Pregnancy
Pregnancy is a period marked by significant hormonal, physiological, and behavioral changes that can profoundly impact oral health. Research indicates that approximately 11% of pregnant women may suffer from periodontitis, an oral infection that affects the gums and supporting structures of the teeth1.
Common Oral Health Conditions During Pregnancy
Common oral health issues can be prevalent or exacerbated during pregnancy, such as gingivitis, dental caries, pyogenic granuloma, and tooth erosion. Periodontal disease, such as periodontisis or gingivitis, can occur in up to 40% of pregnant women, possibly emerging in the second trimester2. The increased risk of dental caries may be attributed to increased oral acidity, greater sugar intake resulting from what can be related to pregnancy-related cravings, or a potential decline in oral hygiene care. Tooth erosion can also be a common occurrence, from what is possibly caused by repeated exposure to stomach acid during episodes of morning sickness, hyperemesis gravidarum, or gastric reflux2.
The American Dental Association (ADA) advocates for safe dental treatments during pregnancy, including extractions, root canals, local anesthetics, and radiographs when necessary to manage complex oral health issues and protect both maternal and fetal health3. It is encouraged to check with the obstetrician or healthcare provider before proceeding with any treatments.
Periodontal Disease and Pregnancy Outcomes
Treating periodontal diseases is very important, as it can been associated with negative pregnancy outcomes including preeclampsia, intrauterine growth restrictions, and preterm delivery4.
In adults, the most common pathogen that contributes to periodontal disease development is gram-negative anaerobes. Research has reported that these pathogens disrupt the microbiome and stimulate microbial dysbiosis6. This can allow for disease progression which can result in increased periodontal pocket depth, bleeding upon probing, clinical attachment loss and tooth loss due to alveolar bone degradation5,6. Recent findings suggest that periodontal pathogens can sufficiently modify their environment in a manner favorable for their survival and stimulate microbial dysbiosis. It is suggested that this dysbiosis may be a critical element in the switch from periodontal health to disease6.
Systemic inflammation along with endothelial activation plays a role in conditions like spontaneous preterm delivery and preeclampsia7. While the exact biological mechanisms are not fully understood, the association underscores the importance of maintaining oral health during pregnancy.
Impact on Infant Oral Health
Maternal oral health also influences the child's oral health. Poor maternal oral hygiene and untreated infections could transmit these bacteria from the mother’s mouth to their baby’s and can increase the infant’s risk for early childhood caries and dental pain stemming from cavities8,9. Strong prenatal oral care can build a foundation for positive early childhood oral health.
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