Common oral health problems during pregnancy
The oral changes most frequently reported during pregnancy include salivary changes, gingivitis (inflammation of the gums with bleeding), gingival hyperplasia (swollen and red gums), pyogenic granuloma (over- grown gums), cavities (tooth decay) and dental erosion (tooth wear).
Dental caries/ Tooth decay
Tooth decay or dental caries, is a chemical-bacterial interaction through a series of dynamic interactions between oral bacteria, sugars and teeth. Cavities can be prevented, but when left untreated, they may cause pain, inflammation and infection. It is important to know that women’s teeth themselves do not alter in any way during pregnancy. If a pregnant woman has cavities, it is due to local conditions such as dietary change, poor oral hygiene, changes in oral bacteria or frequent vomiting.
To prevent tooth decay during pregnancy, the dentist will establish practices according to your needs, such as making regular appointments to monitor your oral condition, carrying out professional dental cleaning (scaling & polishing), using fluoride and chlorhexidine as well as providing advice regarding eating habits and home oral hygiene.
Dental erosion
Dental erosion is tooth wear without the presence of bacteria. It may occur during pregnancy due to frequent vomiting over a period of time, or possibly from eating acidic foods, causing sensitivity.
Dental erosion results in a smooth tooth surface, with a loss of enamel and/ or dentin. Depending on the level of loss, it may cause sensitivity, pain and aesthetic damage. To prevent this, your dentist will record a risk assessment for you. Your risk of erosion will increase if you suffer from vomiting or reflux. It is possible to use fluoride to prevent further erosion, and in severe cases, restorations may be required.
Gingivitis & Periodontal disease
Pregnancy can make the gums and other tissues that support the teeth more susceptible to inflammation and infections. This is called periodontal disease. It happens because of hormonal changes affecting the oral flora (saliva and gingival fluids). Pregnant women who have diabetes are also more prone to having periodontal disease.
The inflammation of gums specifically is called gingivitis. This is fairly common during pregnancy, and if a pregnant woman brushes and flosses her teeth properly, she will be less likely to suffer with such gingival diseases. When inflammation and infection are poorly controlled, it can result in the loss of the bone that supports and surrounds the teeth. This disease is called periodontitis. Research has linked periodontal disease in pregnant women with preeclampsia, premature and low birth weight babies. Keep in mind, though, that pregnancy does not cause gingival diseases. This is the result of poor oral hygiene causing changes in the gums.
Gingival hyperplasia & Pyogenic granuloma
Hormonal changes that occur during pregnancy may be associated with a specific or generalized form of gingival hypertrophy, which is the overgrowing of the gums. The presence of local factors, such as biofilms, calculus and overhanging restorative dental materials may accentuate the response of the gums, forming a pyogenic granuloma, which is a benign, fast-growing lesion, usually occurring in the 1st trimester of pregnancy and extending to the 3rd trimester.
A good oral hygiene regime is important to minimize systemic factors for all forms of gingival hyperplasia. Generally, pyogenic granulomas shrink away after birth; however, surgical excision may be required. Pregnant women must be aware that it may recur, thus professional monitoring is of high importance.
Xerostomia
Some pregnant women may suffer from temporary dry mouth (xerostomia). The hormonal changes associated with the pregnancy are a possible explanation for this. It is advisable to sip water more frequently and chew chewing gum containing xylitol (no sucrose) to help alleviate this dryness. Frequent usage of toothpastes and mouthwashes with fuoride can also help restore minerals to the teeth and reduce the risk of cavities and localised sensitivity.
