Oral Health Concerns at Pregnancy

What are the special oral health concerns of pregnant women?

Pregnancy Gingivitis

Most women notice changes in their gums during pregnancy. Some women notice that their gums look redder and bleed when they brush their teeth. And some women have severe swelling and bleeding.

All of these changes are referred to as “pregnancy gingivitis.” They can start as early as the second month. The condition tends to peak around the eighth month and then taper off after the baby is born.

Pregnancy gingivitis is most common in the front of the mouth. The symptoms are the same as those for gingivitis, but some of the causes are different. Increased hormone levels may be partly responsible for pregnancy gingivitis. During pregnancy, the level of progesterone in your body can be 10 times higher than normal. This may enhance growth of certain bacteria that cause gingivitis. Also, your immune system may work differently during pregnancy. This could change the way your body reacts to the bacteria that cause gingivitis.

To minimize the effects of pregnancy gingivitis, practice good oral hygiene: Brush twice a day, for at least two minutes each time. Floss every day. Using an antimicrobial mouth rinse also may help you control your gum infection. Some dentists suggest using rinses that don’t contain alcohol, but it is not clear whether alcohol-based rinses have a negative effect on pregnancy.

Be sure to have your dentist check the health of your gums while you are pregnant. Pregnancy gingivitis usually can be treated with a professional cleaning. This can be done at any time during your pregnancy, but preferably during the second trimester. More aggressive treatments, such as periodontal surgery, should be postponed until after delivery.

Pregnancy Granuloma (Pyogenic Granuloma or Pregnancy Tumor)

A pregnancy granuloma is a growth on the gums that occurs in 2% to 10% of pregnant women. It is also known as a pyogenic granuloma or pregnancy tumor. Pregnancy tumors are misnamed. They are not actually tumors and are not cancerous. They are not even dangerous, although they can cause discomfort.

Pregnancy granulomas usually develop in the second trimester. They are red nodules, typically found near the upper gum line, but can also be found elsewhere in the mouth. These growths bleed easily and can form an ulcer or crust over. Pregnancy granulomas usually are attached to the gum or mucous membrane by a narrow stalk of tissue.

The exact cause of pregnancy granulomas is unknown, although poor oral hygiene is a primary factor. Trauma, hormones, viruses and blood vessel malformations have also been suspected as co-factors. Women with these growths usually have widespread pregnancy gingivitis.

Pregnancy granulomas will disappear after your baby is born. If a growth interferes with speaking or eating, you may need to have it removed before you give birth. However, about half the time, the growth will come back after it has been removed.

Tooth Erosion

In women with severe morning sickness, frequent vomiting can erode the enamel on the back of the front teeth. If you are vomiting frequently, contact your dental office for information on how to prevent enamel erosion.

Dry Mouth

Many pregnant women complain of dry mouth You can combat dry mouth by drinking plenty of water and by using sugarless hard candies or gum to stimulate saliva secretion and keep your mouth moist.

Excessive Saliva

Less commonly, pregnant women feel they have too much saliva in their mouths. This condition occurs very early in a pregnancy. It disappears by the end of the first trimester. It may be associated with nausea.