Gingivitis

tHE SURGING HORMONES of pregnancy affect more than your mood; they can affect the health of your mouth. And how you maintain your teeth and gums while you're expecting also can influence your baby's well-being: In fact, a woman with severe gum infection is seven times more likely to deliver an infant who arrives too early and/or weighs too little.

Throughout your reproductive life, fluctuating estrogen and progesterone levels can cause your gums to react differently to the bacteria in dental plaque (the soft deposits that accumulate on teeth). Some women first notice this connection between hormones and gum problems during their menstrual cycles, but for many, the awareness hits early in pregnancy.

Beginning in the second or third month, 50 to 70 percent of expectant moms will have experienced the swollen, red, tender and bleeding gums known as pregnancy gingivitis. Pregnancy doesn't cause gingivitis, but it can aggravate a preexisting condition. Untreated, gingivitis may progress to periodontal disease, a serious gum infection that can ultimately cause tooth loss.

But the damage doesn't limit itself to a pregnant woman's mouth. The bacteria in tooth plaque send toxins into her bloodstream and across the placenta, where they can restrict fetal growth and lead to low birth weight. The infection also releases a chemical called prostaglandin, which can cause the cervix to dilate and set off uterine contractions, resulting in premature labor.

To minimize risks to yourself and your baby, begin pregnancy with a healthy mouth. "Have a regular cleaning, get any necessary X-rays and treat problems before you get pregnant," says Michael P. Rethman, D.D.S., M.S., president of the American Academy of Periodontology. If you didn't have a dental checkup and cleaning before conceiving, do it in your first trimester, but be sure to tell your dentist that you're expecting. And avoid X-rays unless absolutely necessary: Researchers recently found an association between dental X-rays during pregnancy and the delivery of low-birth-weight babies at full term.

Dentists suggest doing the following on your own:

* Brush in the morning, at night and after meals, paying special attention to your gum line. Use fluoride toothpaste.

* Floss at least once a day.

* Consider using a gum stimulator or anti-plaque rinses.

If you already have pregnancy gingivitis, your dentist may want to treat you more often. And if your gingivitis worsens, see a gum specialist. When done before the 35th week of pregnancy, a periodontal cleaning of the tooth-root surfaces known as "scaling and root planing" reduces the risk of preterm birth by 84 percent, according to a report in the Journal of Periodontology.

For more information on your oral health during pregnancy and after, visit the Web site of the American Academy of Periodontology at www.perio.org.

RELATED ARTICLE: After your baby is born

Your own dental health may affect your baby's even after you give birth. Experts now agree that children can "catch" tooth decay from adults whose mouths contain the bacterium that causes dental caries (aka cavities). Infection usually occurs early, within the baby's first two years, and is spread via kissing and sharing food. Children most often are infected by their moms, as babies' and toddlers' immature immune systems do not recognize their mothers' bacteria as foreign. "To protect your baby's mouth, keep your own free of cavities and gum disease, and start cleaning your baby's teeth as soon as they erupt," says Richard D. Udin, D.D.S., director of the advanced pediatric dentistry program at the University of Southern California in Los Angeles.

COPYRIGHT 2004 Weider Publications
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