What Every Expectant Mother Should Know
By Sheila Wolf, RDH
On at least three separate occasions, I can
remember having the privilege of breaking the news of a young
woman's pregnancy from my side of the dentist's chair. I use
the word "privilege" with my tongue planted firmly in my cheek,
however. After all, the diagnosis was only determined because
of the patient's tender, red, swollen gums. Ouch!
Talk about taking the good news with the
bad . . .
Known as pregnancy gingivitis, this unpleasant
condition is often assumed to be one of the natural consequences
of the hormonal changes often found in pregnant women. The
hormones involved, estrogen and progesterone, are secreted
in progressively greater concentrations throughout most of
pregnancy. While this reaction is necessary for preparing
a woman's body for the journey ahead, the resulting flood
of hormones results in a variety of effects.
Hormones tell the kidneys to retain water in
order to build blood volume to have enough to nourish the
placenta. Thus a pregnant woman has 40% more fluid in her
body. As a result, this increases the amount of fluid in all
the cells in the body, including the gum tissues, which causes
them to become "puffy." Between the time of conception and
the seventh month of pregnancy, hormones will triple in quantity,
and then remain at that heightened level until delivery.
Meanwhile, as if she doesn't have enough to
contend with, the pregnant patient with hormones out of whack
is swollen and tender and sometimes cannot do an effective
job with her oral hygiene.
I am pleased to tell you that with above standard
oral hygiene, this condition can be almost entirely avoided.
Remember, it is the bacteria, not the hormones, which cause
the gingivitis. Despite the fact that the statistics reveal
50-75% of all pregnant women develop pregnancy gingivitis,
that doesn't have to mean you. If you are reading this book
after the fact, you can be assured that this condition is
reversible with proper home care, techniques, tools, and medicines.
Dr. Thomas Rams, professor and chairman of the
Department of Periodontology at Temple University School of
Dentistry in Philadelphia, says, "There are hormonal shifts
in pregnancy that reduce the gingival tissue resistance to
infection, and there is also an increased risk that the hormones
circulating will help promote the growth of certain bacteria
and plaque, which causes inflammation."
Rams also says, "In periodontitis, bacterial
plaque infection not only causes inflammation of gingival
tissues like gingivitis, but also progressively destroys connective
tissue fibers and surrounding bone anchoring teeth to the
jaws, resulting in the loss of teeth."
Knowing how to minimize the bacterial biofilm
in your mouth, and especially along the gum line, is the key
factor in preventing pregnancy gingivitis and the escalating
symptoms that often continue during pregnancy. However, a
woman needs to be taught before she gets pregnant how to eliminate
bacteria on a daily basis.
Because gums can be painful, puffy, and bleeding
during pregnancy, the tendency is to avoid touching them.
However, it is imperative that you practice good oral hygiene
during pregnancy to avoid both tooth decay and gum infections.
Pregnancy, with its three-fold increase in hormones, may exaggerate
the body's normal response to dental plaque.
It need not increase your risk of getting
gum disease . . .
Although relatively rare, the body's response
to inflammation may produce another offset of the "joy" of
childbirth: a pregnancy "tumor" (also called pyogenic granuloma).
This "tumor" may develop on the gums in response to the irritating
bacteria that collects there. Rest assured, however, that
these growths of extra tissue are usually painless, and totally
benign. However, if they get large these "pregnancy tumors"
can become annoying and should be treated. Meticulous oral
hygiene is the answer to avoiding the inflammation associated
with these growths, and it is comforting to know that they
usually subside after childbirth.
Fascinating Factoid: "Occasionally chewing sugarless
gum is helpful to increase the amount of saliva in your mouth,
without contributing to the risk of gingivitis. It may also
be helpful in averting the nausea so common in the first three
months of pregnancy."
Brushing, flossing, and irrigating daily (all
done gently but deliberately) are important in preventing
gingivitis, during pregnancy and anytime in your life. In
addition, it is important to pay attention to eating more
healthfully for yourself and your baby, by substituting fruits,
cheese, nuts, and vegetables for those sugary foods you might
have enjoyed before becoming pregnant. If your gums are tender
and brushing is painful, try ice, or several helpful over
the counter products that will soothe painful gums. These
- Peroxyl mouth rinse
- Amosan oral rinse
- Anbesol liquid
- Orajel Mouth-Aid
(Please be sure to ask your doctor if she has
objections to any of these products.)
Sheila Wolf, RDH, affectionately called Mama Gums, has been a registered dental hygienist since 1971. She is currently retired from clinical practice but enjoys writing, speaking, and consulting on various oral health issues. She has authored two award-winning books, Pregnancy and Oral Health: The critical connection between your mouth and your baby, and Your Mouth Could Be KILLING You. Both are available on her website, http://www.mamagums.com/about_book.html, through Amazon, and at finer bookstores everywhere. Sheila also works with people privately as an oral wellness coach, educating and empowering people to keep their natural teeth for a lifetime, avoid gum surgery, and just possibly add years to their lives. You may reach Sheila through her website, www.mamagums.com or in San Diego at 866-MAMA-GUMs.
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