In 2016, The Pulse blogger Melody Watson wrote an excellent article on how dental health affects pregnancy (read it here). She highlighted how gum disease is more common in pregnant women and may be linked to preterm birth. She stressed the importance of maintaining good oral health during pregnancy.
In 2017, the Oral Health Care During Pregnancy Advisory Committee reaffirmed its guidelines on oral health in pregnancy. The Committee noted that despite the importance of oral health in pregnancy, 56 percent of pregnant women do not visit their dentist during pregnancy. They also noted that 40 percent of pregnant women have some type of gum disease. 
The Advisory Committee includes experts from the the American College of Obstetricians and Gynecologists and the American Dental Association. In light of these findings, it is time for a refresher blog on the importance of taking care of your teeth and gums during pregnancy. Not only will your overall health improve, so will the health of your baby. 
How Pregnancy Affects Oral Health
According to the U.S. Department of Human Health and Services, “Oral health is a mirror for general health and well-being.” This is especially true during pregnancy.  Pregnancy puts extra stress on your oral health in several ways:
- Pregnancy hormones increase blood supply through your body, including blood supply to your teeth and gums. Pregnancy hormones also cause an increased inflammatory response in your body. This can cause your gums to swell and bleed more easily.
- Swelling and inflammation of your gums is called gingivitis. Gingivitis is most common during the third trimester. Gingivitis may cause your teeth to become a bit looser. You may also form a type of inflammatory gum growth between your teeth, called a pregnancy granuloma. These growths are benign and usually disappear after pregnancy. [1,2,3]
- Vomiting from morning sickness and heartburn (gastric reflux) increase the amount of stomach acid that flows up into your mouth. Stomach acid can eat away at your tooth enamel and and cause cavities.
- Poor oral health due to cavities and gingivitis can lead to a buildup of bacteria in your saliva called Streptococcus mutans.  The combination of cavities, gingivitis, and bacteria can lead to periodontitis, a destructive infection that can eat away at your gums, teeth, and jaw resulting in tooth loss. [1,2,3]
How Poor Oral Heath Can Affect Your Baby
Poor oral health can affect your baby during pregnancy and after pregnancy. Here’s how: 
- Several studies show a link between periodontal disease and preterm birth. Bacteria that cause periodontal disease may produce inflammatory substances called cytokines. Cytokines may pass through the placenta and and stimulate preterm labor.
- Some studies suggests that periodontal disease may be linked to high blood pressure of pregnancy (preeclampsia). This link needs more research to be confirmed.
- Streptococcus mutans bacteria that live in a mother’s mouth can be transmitted to a baby’s mouth through kissing, licking a pacifier, sharing food, or licking a child’s spoon. These bacteria can increase a child’s risk for early cavities.
Preterm birth is the biggest risk to your baby. Preterm birth is associated with serious health problems including cerebral palsy, respiratory distress syndrome, jaundice, anemia, retinopathy (an eye disease), and heart murmur. 
What You Should Do
You should start by discussing your oral health with your pregnancy care provider. You should keep seeing your dentist every six months, and see your dentist sooner if you are having any oral health issues. Always let your dentist know that you are pregnant. [1-3]
Pregnancy may affect some dental treatments, but the Advisory Committee stresses that most dental treatments are safe during pregnancy and should not be put off until after delivery. These treatments include cleanings, dental x-rays (as long as you have a lead shield over your neck and belly), local anesthesia, cavities, extractions, and root canals. 
These are the other oral health tips for pregnant women:
- Let your health care provider know if you have any signs of gingivitis. These include gum redness, swelling, soreness, and bleeding (especially when you floss or brush your teeth). 
- Let your health care provider know if you have any other signs of oral health disease. These include loose teeth, bad breath, mouth sores, red growths between your teeth, and toothache. 
- If you have gingivitis, it helps to rinse your mouth with warm water several times per day. Use one teaspoon of salt in one cup of warm water. 
- If you have an acid taste in your mouth from gastric reflux, or after vomiting due to morning sickness, rinse your mouth with baking soda and warm water to neutralize the acid. Use one teaspoon of baking soda in one cup of water. 
- If you have frequent heartburn with reflux, ask your health care provider to suggest an antacid you can use. You can also raise the head of your bed and avoid eating several hours before lying down to reduce reflux. 
- Do not eat sugary foods that stick to your teeth. Bacteria love sticky sweets and will convert sugar to acids that cause tooth decay. Drink water instead of soda and eat healthy meals with plenty of fruits, vegetables, and dairy products for calcium. [1-3]
- Brush your teeth twice each day with fluoride toothpaste and a soft bristle toothbrush. Floss your teeth every day. [1-3]
Oral health is an important part of a healthy pregnancy. Make it part of your prenatal care. Think of your dentist as part of your prenatal health care team. Your mouth, your health, and your baby’s health will reap the benefits. [1-3]
- American College of Obstetricians and Gynecologists,
- Committee OpinionAmerican Dental Association, Oral health during pregnancy.
- March of Dimes, Dental health during pregnancy.
- American Academy of Pediatrics, Health Issues of Premature Babies.