On at least three
separate occasions, I can remember having the privilege of breaking the news of
a young woman's pregnancy from my side of the dentist's chair. I use the word
"privilege" with my tongue planted firmly in my cheek, however. After all, the
diagnosis was only determined because of the patient's tender, red, swollen
Sheila Wolf, known affectionately by her patients and colleagues as Mama Gums,
has been a dental hygienist since 1971.
Talk about taking the good news with the bad . . .
Known as pregnancy gingivitis, this unpleasant condition is often assumed to be one of the natural consequences of the hormonal changes often found in pregnant women. The hormones involved, estrogen and progesterone, are secreted in progressively greater concentrations throughout most of pregnancy. While this reaction is necessary for preparing a woman's body for the journey ahead, the resulting flood of hormones results in a variety of effects.
Hormones tell the kidneys to retain water in order to build blood volume to have enough to nourish the placenta. Thus a pregnant woman has 40% more fluid in her body. As a result, this increases the amount of fluid in all the cells in the body, including the gum tissues, which causes them to become "puffy." Between the time of conception and the seventh month of pregnancy, hormones will triple in quantity, and then remain at that heightened level until delivery.
Meanwhile, as if she doesn't have enough to contend with, the pregnant patient with hormones out of whack is swollen and tender and sometimes cannot do an effective job with her oral hygiene.
I am pleased to tell you that with above standard oral hygiene, this condition can be almost entirely avoided. Remember, it is the bacteria, not the hormones, which cause the gingivitis. Despite the fact that the statistics reveal 50-75% of all pregnant women develop pregnancy gingivitis, that doesn't have to mean you. If you are reading this book after the fact, you can be assured that this condition is reversible with proper home care, techniques, tools, and medicines.
Dr. Thomas Rams, professor and chairman of the Department of Periodontology at Temple University School of Dentistry in Philadelphia, says, "There are hormonal shifts in pregnancy that reduce the gingival tissue resistance to infection, and there is also an increased risk that the hormones circulating will help promote the growth of certain bacteria and plaque, which causes inflammation."
Rams also says, "In periodontitis, bacterial plaque infection not only causes inflammation of gingival tissues like gingivitis, but also progressively destroys connective tissue fibers and surrounding bone anchoring teeth to the jaws, resulting in the loss of teeth."
Knowing how to minimize the bacterial biofilm in your mouth, and especially along the gum line, is the key factor in preventing pregnancy gingivitis and the escalating symptoms that often continue during pregnancy. However, a woman needs to be taught before she gets pregnant how to eliminate bacteria on a daily basis.
Because gums can be painful, puffy, and bleeding during pregnancy, the tendency is to avoid touching them. However, it is imperative that you practice good oral hygiene during pregnancy to avoid both tooth decay and gum infections. Pregnancy, with its three-fold increase in hormones, may exaggerate the body's normal response to dental plaque.
It need not increase your risk of getting gum disease . . .
Although relatively rare, the body's response to inflammation may produce another offset of the "joy" of childbirth: a pregnancy "tumor" (also called pyogenic granuloma).
This "tumor" may develop on the gums in response to the irritating bacteria
that collects there. Rest assured, however, that these growths of extra tissue
are usually painless, and totally benign. However, if they get large these
"pregnancy tumors" can become annoying and should be treated. Meticulous oral
hygiene is the answer to avoiding the inflammation associated with these
growths, and it is comforting to know that they usually subside after
Fascinating Factoid: "Occasionally chewing sugarless gum is helpful to increase
the amount of saliva in your mouth, without contributing to the risk of
gingivitis. It may also be helpful in averting the nausea so common in the
first three months of pregnancy."
Brushing, flossing, and irrigating daily (all done gently but deliberately) are
important in preventing gingivitis, during pregnancy and anytime in your life.
In addition, it is important to pay attention to eating more healthfully for
yourself and your baby, by substituting fruits, cheese, nuts, and vegetables
for those sugary foods you might have enjoyed before becoming pregnant.
If your gums are tender and brushing is painful, try ice, or several helpful over the counter products that will soothe painful gums.
Products That Will Soothe Painful Gums
Peroxyl mouth rinse
Amosan oral rinse
(Please be sure to ask your doctor if she or he has objections to any of these
Sheila Wolf “BIO”
RDH, affectionately called “Mama Gums,” has been a registered dental hygienist
since 1971. She is currently retired from clinical practice but enjoys
writing, speaking, and consulting on various oral health issues. She has
authored two award-winning books, Pregnancy and Oral Health: The critical
connection between your mouth and your baby, and
Your Mouth Could Be KILLING You. Both are available on her
through Amazon, and at finer bookstores everywhere. Sheila also works with
people privately as an oral wellness coach, educating and empowering people to
keep their natural teeth for a lifetime, avoid gum surgery, and just possibly
add years to their lives. You may reach Sheila through her website,
or in San Diego at 866-MAMA-GUMs.
Copyright © 2007 by Sheila Wolf, RDH www.mamagums.com
. Reproduced with permission.