Gum Disease and Pregnancy
"Health is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity."
World Health Organisation
A woman's oral health can be affected during pregnancy for a number of reasons including chronic morning sickness and increased gingival blood supply; a tendency towards gingival swelling and periodontitis.
At the same time, a suppressed immune system, lowered blood pressure and tiredness from discomfort during sleep can result in neglected oral hygiene regime, which raises the risk of periodontal disease.
The European Federation of Periodontology
The European Federation of Periodontology states in its manifesto that evidence has shown that certain oral bacteria can enter the bloodstream and cause inflammatory and immune responses that affecting the foetoplacental unit.
Results from clinical trials have shown that certain populations of pregnant women may benefit from periodontal therapy, such as scaling and root planning carried out during the second trimester.
Clinical studies have associated low birth weight, pre-term birth and pre-eclampsia with maternal periodontal disease in the mother. However, the strength of these connection varies between studies, and some show no association, likely due to differences in study designs study populations and different methods used for assessing and classifying periodontal disease.
What can dental professionals do?
- Careful attention should be given to a woman’s periodontal health prior to (if possible) and throughout pregnancy in order to prevent periodontal disease or identify disease occurrence at an early stage
- Effective preventive measures include diet and nutritional advice
- Recommending a diet rich in antioxidants and fibre while reducing refined sugar intake can be vital for the prevention and management of periodontal conditions
- Periodontal screening for all pregnant patients is essential as well as a detailed medical history is to be recorded and kept up to date throughout pregnancy. Avoid radiographs and elective treatment in the first trimester
- In case of complications or malnutrition problems, specialist advice or referral to a nutritionist must be considered
- Patients should be educated in oral hygiene maintenance and given detailed oral hygiene instructions in order to modulate disease risk throughout pregnancy
- Pregnancy should be seen by dental professionals as a key time to convey the importance of oral healthcare and good nutrition as this advice will be carried through to children and can impact their oral health