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Dental Problems and Preterm Delivery: What is the Relation Between Oral Health and Pregnancy?

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Oral health is an integral part of general health. And dental issues during pregnancy are often associated with preterm births. Evidence suggests that oral diseases, particularly gum diseases, may influence preterm births and low birth weight babies. 

Pregnant women with gum issues are seven times more likely to have premature births and children with low weight at birth. And so, pregnant women particularly will need to take care of their oral hygiene and have regular dental checkups. And avoid the build-up of plaque over the gums and teeth. 

This article explores everything you need to know about oral health during pregnancy and how good oral hygiene promotes a healthy pregnancy. 

Also Read: https://pregajunction.com/blog/maggi-during-pregnancy/

How are oral health and pregnancy interlinked?

Good dental hygiene is an integral part of ensuring a healthy pregnancy. The fluctuating hormones during pregnancy can affect gum tissues, causing inflammation, redness, and soreness. This condition, referred to as pregnancy gingivitis, causes the plaque and bacteria to accumulate along the gum line and between the teeth. Thus, worsening gingivitis, leading to periodontitis. 

Additionally, vomiting due to morning sickness may cause the stomach acids to reach the mouth and harm the teeth. The stomach acids can erode the tooth enamel, promoting tooth decay and infections. 

A regular checkup at the dentist during pregnancy is often recommended as preventive treatments like dental cleanings during the first trimester will help keep gums healthy and strong. Sometimes, your dentist may suggest X-rays or additional invasive dental procedures to treat dental decay and infections. 

It is important to note that the radiations from the X-rays are principally low and are less likely to cause any risks. Women during pregnancy and breastfeeding can have an X-ray and required dental procedures done. 

Maintaining good oral health during pregnancy is paramount as gum diseases during pregnancy may impact the incidence of preterm births and low birth weight babies.

Preterm births and developmental delay

Preterm births are when a newborn is born before 37 weeks gestation. Preterm births can result in; 

  1. Low birth weight (LBW), where the child’s weight at birth is lesser than 2.5kgs or 5.5 pounds or 
  2. Very low birth weight (VLBW) babies with a birth weight of less than 1.5kgs or 3.3 pounds. 

One of the major reasons for short gestation and premature births is malnutrition and poor hygiene. Statistics show that premature birth and low birthweight babies significantly contribute to infant mortality, congenital development delays, and disabilities in India. Disorders associated with short gestation and low birth weight are the second leading cause of infant death in India. 

With long-term health consequences and numerous health complications, babies born before the term are the leading obstetric problems in India and the world. 

Association between periodontal disease and preterm births

Gum infections, periodontal diseases, or periodontitis are highly preventable infections caused by bacteria that initiate plaque formation and damage the soft tissue of the gums. If left untreated, it can damage the bone supporting the teeth. Healthy gums are firm, pale, and light pinkish, while the diseased gums have some of the following features indicating periodontitis. 

  • Inflamed, puffy gums
  • Reddish or purplish gums
  • Tender gums that bleed easily
  • Bleeding while brushing or flossing teeth
  • Bad breath
  • Pus formations in the gums or between the teeth
  • Receding gums and the teeth look longer than usual
  • Loosening of teeth
  • Painful gums while chewing
  • Extra spaces developed newly between the teeth

Increased activity of the gram-negative bacteria in periodontal diseasesA. actinomycetemcomitans, P. gingivalis, P. intermedia, B. forsythus, C. rectus, E. nodatum, P. micros, S. intermedius, and Treponema sp have their activity up to 10(5) times larger. The escalated bacterial activity in pregnant women with periodontitis is known to be the culprit for preterm births and low birth weight babies. 

A couple of theories explain how oral bacteria can affect pregnant women, causing preterm deliveries and low birth weight infants. It is believed that periodontal or gum diseases may lead to bacteria spreading from the mouth to the placenta or amniotic fluid, causing preterm births. Another theory explains that the systemic inflammation and damaged gums caused by prostaglandin may be the reason for preterm labor and early membrane rupture. 

Preterm babies come with a bundle of health issues and associated long-term consequences. As periodontitis is a preventable oral condition, the pregnant mother needs to improve oral health before and during pregnancy. 

The relation between gingivitis and preterm births

Among the other dental issues, many pregnant women experience gingivitis. Seen mostly during the second or third month of pregnancy, significantly increases in severity up to eight months of pregnancy. Statistics suggest at least half of the pregnant population experience gingivitis. Gingivitis is a milder version of periodontal infection but is highly common among pregnant women. Caused by the P. gingivalis, gingivitis causes redness, inflammation, and irritation of the gingiva- the area of the gum forming the base of the teeth. 

Gingivitis can lead to more serious infections like periodontal disease and loss of a tooth. This uncomfortable condition, gingivitis, sometimes reacts with irritants causing ‘pregnancy tumors’- painless, non-cancerous growths in the oral cavity. The plaque formation build-up is one of the main reasons for gingivitis that can create a risk of preterm birth in pregnant women

However, good oral health habits- brushing at least twice a day, flossing daily, and getting regular dental checkups can help prevent and reverse gingivitis.

How to improve oral health before and during pregnancy

Some of the tips for maintaining good oral hygiene include: 

  • Brushing teeth with fluoride toothpaste and gums twice a day and flossing every day. 
  • Visit the dentist regularly during pregnancy to check on the oral health condition. 
  • Make wise nutritional choices and choose healthy snacks between meals. 
  • Limit the intake of sweets and sugar-based foods and drinks. Snacking more often between meals and eating too many sweets may lead to tooth decay and plaque formations. 
  • Include Vitamin C and Calcium-rich foods in the diet and include vitamin and calcium supplements, if necessary, after consulting with the doctor. 
  • Avoid smoking before and during pregnancy.

Also Read: https://pregajunction.com/blog/guava-nutrition-facts-safe-pregnancy/

Conclusion

For questions- is it necessary to visit the dentist during pregnancy? How is dental health related to pregnancy health? Or is it safe to take a dental X-ray during pregnancy?

Oral health is an inevitable part of general health. Pregnancy health also is greatly influenced by dental health conditions. Pregnancy hormones play a vital role in increasing oral bacterial activity, causing dental problems. The article talks about how oral health can impact pregnancy outcomes and how dental infections are prevented. 

For pregnant women, ensuring healthy teeth and gums before, during, and after pregnancy is essential to avert the risk of preterm birth and low birthweight babies.

Pooja N Swamy (M.Sc Biomedical Sciences)
Pooja Holds Master's Degree in Biomedical Sciences from Vellore Institute of Technology. She believes in strong research and clear understanding over the subject. Always determined and focussed with a thirst to learn new things. Hardworking, flexible and grounded to align with the goals.

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