Expectant mothers have long been warned that gum disease can cause a baby to be born prematurely or too small. This link between gum disease and premature, low weight births in pregnant women has been well documented for many years.
Women who have chronic gum disease are more apt to deliver pre-term than women who do not have the disease. It is between four to seven times more likely that the delivery would occur before the 37th week of pregnancy. Women with more serious gum disease will likely deliver around 32 weeks. When a child is born prematurely, he or she is at a greater risk for several health problems. These problems may include learning disabilities, neurological conditions, respiratory problems and infections.
Though it has been known for some time that babies could be born pre-term as a result of gum disease, only in the past few years has there ever been a connection to stillbirths. In 2010, for the first time, a mother’s gum infection was shown to cause the death of her stillborn full-term baby.
An article, published in the January 2010 Journal of Obstetrics and Gynecology, describes the findings by scientists from Case Western University. A 35-year-old California woman contacted them to help investigate the death of her baby. The California woman told researchers that she had experienced heavy bleeding from her gums — a sign of gum disease — during her pregnancy. Plaque samples from the woman’s teeth were found to be positive for the exact same strain of the oral bacteria found in the dead baby’s stomach and lungs.
Usually bacteria that travel up from the vaginal canal cause infections that are found harmful to a developing baby. But in this case, the bacteria found in the baby were not the type that is typically found in the vaginal region, but rather one that matched the mother’s gum infection. Bacteria in the mouth can easily travel into the bloodstream from bleeding infected gums and then spread from the bloodstream to the placenta. While the immune system of the mother fights the bacteria throughout her body, the fetus is more susceptible to bacterial infection since an immune system is not established until after birth.
Though this case is a major concern, women shouldn’t be overly alarmed. Research reveals that this was a rare case. Women should, however, be careful to maintain good oral health while they are pregnant because it definitely can affect the baby.
Bleeding gums are common in pregnant women, with about 75 percent developing from pregnancy gingivitis, a condition due to normal hormonal changes. It can be treated effectively by brushing, flossing and profession cleanings by a dental hygienist. However, this study emphasizes the importance of good oral health not only for pregnant women, but also for those contemplating pregnancy.
Gingivitis is a beginning stage of gum disease. It will affect over 90 percent of Americans at some point in their lives. Gingivitis is caused by an accumulation of bacterial plaque that sticks on the teeth, tongue and gums. The gums become tender, swollen and red and begin to bleed. Gingivitis is especially common during pregnancy. Gingivitis has been reported to occur in approximately 60 to 75 percent of all pregnant women. The severity of the condition can range from mild inflammation with redness, to inflammation with edema and bleeding, to even more severe cases where periodontal surgery is necessary.
Pregnancy causes tremendous change in a woman’s hormonal activity. Between the time of conception and the seventh month of pregnancy, hormones will triple in quantity, and then remain at that heightened level until delivery. Estrogen and progesterone are secreted in progressively greater concentrations throughout most of pregnancy, causing a better environment for bacteria in the mouth to grow. In particular, the increased level of progesterone makes it easier for certain gingivitis-causing bacteria to grow, as well as makes gum tissue more sensitive to plaque and even exaggerates the body’s response to toxins (poisons) that are produced by bacterial plaque.
During pregnancy water is retained in order to build blood volume to nourish the placenta. Thus, a pregnant woman has 40 percent more fluid in her body. As a result, this increases the amount of fluid in all the cells in the body, including the gum tissues, which causes them to become “puffy.” The swelling of the gums increases the effect of pregnancy gingivitis and makes a better environment for bacterial growth.
It is important to understand that pregnancy gingivitis can only occur if gum disease is already present. But pregnancy can make gum disease significantly worse. Remember, it is the bacteria, not the hormones, which cause the gingivitis. This condition can be almost entirely avoided with good oral hygiene habits, which include brushing at least twice a day, flossing once a day and using an antimicrobial mouth rinse. Professional dental cleanings are particularly important during pregnancy, as well as treating any tooth decay. Proper diet and nutrition are vital for health during pregnancy and will limit unnecessary sugar intake and help prevent bacterial plaque buildup in the mouth.
Good health during pregnancy is important for the mom and her developing baby. A healthy mouth, free of gum disease is vital to the general health of both the mom and the baby. If you are pregnant or are considering pregnancy, discuss any concerns you may have with your dentist. And if you are thinking about having a baby, you should consider your oral health before becoming pregnant.
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George Malkemus has a Family and Cosmetic Dental Practice in Rohnert Park at 2 Padre Parkway, Suite 200. Call 585-8595, or email info@ malkemusdds.com. Visit Dr. Malkemus’ Web site at http://www.malkemusdds.com