What you Need to Know about Pregnancy, Gum Infections, and Neonatal Health
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Dr. Ratna Bajpai is a dental surgeon and periodontist with over 15 years of experience as a healthcare provider. She has a background in teaching dental students and volunteers for community outreach programs that improve public health awareness. She looks forward to sharing her clinical experiences through writing.
Welcome to the second trimester! Your trusted guidebook says that this is going to be the most comfortable phase of your pregnancy, and you’re looking forward to it. Radiating a spirit of confidence, you begin the day with the tooth brushing routine. All of a sudden, your effervescent demeanor seems to be replaced by a sense of uneasiness. You realize that what you’ve just rinsed out looks unmistakably blood tinged!
Few things can be more upsetting than the discovery of blood, especially if it happens to be one’s own. The sight of it tends to get on your nerves and stay there. You lean towards the mirror and peer anxiously into your mouth. When you come to inspect it in detail, it occurs to you that the gums look noticeably redder and slightly swollen too!
If you’re brooding over this sudden and unexpected turn of events, you’re not alone.
Pregnancy and Gum Infections
Pregnancy, itself, does not cause gingivitis or gum inflammation. The hormonal changes during pregnancy alter the response of the gum tissues to oral bacteria. Increased levels of estrogen and progesterone can dilate the tiny blood vessels present in the gums, and make them more permeable. These mechanisms increase the risk of inflammation leading to a condition called “pregnancy gingivitis.”
If left untreated, the condition may worsen and involve the deeper supporting tissues leading to gum disease. Gum infections are silent infections that go undiagnosed until irreparable damage occurs. One or more of the following changes may become noticeable from the second or third month of pregnancy and increase in severity by the eighth month:
- Redness, tenderness, swelling of gums.
- Bad breath.
- Gums that bleed on brushing or eating.
- Discharge from gums.
- Tooth mobility.
- In some cases, there may be inflammatory overgrowths on the gums in response to bacterial irritation. If these growths interfere with the bite, there may be ulceration and pain.
Gum Infections and Neonatal Health
Multiple studies have reported that bacteria associated with gum disease in pregnant women have the pathogenic ability to increase the levels of certain inflammatory mediators in the blood circulation. These, in turn, stimulate dilation of cervix and labor, leading to premature births and low birth weight babies. Pregnancy complications are not only a source of emotional trauma to the expectant mother and the family; they also substantially escalate the nation’s health care costs.
Clinical recommendations from The American Academy of Periodontology (AAP) and The European Federation of Periodontology (EFP), in 2013, urge pregnant women to maintain gum health:
- All women who are pregnant or planning a pregnancy should receive dental counseling. It is important to have a conversation with your dentist about the most appropriate form of dental care.
- Dental hygiene procedures like scaling and root planing are effective in controlling gum inflammation and can be safely carried out in any phase of pregnancy.
- During pregnancy, one needs to increase the caloric intake in the form of multiple, small meals; thus increasing the chance of dental decay. It is important to restore such teeth and address the infection at the source.
- Most routine procedures can be carried out in any stage of pregnancy. However, the second trimester is considered to be most favorable.
- In case of acute infection, immediate treatment is important to minimize complications, regardless of the stage of pregnancy.
- Home oral care should be meticulous.
- A healthy diet, exercise, maintenance of optimal body weight and smoking cessation are essential. They help to promote immune functions, reduce inflammatory responses and improve glucose control.