HEALTHY TEETH HEALTHY PREGNANCY

Physiologic changes during pregnancy may result in noticeable changes in the oral cavity. These changes include pregnancy gingivitis, benign oral gingival lesions, tooth mobility, tooth erosion, dental caries, and periodontitis. It is important to reassure women about these various changes to the gums and teeth during pregnancy and to reinforce good oral health habits to keep the gums and teeth healthy.

✳ Pregnancy gingivitis

An increased inflammatory response to dental plaque during pregnancy causes the gingivae to swell and bleed more easily in most women. Pregnancy gingivitis typically peaks during the third trimester. Women who have gingivitis before pregnancy are more prone to exacerbation during pregnancy.

✳ Benign oral gingival lesions (known as, granuloma gravidarum or epulis of pregnancy)

In approximately 5% of pregnancies, a highly vascularized, hyperplastic, and often pedunculated lesion up to 2 cm in diameter may appear, usually on the anterior gingiva. These lesions may result from a heightened inflammatory response to oral pathogens and usually regress after pregnancy. Excision is rarely necessary but may be needed if there is severe pain, bleeding, or interference with mastication.

✳ Tooth mobility

Ligaments and bone that support the teeth may temporarily loosen during pregnancy, which results in increased tooth mobility. There is normally not any tooth loss unless other complications are present.

✳ Tooth erosion

Erosion of tooth enamel may be more common because of increased exposure to gastric acid from vomiting secondary to morning sickness, hyperemesis gravidarum, or gastric reflux during late pregnancy.

✳ Dental caries

Pregnancy may result in dental caries due to the increased acidity in the mouth, greater intake of sugary snacks and drinks secondary to pregnancy cravings, and decreased attention to prenatal oral health maintenance.

✳ Periodontitis 

Untreated gingivitis can progress to periodontitis, an inflammatory response in which a film of bacteria, known as plaque, adheres to teeth and releases bacterial toxins that create pockets of destructive infection in the gums and bones. The teeth may loosen, bone may be lost, and a bacteremia may result.