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Pregnancy-Induced Gum Disease

Wait! Is that a faint second line? Once that pregnancy test kit shows a positive result, so many thoughts start running through your mind. Questions as to whether you should re-take the test, whether it is a boy or girl, whether you should inform your partner immediately or whether the baby is going to be healthy or not. The state of your teeth and gums will definitely not be on your priority list during pregnancy.  I am here to inform you that your oral health should never be neglected during this period. Pregnancy is a stage where hormonal changes can cause mayhem in your mouth especially when preventative measures are not put in place.

Gum disease in the mouth is usually seen during the second or third month of pregnancy. It becomes more severe by the eighth month and decreases during the ninth month. If you brush your teeth, you may notice some bleeding and mild-to-moderate puffiness of your gums. Sometimes, they may look reddened and occasionally be tender. This is scientifically termed pregnancy-induced gingivitis. This is because during pregnancy, your progesterone hormone levels are heightened, making you more susceptible to plaque (bacteria) in the mouth which attacks the gums. Your gum tissue becomes more sensitive to plaque (bacteria) and exaggerates your body’s response to the toxins from the plaque. This condition affects 40% of pregnant women. If nothing is done about this, it progresses into a much more severer form called periodontal disease where the supporting structures of the tooth get damaged and you may end of losing some teeth. Did you know that recent literature suggests that severe gum disease (periodontal disease) is a risk factor for delivery of low-birth-weight infants and premature labour?

Another type of gum disease that occurs during pregnancy is pregnancy epulis which is generally not painful. It can occur at any point of the pregnancy but it is more common in the third trimester of pregnancy and it is characterized by a large red lump on the gum that bleeds spontaneously and causes discomfort when eating or speaking. This condition is an extreme gum inflammatory reaction to local irritation such as food debris and plaque. It is also due to the increased levels of progesterone hormone during pregnancy which makes it easier for certain gum disease bacteria to grow and cause problems.

Treatment of these conditions starts with prevention. Pregnancy-induced gingivitis can be avoided if your mouth is in top shape. This means that if you practice very good oral hygiene habits, you can keep gum-disease bacteria at bay. This involves brushing twice daily with a soft bristled-toothbrush and fluoride-containing toothpaste, flossing your teeth at least once daily, and visiting the dentist regularly for a routine check-up and dental cleaning (scaling and polishing). One may think that dental visits are contraindicated during pregnancy but this is false. If you are due for you regular dental cleaning, you should not skip the appointment. Consequently, regular scaling and polishing helps to remove plaque (bacteria) and tartar which trigger the gums to bleed. With regards to pregnancy epulis, they usually disappear on their own after the baby’s birth. Nevertheless, one should see the dentist if it interferes with eating or speaking. The dental specialist will perform a very simple procedure to remove the lump under local anesthesia. However, pregnancy epulis removed during pregnancy can recur in approximately 50% of cases.

Let us endeavour to educate our expectant mothers at home, in the office and also at the antenatal clinic to take very good care of their mouth. Counseling and early intervention by healthcare providers such as physicians, nurses and dentists are essential in order to help expectant mothers understand the importance of oral health care during pregnancy.

Thanks for reading.

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