Pregnancy

The importance of oral health for pregnant women and newborns

Thinking about pregnancy immediately evokes the idea of ​​a unique and happy moment in a woman’s life.

This very special moment, however, is associated with a greater risk of developing certain problems in the oral cavity, including gingival inflammation (or gingivitis) and periodontal disease (or periodontitis) , which in turn can influence the success of the pregnancy .

For this reason, in the perinatal process, it is important to learn and perform the correct oral hygiene maneuvers , necessary to prevent the onset of these and other related pathologies.

Oral health in pregnancy: gingivitis

To talk about oral health during pregnancy, we consulted  Dr. Lorena Rispoli , periodontologist at the Pregnancy Periodontology clinic of Humanitas Medical Care . For the “non-experts”, we explain that periodontology is a branch of dentistry dedicated to the prevention, diagnosis and treatment of tooth support tissues (such as the gums and bone), and the periodontist is precisely the specialist who takes care of it.

As Dr. Rispoli  explains, «Oral alterations are observed during pregnancy, due to hormonal and vascular changes. These can contribute to diminishing the immune response and compromising the necessary gingival defense mechanism. The changes that the oral microbiota undergoes during this period can also aggravate gum inflammation. These conditions can compromise not only the oral health of new mothers, but also that of the baby. Among the problems, the most frequent is pregnancy gingivitis: an inflammatory condition characterized by redness , swelling and  gingival bleeding , also associated with minimal deposits of bacterial plaque.

Dental visits during pregnancy: when are they recommended?

Dr. Rispoli underlines that «the period before conception and up to the 12th week of pregnancy are ideal for an oral evaluation and a periodontal examination . During this appointment, the periodontist will verify the levels of gingival inflammation and the possible accumulation of plaque, the individual genetic profile and the associated local and systemic risk factors to be kept under control. The inflammatory process triggered by periodontitis , evolution of gingivitis, can in fact be associated with an increased risk of pregnancy complications , such as  premature birth and low birth weight ».

What if there are oral or periodontal health problems? ” The safest time to perform dental treatment during pregnancy is the beginning of the second trimester”  replies Dr. Rispoli “that is, from the 14th to the 20th week of gestation “.

Dental visits in pregnancy: why are they important?

” Dental visits during pregnancy are an opportunity to check the state of oral health and remind women what precautions to follow to counteract the oral outcomes of physiological changes during pregnancy” continues Dr. Rispoli. “Eating habits change and oral hygiene carelessness increases: pain , swelling and gingival bleeding during pregnancy often lead to a reduction in brushing “.

Repeated episodes of nausea, vomiting and oesophageal reflux can also lead to the loss of superficial enamel and the increase in dental sensitivity due to the reduction of remineralization.

Changes in salivary flow and composition and bacterial flora in favor of cariogenic bacteria and lactobacilli may then temporarily predispose to dental erosion and caries or to the progression of untreated lesions.

After a careful initial assessment of the health of the oral cavity, the periodontist schedules minimally invasive and short oral hygiene sessions . These will be repeated on a monthly or quarterly basis , based on the period of ovarian stimulation and gestation, to monitor the state of inflammation of the gums and the general health of the oral cavity.

How to take care of your oral health during pregnancy?

As highlighted by Dr. Rispoli, every woman can put into practice some simple precautions to take care of her oral health, and in particular:

  • in case of vomiting , rinse the mouth with running water in which a teaspoon of bicarbonate has been dissolved , to neutralize the acidity of the oral environment;
  • space the use of toothbrushes (with soft bristles) and toothpastes (with non-abrasive fluorine) at least one hour after vomiting episodes, to prevent damage to the demineralised surfaces from contact with the acid content;
  • brush teeth twice a day and use dental floss or other interdental device;
  • ensure an adequate supply of protein , B vitamins  and  folic acid  in the diet, to reduce hypersensitivity and gum lesions (fruit with little sugar and vegetables);
  • include foods rich in Omega3 fatty acids , minerals and  trace elements (zinc, iron, copper and magnesium) in the diet , for a better immune and reparative response and to decrease gingival tenderness and bleeding;
  • introduce an adequate quantity of Vitamins K2 , D and  A Vitamins K2, D and A , to increase the absorption of calcium and phosphorus, and of  Vitamin C , to provide amino acids which make up the collagen inside the tissues;
  • avoid foods rich in simple carbohydrates or limit their intake only during meals;
  • avoid carbonated drinks ;
  • comply with scheduled professional oral hygiene appointments .

Is it possible to take care of the oral health of newborns?

«The answer is yes» confirms Dr. Rispoli. « Protecting the oral health of children is very important . The earlier direct mother-to-child transmission of cariogenic bacteria occurs through the placenta, breast milk and/or through any subsequent salivary contact, the greater the risk of developing caries in the perinatal period and in childhood.

After the eruption of the first teeth (around 4-6 months) it is time to start using, in addition to massaging the gums with a wet gauze after each feed, also a soft-bristled children’s toothbrush with a soft head, with very little toothpaste to avoid the risk of developing stains on the teeth (fluorosis). Avoid putting babies to sleep with a pacifier or bottle containing sugary drinks . Avoid saliva-exchanging behaviors (sharing baby food spoon or pacifier or cleaning the pacifier with your own saliva).

“Furthermore” concludes Dr. Rispoli “a first visit to the dentist within the first birthday or within 6 months of the appearance of the first tooth would be indicated , to receive information on how to protect children’s teeth and gums”.

Kathryn Barlow is an OB/GYN doctor, which is the medical specialty that deals with the care of women's reproductive health, including pregnancy and childbirth.

Obstetricians provide care to women during pregnancy, labor, and delivery, while gynecologists focus on the health of the female reproductive system, including the ovaries, uterus, vagina, and breasts. OB/GYN doctors are trained to provide medical and surgical care for a wide range of conditions related to women's reproductive health.

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