Gum Disease and Pregnancy

Pregnancy brings about hormonal changes and physiological adaptations that can affect oral health. Factors such as chronic morning sickness, increased gingival blood supply, and hormonal fluctuations contribute to gingival swelling and an increased risk of gum disease. Additionally, a suppressed immune system, lowered blood pressure, and discomfort during sleep can lead to a neglected oral hygiene routine, further raising the risk of periodontal disease. 

 
Read on to explore the relationship between pregnancy and oral health, discuss the potential risks involved, and provide evidence-based recommendations for preventive and therapeutic measures.

The European Federation of Periodontology

The European Federation of Periodontology emphasises in its manifesto that certain oral bacteria can enter the bloodstream during periodontal disease, triggering inflammatory and immune responses that can impact the fetoplacental unit.  

While evidence suggests a potential association between periodontal health and pregnancy outcomes, further research is required to establish a conclusive causal association and identify specific populations that may benefit from periodontal therapy.

Effects on pregnancy outcomes: ongoing research

Several studies have investigated the potential causal relationship between periodontitis and adverse outcomes during pregnancy. Here are some notable studies:

• Sant'Ana et al. (2011): This study investigated the impact of periodontal treatment on adverse pregnancy outcomes through a controlled clinical trial. The findings of the study indicated that periodontal treatment during pregnancy led to a decrease in the rate of adverse pregnancy outcomes. This suggests that managing periodontal disease during pregnancy can have a positive effect on pregnancy outcomes.

• Daalderop et al. (2018): This overview of systematic reviews was conducted to assess the relationship between periodontal disease and pregnancy outcomes. The findings of the study suggested that there is evidence of an association between periodontal disease and adverse pregnancy outcomes, such as preterm birth and low birth weight. However, the strength of the association varied across the systematic reviews, indicating that further research is needed to establish a definitive causal relationship.

• Zheng et al. (2021): This study aimed to assess the prevalence of periodontitis in individuals clinically diagnosed with diabetes mellitus through a meta-analysis of epidemiologic studies. The findings of the study revealed a higher prevalence of periodontitis among individuals with diabetes compared to those without diabetes. The meta-analysis provided evidence of a significant association between diabetes mellitus and periodontitis. 

• Padilla-Cáceres et al (2023): The study found a significant association between periodontal disease in pregnant women and an increased risk of preterm birth and low birth weight in newborns. Pregnant women with periodontal disease are two to three times more likely to experience these adverse outcomes. 

It is important to note that while these studies provide valuable insights, further research is necessary to establish a definitive causal relationship between periodontitis and adverse pregnancy outcomes. The complex nature of pregnancy and the multitude of factors involved make it challenging to establish causation with absolute certainty. However, these studies collectively suggest a potential link and highlight the importance of periodontal health in pregnancy.

Recommended actions for Dental Professionals

To ensure optimal oral health for pregnant women, dental professionals should adopt a proactive approach focusing on prevention, treatment, and communication.

Ongoing dental care is vital during pregnancy

By understanding the impact of pregnancy on oral health and implementing evidence-based strategies for prevention and treatment, dental professionals can contribute to the overall well-being of both mother and child. Ongoing research is necessary to further confirm the precise mechanisms underlying these relationships. By staying informed and continually updating professional knowledge, dentists can provide the best possible care to their pregnant patients.