Dr. Anuj Manocha

Oral Health Complications During Pregnancy

Recent findings have reported that oral bacteria and their by-products can possibly pass the placental barrier keeping oral health at prime importance during pregnancy. An awareness related to oral health during pregnancy cannot be neglected or avoided in order to minimize the complications.

This article focuses on few points related to the necessity of oral health during pregnancy. 

Pregnancy comes with many responsibilities making expecting mothers more concerned about their health. However, many pregnant women may not be aware of oral health and its effect on the developing child. Negligence of oral health is quite common during pregnancy due to lack of alertness of oral hygiene and its effect on systemic health.

Moreover, pregnancy discomforts like frequent bouts of nausea, increased physical demands, weight gain or certain dental problems like pregnancy gingivitis or inflammation of gums may be dangerous to developing fetus.  

Risk of oral problems during pregnancy:-

Few common oral problems associated with pregnancy are as follows. 

Pregnancy Gingivitis: 

Hormonal changes during pregnancy leads to pregnancy gingivitis. It is a condition of bleeding gums, redness. Moreover inflammation, swelling and tenderness are also observed. Ignorance of such problems may lead to serious gum disease.  Frequent cleaning can avoid such dental issues. Progesterone levels are elevated during pregnancy which stimulates the production of prostaglandins and leads to inflammation of blood vessels in gums.

Tooth Decay:

Diet during pregnancy is of high importance. It is designed to nourish both mother and unborn baby. Diet rich in carbohydrates actually increases the risk of tooth decay. The morning sickness increases acid secretion in the mouth which is harmful to enamel. 

Pregnancy tumors: 

Overgrowth of tissue on gums in pregnant women are called as pregnancy tumors. They are noncancerous and generally observed in the second trimester of the gestation period. It is nothing but swollen gums between teeth. The bleeding and reddening of gums observed in such conditions.  

Periodontal disease and preterm birth:

Untreated gum disease or periodontal problems can development periodontitis characterized by inflammation and infection of the gums and supporting structures of the teeth. 

This ultimately leads to loss of supporting material and finally the teeth themselves. 

A study result has revealed that there is a relation between preterm birth and presence of gum diseases in the pregnant women. The reason is not yet known. 

However, research study findings have evidence that oral bacteria or their byproducts can pass placental barrier. This initiate inflammatory response leading to preterm birth. 

Another correlation exists between the gum disease and the increased rate of pre-eclampsia, a condition of high blood pressure during pregnancy. The positive correlation suggests that gum disease may cause stress to the blood vessels of the mother, placenta and the fetus.

The basic periodontal therapies like oral hygiene instructions, scaling, root planing and prophylaxis can substantially decrease the level of prostaglandin responsible for inflammatory response. 

The regular treatment and follow-up in pregnant women can maintain good oral health and minimize the risk of preterm birth. 

Dental treatment during pregnancy: 

The dental procedures mostly include the use of X-rays and use of anesthesia. In the case of pregnancy, these procedures can be used with precaution. 

Therefore, before sitting on dental chair patient should declare her pregnancy to the physician. Untreated dental infections can harm fetus as well as the mother. 

The emergency situations request use of dental radiographs which can’t wait. The radiation of dental x-ray is generally very low and precaution is always taken for lowest radiation exposure. A leaded apron including collar, shields can be used to prevent abdominal exposure to the x-ray radiation. 

Use of dental X-ray is not at all contraindicated in pregnancy when used with precaution. 

The use of local anesthesia is also not contraindicated in the pregnancy. 

A clinical trial result showed that there is no harm in the use of local anesthetics during pregnancy. It is not linked with increased risk for major medical problems like cerebral palsy, cleft lip and heart defect in newborns. 

The medication prescribed during dental treatment mainly includes local anesthetics, analgesics, and antibiotics. Most of them can be used with safety precautions. Each drug has its own pregnancy category which should be considered during its use. 

The antibiotic like tetracycline can permanently cause discoloration of developing teeth.  

Prevention: 

Dentists can educate patients with following points to avoid problems associated with oral hygiene. 

• The patient should declare the pregnancy to  the Dentist 
• Follow routine oral checkup. 
• Undergo all elective and emergency procedures. 
• Follow good oral hygiene practice ask for a better toothpaste.
• In the case of morning sickness avoid sweets and snacks which increase the risk of tooth decay. 
• Have healthy and balanced diet. 

Awareness of oral health during pregnancy is a must to avoid complications.