Pregnancy = Cavities + Gingivitis?

Just found out today a dear friend of mine is pregnant with her first child. I asked her if she was brushing more often, or was unable to brush at all. She told me that, fortunately, she was able to brush but wanted to know why she needed to brush more often. I explained that pregnancy actually compromises her immune system, since it is now all about protecting baby, not mommy against cavities and gum disease. She had no idea! Her obstetrician had never told her that.

Another friend of mine after she had her child called me up freaking out; “I have 6 cavities! I’ve never had a cavity in my life! How could this have happened?” Since I was in dental school in another state at the time, I couldn’t provide her with a second opinion, but I did explain that not only were women more susceptible to cavities, but to gum disease as well. In fact, there is a syndrome called “pregnancy gingivitis” that occurs usually with first-time pregnancies in the first trimester.

So, why does this happen?

Pregnancy is a serious stage in a woman’s life which brings many unexpected changes in her body. It is also a natural stage wherein the body undergoes various hormonal changes in order to support the growth and development of the baby. These hormonal changes result in some psychological as well as physical changes in the body. One such change that nearly 90 percent of pregnant women experience during those nine crucial months is weakened immune system. Though very common, weakening of immune system at the time of pregnancy can increase the risks of bacterial or viral infestations in the body. And what is a cavity? A bacterial infection of a tooth. What causes gingivitis? Bacterial invasion into the gums causing redness, inflammation and bleeding. There are various factors that contribute to this during pregnancy.

Without getting too technical, with the increase of hormone levels many women find themselves with nausea and fatigue, which can lead to nutritional deficiency. Since the body is supporting the baby first, then the mother, by providing essential nutrients and minerals, nutritional deficiency can lead to a weakened defense mechanism, allowing the expectant mother to become more susceptible to infection. In fact, the first trimester is considered to be a “proinflammatory phase”. The mouth is on the bottom of the immune system’s list in order of importance to protect, so it is of utmost importance to brush at least twice daily, floss daily, use an alcohol-free mouthwash, and, if she has a history of being in the dental chair for work done, it is even that more serious to be seen by a dentist at least once during the pregnancy (at the second trimester is most recommended by dentists, when more growth than development is happening) to make sure all is well in the mother-to-be’s mouth.

How to prevent these issues? The simplest way to improve immunity is to incorporate a healthy lifestyle that can minimize the risks of getting infected by any disease or infection.

First and foremost, the mother has to make healthy dietary changes by including fruits and vegetables rich in immune-boosting carotenoids and flavenoids (berries are the best!) in her diet which are rich in vitamins, minerals and antioxidants. Also as far as possible she should avoid eating junk or fast foods which are loaded with fats and calories but have no nutritional value, for mother or child.

Have protein at every meal. Minimize sugar and refined flours: studies found that consuming about two sodas’ worth of sugar knocked down the effectiveness of white blood cells by roughly 50% within one hour, with residual effects lasting for several more hours. Finally, a low-fat diet with minimal caffeine has also been shown to improve immune function.

Hence, having a balanced pregnancy diet along with maintaining proper hygiene like washing hands before and after meal can also enhance the immune system. Furthermore, studies have shown that simply chewing sugar free gum after a meal can prevent cavities because it continuous saliva stimulation, which helps break down food stuffs, not allowing them to stick to the teeth. This is a helpful hint for everyone!

Most pregnant women I know are on pre-natal vitamins. It is always in the patient’s best interest to make sure if this is right for them. Drinking water is also effective in keeping the body, and baby, hydrated; another tried and true way to stay healthy.

There is an old wives’ tale that one knows how many children a woman has had by the number of missing teeth. I had heard about this in dental school, then a patient confirmed it when in residency. From Ecuador, she said that most women she knew back home lost one tooth — at least — per pregnancy. How horrible, and completely preventable!

Pregnancy is a time in which many demands are being placed on the body to help the unborn baby grow. Staying as healthy as possible during pregnancy can help baby develop on schedule and gives the energy needed to support the additional demands and have a healthy birth. Building the immune system during pregnancy mainly means taking care through diet and proper oral hygiene. Happy brushing!