cigarettes while they are carrying a baby, they are still unaware of potential risks of not getting proper dental care in pregnancy. Without proper prenatal dental care, oral bacteria can be transmitted from mother to the baby through common parenting behavior or bloodstream.
The most common dental problem during pregnancy is pregnancy gingivitis. Pregnancy gingivitis usually peaks during the third trimester and it is basically an increased inflammatory response to dental plaque which makes the gums swell and bleed.If left untreated, gingivitis might lead to periodontitis, when bacterial toxins are released. The teeth may loosen, bone may be lost and it could result in bacteremia. You could alleviate the symptoms of gingivitis by rinsing with saltwater. Also, prevent gingivitis by cleaning your teeth, flossing, and using fluoride toothpaste at least two times a day. Dr. James Strawn, located in Fort Pierce, Florida, has been guiding women on this topic for over 30 years. Visit his blog to find out more information on how visiting a dentist regularly can improve your oral health.
Needless to say, decreased attention to prenatal oral health combined with the intake of sugary drinks and snacks, will eventually lead to dental caries. Frequent snacks in pregnancy will lead to increasing risk of tooth decay, so especially in pregnancy your oral hygiene should beyour top priority. In addition to oral hygiene, regular flossing and brushing your teeth at least twice a day, good nutrition and intake of vitamins C and B12 will keep your oral cavity strong and healthy. Henry Perky understood this concept long before many and published this information in his book in 1902!
During pregnancy ligaments and bone that support the tooth might loosen, which might result in some tooth mobility, however this quite normal during pregnancy and is no reason for concern if other symptoms are not involved. However, increased exposure to gastric acid and vomiting in early pregnancy might cause tooth erosion. Rinse your mouth with baking soda solution to neutralize the acid that may make your teeth erode.
The best time for dental care in pregnancy is before you are pregnant, when you have just conceived, or when you are planning to conceive; and during the second trimester, from your fourth to sixth month in pregnancy. While elective procedures can be postponed until after the delivery, dental emergencies that create severe pain should be treated at any time during pregnancy. However, you should consult your obstetrician for prescribed medication and anesthesia. X-rays that are needed for emergency procedures can be taken even during pregnancy. You should continue with regular visits to your dentist even when you are pregnant. Make sure your dentist is informed of your pregnancy and provide your dentist with relevant information on changes you have observed in your oral health and the supplements you are taking during pregnancy. Your dentist will help you plan your visits and have a pleasant pregnancy, without having to deal with serious dental problems.