The link between pregnancy complications and gum disease

Dentist Dr Mark Psillakis discusses the link between premature birth and oral health and why it’s so important to visit your dentist when you’re expecting. 

If you’ve recently discovered you’re pregnant, you’re likely to have already booked an appointment with your doctor. But many people don’t realise how important it is to check in with their dentist too. 

Research suggests that 18 in every 100 premature births may be triggered by an advanced form of gum disease called periodontitis.  

Unfortunately, pregnancy can also make women more susceptible to gum disease. 

Dr Psillakis says many women avoid the dentist during pregnancy because they’re worried routine treatment could harm their unborn baby.

“This is not the case, in fact leaving oral or dental conditions untreated is potentially a lot more detrimental than the treatment,” he says.

Here’s what you need to know. 

Gingivitis during pregnancy

Four in 10 women on average will develop gingivitis (early gum disease) at some stage of their pregnancy, with some studies suggesting it could be as high as 60 to 75 per cent.

“The hormones that are responsible for the development of the placenta also have an impact on gums, which can make them bleed easily,” Dr Psillakis says.

“During pregnancy, gingivitis can be aggravated by fluctuations in oestrogen and progesterone levels, combined with a decreased immune response.”

Symptoms of gingivitis include bleeding gums, particularly when eating or brushing, and swelling or redness of the gums.  

Gingivitis can be caused by poor oral hygiene and can be relatively easy to treat with the help of your dentist.   

Periodontitis during pregnancy

Periodontitis is the most serious form of gum disease during pregnancy.

“Periodontitis is an advanced form of gingivitis which has been linked to preterm birth, low birth weight, or both,” Dr Psillakis says.

“One review confirming this link looked at 24 different studies across 12 countries, so it’s a link we can’t ignore.”

Periodontitis can occur if gingivitis is left untreated, so the best way to avoid it is to pay close attention to your oral hygiene and to regularly visit your dentist.

Symptoms of periodontitis include inflamed, swollen gums, a small (2-3mm) pocket around the tooth, receding gums, bad breath, loose teeth and tenderness when biting.

There are some significant risks associated with premature birth.

The chance of a child surviving premature birth depends on the length of the gestation period and a baby’s birth weight. Full-term pregnancy is considered to be between 37 and 42 weeks.

Some of the complications for a baby born prematurely can include chronic lung disease, breathing difficulties, jaundice, temperature control difficulties and feeding difficulties. Around one in three babies born before 24 weeks will also develop a significant disability. 

Pregnant woman folds baby clothes

Pregnancy tumours 

One in 10 pregnant women on average will develop pregnancy tumours in their mouth, which most commonly occur in the second trimester.

“These lesions are an extreme inflammatory response to irritation from food particles or plaque. This inflammation is exacerbated by the increase in pregnancy hormone levels,”  Dr Psillakis says.

Pregnancy tumours may develop on the gums, tongue, palate or cheeks and usually resolve after childbirth.

“Pregnancy tumours are usually just left alone and observed – unless they bleed, interfere with chewing or do not resolve after delivery,” he says.

Other mouth changes during pregnancy

Dr Psillakis says pregnant women are at higher risk of tooth decay.

Vomiting from morning sickness can cause acidity in the mouth and women often experience an increase in sugary cravings.

Increased levels of oestrogen and progesterone can also affect ligaments and bones that support the teeth, occasionally causing teeth to loosen during pregnancy, even without gum disease. 

Is it safe to visit the dentist when pregnant?

As long as you tell your clinician that you are pregnant, a visit to the dentist is safe during pregnancy.

“During the second and third trimester, dentistry can become a little more uncomfortable simply because it can be difficult to lie in the appropriate position in the chair, as a result of the size of the unborn child,” Dr Psillakis says.

Just as women may prepare their bodies for pregnancy, like losing or gaining weight and taking folic acid, Dr Psillakis says a thorough dental examination should be factored in too. That way any necessary treatment can be completed before conception.

“In the absence of any major issues, expectant mothers should become more thorough with their oral hygiene routines and should certainly maintain their regular check up and clean appointments every 6 months, or more often if deemed necessary by their dental practitioner," he says.

Find out more about x-rays and dental surgery during pregnancy here.

To find your nearest Bupa Dental clinic, which is open to everyone (not just members), click here.

Some extra tips to look after your oral health during pregnancy include:

  • Rinse your mouth after vomiting instead of brushing straight away (this can damage the enamel). Rinsing with a teaspoon of baking soda can help neutralise the acid
  • Book appointment with your dentist
  • Switch to a soft toothbrush
  • Maintain a balanced, healthy diet while limiting sugary foods
  • Brush your teeth twice a day, morning and night
  • Floss daily
If you experience retching while brushing, you could try:
  • Using a smaller brush head (like a child’s toothbrush)
  • Slow down your brushing
  • Listen to music
  • Switch toothpaste brands if your toothpaste is effecting your gag reflex 
Pregnancy oral health - Bupa Dental
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