Article by Dr. Simone Stori
Importance of oral health in pregnancy
Waiting for a child is certainly a magical and fundamental moment in a woman's life. In this delicate period the mouth and oral hygiene must not be neglected, which if left out can lead to important problems both for the future mother and for the baby.
During pregnancy, the woman's body undergoes changes necessary to adapt to the new situation and allow the fetus to develop correctly. Particularly important is the increase in blood circulation, which leads to marked vasodilation and which at the gingival level leads to a swelling and increased redness of the same. If the bacterial plaque is not correctly eliminated, this normally paraphysiological situation quickly leads to a marked gingivitis and sometimes to the appearance of rather annoying growths, which are eliminated by the dentist possibly with the laser, thus avoiding the administration of anesthetic, which can be dangerous. for the pregnant woman.
Another important factor is the appearance of numerous hormonal changes (high concentrations of progestins, 10 to 30 times higher than the menstrual cycle) which also affect the immune system, which momentarily becomes weaker. In patients predisposed to periodontal diseases, or with mild periodontitis, this moment, combined with gravidic gingivitis and incorrect oral hygiene, can quickly lead to the onset of a full-blown periodontitis with serious damage to the dental support (even in the presence of a minimum amount of bacteria), with increased tooth mobility and even the loss of some teeth.
The presence of pyorrhea in pregnancy has been correlated in recent years, by numerous clinical studies, to a greater risk of premature birth (about 37 days before term) and of birth of the underweight child (2.5 kg, below average). What is this correlation due to? It has been shown that in the placental tissues of subjects affected by periodontitis, antigens of Porphyromonas Gingivalis are present, a bacterium closely related to periodontal infection, a sign that the placenta can be bypassed by these microorganisms which, coming into contact with the amniotic barrier, produce toxins . The body, responding with the production of inflammatory substances, can lead to an increase in physical stress that can lead to delivery in advance. Also noteworthy is the presence of periodontitis. therefore of an infection in the mouth of the mother. may lead to early contamination of the newborn's mouth with annoying consequences.
Neglected gingivitis, in addition to being transformed into pyorrhea, can lead to more serious but fortunately rare localized lesions, such as the gravid epulis which must be removed surgically or with a high-power laser. It is therefore clear that it is really important to treat oral hygiene during pregnancy to prevent problems with the gums but also with the teeth, as it also significantly increases the risk of tooth decay. For this reason, if possible, it would be a good idea to carry out a complete check-up of the mouth before planning the pregnancy, in order to eliminate and prevent any problems that may occur.
What to do during pregnancy
It is necessary to contact the dentist and plan an oral hygiene and prophylaxis session during the 2nd or 3rd month ; during the session it is necessary to check the presence of some dental problems (tooth decay or other), which can be safely treated during the second trimester of pregnancy or kept under control until the end of the same. The state of health of the gums must therefore be carefully checked, with a millimeter probe, in order to verify the possible presence of periodontal pockets greater than 4mm.
In the presence of signs of periodontitis, a more in-depth diagnostic investigation (complete survey, genetic and microbiological analysis) should be planned, clearly leaving out radiology, and a non-invasive therapy should be planned as soon as possible. The approach with the laser and microscope, as non-surgical and practically painless, can be performed safely and with excellent results even in pregnant patients, as well as in elderly patients or with systemic diseases.
If there are no signs of periodontitis, a second check and hygiene session will be scheduled for the 8th month of gestation. It is however necessary to contact the dentist immediately in the event of frequent bleeding, excessive gum swelling or other discomfort. We should not be afraid of dental visits during pregnancy, as even if anesthesia and radiological investigations are necessary, the advent of digital radiology and the use of vials without adrenaline have definitely reduced all possible risks.
Some practical tips
Here are some practical tips to follow:
- No smoking . Active and passive smoking should be avoided for at least 9 months of waiting.
Smoking leads to a reduction in the oxygen that reaches the fetus, damaging its formation. Furthermore, smoking, combined with a high genetic predisposition, increases the risk of developing periodontitis by almost 8 times.
- Take fluoride . Fluorine strengthens the dental elements against the action of caries bacteria.
Fluorine can be taken with mineral water (check the fluoride content on the label) and with toothpaste and mouthwash (ask the dentist for the most suitable aids). Sometimes it can be indicated to carry out one or two sessions of fluoride professional prophylaxis to strengthen teeth, a painless process lasting about 45 minutes.
- Treating oral hygiene . Brush your teeth at least 2 times a day for two minutes, using a soft toothbrush, dental floss and a fluoride-based mouthwash or essential oils to reduce plaque. The dentist or hygienist will be happy to advise you. Starting from the 7th month it can be useful to carry out a daily rinse with a chlorhexidine 0.12% mouthwash.
- Use xylitol-based chewing gum, 2 per day, which has benefits on the development of the baby's teeth as well as on the mother's.
- Treat the power supply . It is very important to correctly integrate the C vitamins (citrus fruits, kiwi, tomatoes), D and A, and minerals such as iron and calcium (milk, cheese, yogurt) which is important for bone and tooth mineralization. In particular, during pregnancy, the calcium requirement increases to around 1500mg a day.
