Pregnancy and Oral Health

I was going through social media and I came across two women narrating their experiences during pregnancy, One of them claimed she ‘lost her teeth’ during her own experience. Another chimed in “Na wetin concern teeth with belle?” This birthed this article.

Pregnancy is the state of having an implanted embryo in the uterus until delivery or spontaneous/elective abortion.

Two major hormones are produced during pregnancy called Estrogen and Progesterone. Both of these hormones have been shown to have effects on the mouth and gums that could lead to several pregnancy-induced lesions.

Effect on Micro-organisms in the mouth

  • There’s alteration in the composition of plaque (sticky white substance) around the teeth.
  • There’s an increase in growth of periodontal pathogens such as Prevotella intermedia and B. melaninogenicus in sub-gingival plaque, these hormones act as growth factors for these bacteria.

Effect on the Host (pregnant woman).

  • High levels of progesterone and estrogen associated with pregnancy (also use of contraceptives) have been shown to suppress resistance to plaque.
  • Estrogen and Progesterone affects inflammatory response and contributes to an exaggerated response of the gums to bacterial plaque.

Simply put, during pregnancy, plaque increases, bacteria that are bad for the gum increases and your body’s ability to fight it decreases.

CONDITIONS FOUND IN THE MOUTH

Gingivitis

  • The higher the levels of estrogen and progesterone, The greater the incidence of gum inflammation.
  • Usually starts in the 2nd month and is at the peak by the 8th
  • Characterized by swelling of gum margins, redness and increased bleeding on brushing.

Periodontitis

  • Loss of structures holding the tooth in place can lead to tooth mobility.
  • Mouth breathing associated with pregnancy rhinitis (allergies, stuffy nose) can worsen it.

Pregnancy Tumor, Epulis or Granuloma.

  • Commonly occurs in the 2nd and 3rd trimesters of pregnancy.
  • It’s usually found on the gum of upper front teeth.
  • Color ranges from bright red to purplish/bluish red.

Tooth Decay

  • Pregnant women are prone to snacking a lot, predisposing them to tooth decay.
  • Tooth decay results from demineralization of hard tooth surface by acid produced by bacteria from refined sugar in our diet.

Tooth Erosion

  • This is the wearing off of tooth surface by acids from diet or being brought up in the mouth by reflux and vomiting.
  • It results in sensitivity and usually affects the anterior teeth especially the lower incisors.

WHAT CAN BE DONE?

These conditions can be treated with intensive oral hygiene instructions, Scaling and Polishing and deep curettage.

Applying fluoride varnish may help to reduce the sensitivity associated with erosion, varnish is preferred over gels due to nausea.

Pregnancy Tumor/epulis usually regresses after pregnancy. If lesion persists after delivery, it can be surgically excised by a dentist.

Regularly scheduled appointments with your dentist help to prevent the development of these conditions, it is recommended that you see a dentist at least twice a year.

The safest period for dental visits is the 2nd trimester, although with adequate safety precautions treatment can be done at any time.

Try to reduce snacking in-between meals and reduce consumption of refined sugar.

Strict oral hygiene practices should be observed at home, in addition to brushing at least twice a day, rinsing with salt water or mouthwash is recommended.

The dentist should liaise with obstetrician when planning treatment and scheduling appointments.

DON’T self-medicate, consult a doctor before taking some drugs!

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