How many of you know that your dental health is particularly at risk when you’re pregnant? There’s an old Chinese saying “gain a child, lose a tooth” 生一個孩子，掉一顆牙 – a traditional belief that the foetus strips away the calcium from the mother’s teeth, leading to tooth loss. According to the WHO, over 90% of the population will have some sort of gum disease at some point in their lives, and women in pregnancy are particularly at risk.
We spoke to a Hong Kong periodontist (dentist that specializes in gum disease), Dr. Jonathan Lui 雷威鴻醫生 about why women are particularly at risk of gum issues during pregnancy and how expectant mothers should take care of their oral health.
A lot of us have gum disease. Why is it so important we pay attention to our gum health?
The WHO (World Health Organization) has recognized gum disease as one of the most prevalent diseases in the world. This includes gingivitis, which is a reversible inflammation of the superficial gum tissue; and periodontitis, an irreversible erosion of the bone and supporting tissues around the root of the tooth. Both of these diseases are triggered by bacteria found in dental plaque. Untreated gingivitis may progress to periodontitis, which is a major cause of early tooth loss. At least 90% of the adults in Hong Kong have gum disease but over 50% are unaware of their condition.
The common signs of gum disease include puffy and bleeding gums, gum shrinkage (recession), tooth sensitivity, tooth loosening and bad breath. In spite of this, there is often very little or no associated pain. Sufferers have sometimes linked these signs to 熱氣 (hot wind). Ignoring these early signs of gum disease can potentially lead to advanced periodontitis and eventually an expensive tooth replacement!
Why are pregnant women particularly at-risk for developing or accelerating gum disease?
During Pregnancy, the woman undergoes a number of physiological changes to her body including fluctuating hormones, change in oral environment and decreased immune response. This can result in gums which are extra sensitive to dental plaque. Pregnant women are therefore much more likely to develop gingivitis as well as other gum problems such as pregnancy granulomas.
There is also evidence to show that pregnancy can also have an impact on untreated gum disease such as if the mother has existing periodontitis. The changes in hormones can accelerate the destruction of the tissues, leading to a more rapid progression of erosion.
How does gum disease affect pregnant women? How does gum disease affect foetuses?
Gum disease, especially periodontitis, have been associated with adverse pregnancy outcomes. Studies have shown women with untreated periodontitis can have an increased risk of pre-term birth (pregnancy before 37 weeks) and low birth weight (lighter than 2.5 kg). These factors can significantly affect the survivability and future physical and mental development of the baby.
Women with existing periodontitis can safely have treatment during pregnancy, ideally during the 2nd trimester. Studies have also shown that treating gum disease can even reduce the risk of adverse pregnancy outcomes!
How should women take care of their dental health during pregnancy?
Although “Gain a child, lose a tooth” is mostly a myth, there might be some truth behind it. Mothers who lose teeth after a pregnancy may blame it on calcium loss, however we now know that foetal calcium sources come from the mother’s diet and bones. Tooth loss after pregnancy is often due to oral neglect during and after gestation period, leading to extraction due to dental decay or advance gum disease.
There should be a push for women to seek dental advice if they are planning conceiving and to continue dental care during their pregnancy. Dental treatments are safe during the pregnancy cycle, although treatment during the first trimester should be limited to examination and simple polish. Other treatments such as scaling and fillings can still be done, but they are best reserved for the second and early third trimester.
Regards to home care, brushing twice a day with a toothbrush and fluoride toothpaste is recommended, as well as regular use of floss or interdental brushes. By keeping her teeth and gums clean, the mother can not only benefit herself but her future baby as well!