Maintaining good dental health is important during pregnancy as hormonal changes can make gums more sensitive and increase the risk of gum disease. Known as pregnancy gingivitis, it is quite common and affects 60 to 75% of pregnant women. Pregnancy gingivitis often occurs between month 2 and 8 of the pregnancy but often reaches its peak in the third trimester. Sore, swollen and bleeding gums can be unpleasant during pregnancy so it is important to know what to do. In this article we will explain exactly what pregnancy gingivitis is, symptoms and causes, management and treatment and how best to prevent it.
What is Pregnancy Gingivitis?
Pregnancy gingivitis is inflammation of the gums due to a build up of plaque along the gumline during pregnancy. Similar to normal gingivitis, pregnancy gingivitis has common symptoms of gum swelling and bleeding. However, pregnancy gingivitis is often caused by hormonal changes during pregnancy which exaggerate the body’s response to plaque.
Causes of Pregnancy Gingivitis
Pregnancy gingivitis is caused by a number of factors that are exacerbated by the hormones of pregnancy. Causes of pregnancy gingivitis include:
- Changes in hormonal levels due to pregnancy: Pregnancy gingivitis is caused by an increase in the levels of oestrogen and progesterone. During pregnancy these hormone levels increase to help the baby grow and develop. However, they can also cause pregnancy gingivitis to develop.
- Increased blood flow to the gum tissue: During pregnancy there is an increase in blood flow to the gums which makes them more sensitive to things like plaque and bacteria that may irritate them.
- Decreased ability of your body to respond to plaque bacteria: The hormonal changes during pregnancy cause a decrease in the ability for a pregnant woman to respond to plaque bacteria.
- Increased plaque buildup: Plaque builds up naturally in the mouth because bacteria, food and saliva form a sticky film which settles on the teeth and gumline. Frequent vomiting during pregnancy can increase the level of plaque buildup and cause pregnancy gingivitis.
Symptoms of Pregnancy Gingivitis
The hormonal changes of pregnancy and resistance to plaque build up can often result in pregnancy gingivitis. The main symptoms of pregnancy gingivitis include:
- Tender, swollen and red gums: Sometimes during pregnancy gums can become tender, swollen and red due to the surge in hormones.
- Bleeding gums: A common sign of gingivitis, during pregnancy gums can start bleeding when brushing teeth or flossing.
- Receding gums: Although unlikely with mild pregnancy gingivitis, occasionally it can escalate to a more advanced type of gum disease which causes gums to recede. Gum recession is when the gums pull away from the teeth and expose the root of the tooth.
- Bad breath: The plaque that builds up on the teeth and gumline contains bacteria which can have an unpleasant odour that leads to bad breath.
- Sensitive teeth: Increased tooth sensitivity is a symptom of pregnancy gingivitis due to the increased blood flow and hormonal changes of pregnancy. Gums become inflamed which often makes teeth feel sensitive.
- Pregnancy epulis: This is a non cancerous growth that can form on the gums during pregnancy.. While not a direct sign of gingivitis, it usually occurs in the area where gingivitis is present and can be an indication of pregnancy gingivitis.
Diagnosis and Tests for Pregnancy Gingivitis
Pregnancy gingivitis is diagnosed by a dental practitioner or dentist who will look at your gums and ask about any bleeding or other symptoms. To diagnose and test for pregnancy gingivitis, a dental checkup will be required. The dentist will look for any visual signs of gum disease like redness and swelling and may use a probe to see if there are any unhealthy pockets where tartar has formed.
As dental X-rays have particularly low radiation, the dentist may order an X-ray to see if the disease has progressed and there is any bone loss. Blood tests for the c-reactive protein evident in gum disease may also be carried out.
How is Pregnancy Gingivitis Treated?
There are a few ways to treat pregnancy gingivitis from improving oral hygiene to dental treatments, depending on the severity of the gum disease. Pregnancy gingivitis is treated in some of these ways:
- Improve oral hygiene: To maintain oral health during pregnancy and treat any gingivitis that may have formed, brush teeth twice daily with a soft toothbrush. Floss once a day between the teeth.
- Saltwater rinse: A warm saltwater rinse can do wonders for reducing gum inflammation that occurs with pregnancy gingivitis. Add one teaspoon of salt to a warm cup of water and then gargle to relieve swollen and infected gums.
- Dentist removes tartar buildup: It is quite safe for a pregnant woman to have a scale and clean to remove any tartar buildup. The dentist will use a special instrument to remove the tartar during this procedure.
