Specialist Dental Group has launched an on-going series of blog posts by our individual dental specialists. All views provided are the dentist’s own opinions and are posted on this blog as part of our on-going efforts to educate the public about dental issues and other matters of interest relating to dentistry and healthcare.

Being pregnant is a process that half the human race could potentially experience…..the female half, that is. And it is the most natural and satisfying experience a woman could hope to encounter, if blessed with such an opportunity!

Pregnancy is not a disease, but the changes it brings on can be associated with other “diseases”. The earliest changes are the surge in the “female” hormones, estrogen and progesterone. These hormones help maintain the pregnancy, but they also contribute to bouts of nausea, the severity of which may vary from one woman to another.

In bad cases, even the usually well-loved food odours become repulsive. Nausea and vomiting that persist for a long time can affect the nutritional status of the mum-to-be, since she may not be retaining sufficient food for good nourishment. Constant vomiting also brings up a lot of gastric acid, which over the long term may cause erosion of the enamel surfaces of teeth. This author can even attest to the fact that tooth-brushing becomes difficult. During both my previous and present pregnancies, I have not been able to tolerate the smell or taste of toothpaste. The process of trying to brush my back teeth (molars) causes the inevitable vomiting. And I have anecdotal evidence from some of my female patients that they have faced the same trials. So, through my own experiences, I empathise with these patients, when they present with poorer oral hygiene during or after pregnancy.

Another important change caused by the surge of hormones is the flare-up of swollen and bleeding gums that women experience in pregnancy. Much research has been devoted to this form of gum disease. It is true that the hormones, estrogen and progesterone, make the gums more sensitive to the effects of bacterial plaque. However, if the levels of dental plaque and calculus (the main causes of gum disease) were kept under control before pregnancy, then no noticeable changes in gum disease should occur. Conversely, if there is underlying, untreated gum disease, then during pregnancy, the gums swell alarmingly, bleed easily when touched and teeth become more mobile. Persistent, severe gum disease has been associated with  higher rates of miscarriage and preterm labour.  Preterm birth results in low birth-weight babies who are faced with more developmental issues.

Gum disease has also been strongly associated with diabetes, where there is lack of control of sugar levels in the blood. Since diabetes is also a potential complication of pregnancy, we strongly advice that taking good care of dental health before and during pregnancy is as essential as the consumption of good
food and vitamins and all the antenatal care that the doctor provides.

I make it a point to educate my young female patients that they should take care of their oral hygiene well before planning for a baby. Prevention is better than cure: when one starts early with regular brushing and flossing and visits to the dentist, then maintaining good dental health in any phase of life becomes easier. Even when faced with the alarming scenario of swollen and bleeding gums, the mum-to-be should not ignore the problem, but rather seek help from a dentist or periodontist to get the condition under control. Contrary to the “old grandmother’s tales”, dental treatment is safe during pregnancy. Only the use of x-rays is avoided.

With the easy availability of information and the good dental and medical care that women in Singapore in particular enjoy, pregnancy should be smooth-sailing, just as it has been for me. As I look forward to the birth of my second son, I wish all mothers and mums-to-be out there good health and happiness!

Dr Helena Lee is a Periodontist with Specialist Dental Group. She holds an appointment as an Adjunct Lecturer in the Department of Preventive Dentistry, National University of Singapore. She has co-authored several papers in peer-reviewed journals and has lectured at professional local and international conferences. Dr Lee has a special interest in the treatment and prevention of periodontal disease, gingival plastic surgery, soft and hard tissue grafting and dental implants. For more information on Dr Lee, click here

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2014

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