During the nine months of pregnancy, a woman`s body undergoes several changes. We are aware of visible bodily changes, such as a growing belly, weight gain, an enlarged uterus, morning sickness, sensitive or sore breasts, and backaches. But how about your dental health?
The most common oral manifestations during pregnancy are caries, gum disease, and bleeding from gums. These are frequently associated with increased hormone production, nutritional changes, and food cravings.
Oral lesion:
Morning sickness (nausea) is a common symptom of early pregnancy. Repeated acid reflux and frequent vomiting expose the oral cavity to gastric acid leading to enamel erosion.
Management strategy:
Reduce oral acid exposure through diet and lifestyle changes, anti-emetics, antacids, or both.
Avoid brushing your teeth immediately after vomiting. Wait an hour and use a soft bristle toothbrush to reduce the risk of damaging the enamel.
Rinse your mouth with plain water instead of products containing alcohol.
Fluoride mouthwashes can protect eroded and sensitive teeth.
2. Caries:
Pregnant women often have late-night cravings for sweet things like chocolate, ice cream, and soft drinks. Snacking often between meals can lead to increased bacterial growth in the mouth, contributing to tooth decay and cavities. Untreated dental caries can lead to oral abscesses and facial cellulitis.
Management strategy:
Brush with fluoride toothpaste and floss often between meals. If you cannot brush your teeth then drink water and rinse your mouth immediately after meals and avoid late-night snacking.
Floss daily to prevent gum disease.
Increase the intake of calcium and vitamin D.
Limit intake of sugary food.
3. Pregnancy oral tumor
Pyogenic granuloma is a vascular lesion caused by increased progesterone in combination with local irritants and bacteria. It is not cancerous. Pregnancy tumors are most common after the first trimester, they grow rapidly and typically recede after delivery.
Management strategy:
Monitoring unless the tumor bleeds, interferes with chewing, or doesn't resolves after delivery.
4. Gingivitis
Gingivitis is the most prevalent oral disease during pregnancy. Gingivitis is an inflammation of the superficial gum tissue in which gums become red and swollen as a result of inflammation that may be exacerbated by fluctuations in estrogen and progesterone levels, changes in oral flora, and an altered immune response.
Management strategy:
Oral hygiene measures such as brushing and flossing are recommended.
Patients with severe gingivitis may need professional cleaning(scaling and root planing) as well as the use of chlorhexidine mouthwash.
5. Periodontal disease(Periodontitis)
If gingivitis is untreated, it can lead to periodontal disease. This causes serious infection in the gums affecting the structure supporting the tooth (gums, ligament, and bone) leading to the formation of periodontal pockets, bone destruction, and tooth mobility. Periodontal diseases appear to be a potential risk factor for preterm birth and low birth weight.
Management strategy:
Eliminate the causes of periodontitis such as comprehensive removal of hard plaques and microbial deposits. The ideal treatment time for periodontitis is during the second trimester(14- 20 weeks)
Pregnancy causes hormonal changes that increase the likelihood of developing gum disease, which can have an impact on the health of your growing baby. It is imperative to prevent the progression of periodontal disease in order to maximize the likelihood of a safe and healthy delivery. Periodontal disease risks can be greatly lowered via adequate home care, dietary adjustments, and vitamin supplementation.
It is essential to maintain proper oral hygiene throughout pregnancy and consult with a dentist about dental procedures that can be safely performed during pregnancy.
References:
1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4318095/
2) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6883753/