18/04/2022
Oral health and pregnancy
Pregnancy is one of the most important phenomena in women’s life. In general females from age 18-45 are most common to carry a pregnancy. That accounts for a large group of population. Women are generally well aware of the dos and donts in pregnancy mostly thanks to experiences from their mother, grandmothers, fellow counterparts etc. Also, Gynecologist and Obstetricians are no longer unfamiliar terms these days with advent of modern medicine. However dental or oral health for pregnant women is not that frequently talked about and there is a still a long way ahead considering the importance of oral health in pregnancy and lactation (feeding mothers).
Now let’s shed light on some common dental problems in pregnant women. Pregnancy is associated with increase in female s*x hormones like estrogen and progesterone. These hormones alter overall defense mechanism of body against infection by reducing antioxidant levels and exaggerating the inflammatory response. It means plaque and calculus in oral cavity will lead to increased inflammation, bleeding, redness and swelling in gums. This is termed as pregnancy gingivitis. If not treated or taken care of can easily lead to periodontitis that leads to destruction of bone supporting the tooth. Ultimately leading to tooth mobility or tooth loss. Pregnancy tumor is also a common finding on gums in pregnancy that might lead to bleeding when touched, eating difficulties, pain and tenderness leading to overall degradation of general health. Also, it is found that bacteria in oral cavity can cross placental barrier leading to complications like early pregnancy (preterm), low birth weight babies (less than 2500gm) or preeclampsia (high blood pressure and loss of protein in urine), Still birth (death of baby before delivery), neonatal deaths (deaths just after delivery) or maternal deaths are also some uncommon complications of poor oral health. Thus, oral hygiene maintenance is no alternative but a must do thing in pregnancy.
Now what to do to avoid these problems? Firstly, do not skip your routine dental examinations. Yes, they are absolutely safe even in pregnancy. Diagnostic radiations (X ray) have shown to have little effect on baby. Ask for lead aprons from your dentist before any dental x ray examination. It will reduce the risk of exposure to your baby. Most medicines routinely used in dentistry are category B drugs and are safe in pregnancy, still they are to be taken only after your dentist recommends. Some drugs may affect health and development of your baby and hence caution is required. No self-medications for sure. Make sure you undergo routine oral prophylaxis i.e., cleaning and polishing as soon as you miss your periods. Maximum pregnancy gingivitis cases are seen in second and third trimester. Second trimester is generally safe for all dental treatments. That doesn’t mean emergency dental procedures are to be postponed. They can be carried out during any trimester. Pregnancy tumor generally subsides spontaneously after delivery as hormonal levels settle down. In some cases, though surgical removal is needed. Plaque control and scaling will help to control tumor size and postpone surgery till delivery.
Need of the hour is awareness regarding oral health of pregnant and lactating mothers. General dental checkup has to be done in first trimester and majority treatments can be carried out and planned in second trimester. Routine oral health measures like brushing twice and flossing along with professional cleaning and polishing can help improve symptoms of gingivitis in pregnancy. It is always advisable to visit a Periodontal Surgeon for pregnancy tumor or pregnancy related periodontitis. Also, carious tooth and dental pain are not to be overlooked as that will impact mothers’ nutrition and indirectly impact growth and development of the baby.
Evidence is also rising regarding association of periodontal status and risk for pregnancy related complications like preterm birth, low birth weight babies and preeclampsia. All and all general dental check ups are absolutely safe in pregnancy and are highly recommended. Dental treatments are not to be postponed if they have an impact on mothers’ nutritional status and general health.
Dr Rishikesh Parekh MDS Periodontology
Dr Shefali Parekh MDS Periodontology
Perio-edge dental Pune
