Why is it important to take care of oral health during pregnancy?

The physical and hormonal changes that take place during pregnancy can have an impact on women's oral health. Increased production of hormones such as estrogen and progesterone can alter the composition and pH of saliva, as well as cause heartburn and vomiting by slowing gastric emptying. These hormonal changes can affect both the amount of saliva produced and its ability to neutralize acids in the mouth.

Studies indicate that pregnant women experience a reduction in the buffering capacity of saliva, which creates an oral environment more prone to the development of oral problems if these factors are combined with poor oral hygiene and a diet high in carbohydrates.

What are the oral risks associated with pregnancy?

Caries formation

The salivary pH regulates the acidity of the mouth and during the gestation period, it tends to become more acidic. This decreases the defensive capacity of saliva to counteract bacteria, and the usual vomiting of this stage can intensify the problem. The erosion of tooth enamel caused by repeated exposure to stomach acid, as well as the proliferation and desquamation of cells in the oral mucosa, create an environment conducive to bacterial growth that increases the risk of caries.

On the other hand, a diet deficient in essential nutrients such as calcium, phosphorus and vitamins A, C and D, coupled with recurrent consumption of sugary foods, also contributes to the formation of dental biofilm and, subsequently, to the formation of caries during pregnancy. These nutritional deficits affect both the integrity of tooth enamel and the overall health of the gums and other oral tissues.

Gingivitis and periodontitis

One of the most relevant physiological changes affecting the oral health of pregnant women is the increased vascularization of the gingiva, which makes them more susceptible to inflammation and periodontal diseases.

Gingivitis is one of the most common affections in pregnant women. It usually appears between the second and third month of gestation, affecting between 60 and 75% of pregnant women. This occurs due to the exaggerated inflammatory response of the gums to dental biofilm. Inflamed and reddened gums may become more delicate and fragile, being prone to bleeding. This situation can escalate to periodontitis when not treated in time.

Tooth loss

Tooth loss, although less common than gingivitis, is a condition influenced by several factors. Studies suggest that pre-existing conditions, such as periodontal disease, may worsen and thus increase the risk of irreversible tooth loss. Tooth loss is not a direct effect of pregnancy, but rather a consequence of intensified risk factors and lifestyle changes.

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How does oral disease affect the health of mother and baby?

Recent research has established an increasingly evident connection between oral diseases and obstetric complications, underlining the importance of prevention and dental treatment during this stage.

Preterm delivery and low birth weight

Oral infections such as gingivitis and periodontitis have been identified as risk factors for preterm labor. The bacteria involved can enter the bloodstream, triggering an inflammatory response that contributes to premature rupture of membranes and premature onset of labor.

In addition, periodontal inflammation releases inflammatory mediators, such as cytokines, which can cross the placenta and affect fetal growth, resulting in newborns with lower birth weight and reduced fetal length.

Preeclampsia

Preeclampsia is a severe hypertensive disorder, characterized by high blood pressure and protein in the urine, which can put both mother and baby at risk. This condition has also been associated with periodontal disease, as bacteria and inflammatory substances from periodontal disease can enter the bloodstream and affect the placental endothelium, contributing to the development of preeclampsia.

Orofacial cleft

Although less studied, a possible connection between oral conditions and orofacial clefts has also been identified. Some research suggests that the presence of periodontitis in the mother may increase the risk of orofacial malformations in the infant, such as cleft lip and/or cleft palate, congenital defects that prevent complete closure of the lip or palate.

Gestational diabetes

Although it is not directly caused by the patient's oral health, but is a disorder that can arise from hormonal changes in women during pregnancy, gestational diabetes can aggravate oral problems such as caries, periodontal disease and lesions in the oral mucosa. Specialized monitoring is necessary to prevent and treat oral complications in this group.

All these cases are related to the lack or absence of dental checkups and oral hygiene habits. Women who do not undergo these check-ups and oral care tend to present more complications than those who do.

What are the recommendations for oral health care during pregnancy?

To mitigate the oral risks mentioned above, it is important for pregnant women to follow a strict oral care routine. Here are the main recommendations:

Rigorous oral hygiene

It is recommended to brush teeth at least twice a day using fluoride toothpaste to help strengthen tooth enamel and fight cavities. Daily flossing helps remove dental biofilm and food debris between the teeth and along the gum line. Similarly, mouth rinses help reduce the bacterial load and minimize inflammation in the gums, helping to prevent gingivitis and periodontitis.

Healthy diet

Pregnant women should be sure to consume adequate amounts of calcium, vitamins A, C, D and folic acid for the formation and maintenance of healthy teeth and gums. Limit the intake of foods and beverages rich in sugar to prevent the formation of plaque and cavities.

Regular dental visits

It is recommended that pregnant women make regular visits to the dentist, especially during the second trimester of pregnancy. During these visits, the dentist can perform routine evaluations and preventive treatments such as teeth cleaning and scaling and root planing if necessary. Dental problems can be addressed in their early stages and more serious complications can be prevented. Dental treatments should preferably be scheduled during the second trimester or early third trimester, when it is safest for both mother and baby.

Oral education

Oral health professionals should provide detailed information to women on how to prevent dental problems during and after pregnancy. This includes guidance on how hormonal changes can affect their mouth, the most appropriate brushing and flossing technique, as well as other preventive measures to take. Prenatal fluoride is one of the usual recommendations to strengthen tooth enamel, facilitate mineralization and inhibit the formation of dental biofilm in the oral cavity.

The many physical and hormonal changes that take place during pregnancy can provide a favorable environment for oral problems such as caries, gingivitis and periodontitis. Moreover, these oral complications not only affect the oral health of pregnant women, but are also associated with obstetric problems. To minimize these risks, it is important to maintain a rigorous oral hygiene, adopt a balanced diet and make regular visits to the dentist, where they will receive proper guidance on oral care to prevent any type of complication.