- Oral antibiotics: If there is advanced gum disease, the dentist may prescribe oral antibiotics to help combat infection. The safe antibiotics during pregnancy are penicillin, amoxicillin and clindamycin.
- Prescription mouthwash: The dentist may also prescribe a medicated mouthwash like chlorhexidine mouthwash to combat pregnancy gingivitis. Mouthwash kills the growth of bacteria which helps treat gingivitis.
- Scaling and root planing: For advanced pregnancy gingivitis, the dentist may decide to perform scaling and root planing. Although this is not a common procedure during pregnancy, it is quite safe and has no effect on the baby’s development.
How to Prevent Pregnancy Gingivitis
Pregnancy gingivitis occurs because of hormonal changes that make the gums susceptible to plaque buildup. It can, however, be prevented by following some good practices from brushing teeth more regularly to avoiding certain foods. To prevent gingivitis during pregnancy, follow these tips:
- Regular brushing and flossing: Strict brushing and flossing with the right toothbrush twice a day is a good way to reduce plaque buildup that leads to tartar if not removed. Brush teeth gently using small circular motions. Sometimes hard teeth brushing can traumatise the gums and cause them to become inflamed, particularly during pregnancy when teeth and gums are more sensitive. Floss between the teeth down to the gumline every day.
- Drink water: Drinking water during pregnancy instead of sugary drinks will help reduce dental inflammation from forming. Water is a good way to help remove food debris and there is no leftover residue that can form into plaque.
- Good diet habits: Diet habits can change during pregnancy, particularly for those who feel nauseated. However it is important to maintain a healthy diet rich in fruits, vegetables and dairy products. Avoid sugary foods as much as possible as sugar settles on the teeth as plaque which damages tooth and gum health. Dairy based snacks like cheese and yoghurt can help neutralise acids and protect against gum disease.
- Rinse your mouth: Mouth rinsing is particularly good for women who have morning sickness during pregnancy. Rinse your mouth with water after vomiting to avoid any acid or plaque buildup on the teeth and gums.
- Regular dental care: During pregnancy it is important to be aware of your oral health as you are more susceptible to gum and teeth issues. Regular dental care is highly recommended. Visit the dentist as soon as you find out you are pregnant to check the health of your teeth and gums and have any procedures that might help inhibit gingivitis forming. It is important to tell the dentist you are pregnant so they can take that into account when organising your dental plan. Most dental treatments are safe during pregnancy but it is wise that your dentist is aware of your condition.
- Avoid bad habits: Most people do not tend to smoke during pregnancy. However, if you are smoking, it is a good idea to quit as this not only affects the developing foetus, it can have an impact on your oral health and exacerbate any gum disease.
Complications from Pregnancy Gingivitis
For those suffering from pregnancy gingivitis, it is natural to be concerned that there may be complications to the baby or mother. It is important to note that mild gingivitis in pregnancy has little or no impact on either the baby or mother’s overall health. With proper oral care and regular dental visits, mild pregnancy gingivitis can be treated effectively and tends to disappear after the baby is born.
Left untreated, however, this mild form of gum disease can turn into the more serious gum disease called periodontitis. There can be complications from advanced gum disease for both baby and mother. Periodontitis during pregnancy can lead to premature birth, low birth weight, and preeclampsia. Bacteria and inflammatory products from the infected gum tissue can enter the bloodstream and travel to the placenta which may trigger premature birth and low birth rate. Because periodontitis can trigger inflammation, it can also lead to preeclampsia which often results in premature birth and low birth weight babies. However, if gum disease is treated in pregnancy, the risk of pre-term birth is reduced by 50%.
Complications for the mother with periodontitis can include serious outcomes such as severe bone loss and tooth mobility issues. Some people even lose their teeth if periodontitis remains untreated.
When To See a Dentist for Pregnancy Gingivitis
Visit your dentist as soon as symptoms of pregnancy gingivitis occur, ideally before the third trimester or before they become worse. If possible, it is a good idea to visit the dentist prior to becoming pregnant or at the start of a pregnancy to assess your dental health as gums and teeth are adversely affected during pregnancy.
Pregnancy gingivitis is a common dental health issue that affects a majority of pregnant women. It can lead to sore, swollen and bleeding gums and even tooth loss if not treated. It is essential to visit your dentist if symptoms of pregnancy gingivitis develop. For further information contact the team at Hawthorn Road Family Dental.
