Gum disease

An old saying has it that "a woman loses one tooth with every pregnancy." While that's clearly a tale from the days before professional dental care, you are more susceptible to dental problems when you're pregnant. The oral changes of pregnancy are linked to an increased amount of plaque, the sticky, colorless film of bacteria that coats your teeth. Hormonal changes also make your gums more susceptible to the damaging effects of plaque. If plaque hardens, it turns into tartar.

When plaque and tartar build up along the part of your gums around the base of your teeth (gingiva), they can irritate your gums and create pockets of bacteria between your gums and teeth. This condition is called gingivitis, a form of gum disease. Gingivitis is characterized by red, swollen, tender gums that may easily bleed, especially when you brush your teeth (see also Bleeding gums).

Many pregnant women are affected by gingivitis to some extent. It usually starts in the second trimester. If you already have some degree of gum disease, it's likely to worsen during pregnancy.

Left untreated, gingivitis can develop into a more serious form of gum disease called periodontitis. This gum infection can cause teeth to loosen and fall out. And serious gum disease poses even more threats to a pregnant woman. It may increase your risk of having a preterm or low-birth-weight baby and also may increase your risk of developing preeclampsia.

■ Prevention and self-care for gum disease

Because your teeth are more susceptible to the harmful effects of bacteria while you're pregnant, it's important to keep up good dental hygiene. Follow these preventive dental care steps to keep your gums healthy:

• Brush your teeth with fluoride toothpaste at least twice a day and after each meal when possible. Brush before bedtime and again in the morning. To further reduce bacteria in the mouth, brush your tongue when you brush your teeth.

• If brushing your teeth triggers nausea, rinse your mouth with water or with anti-plaque and fluoride mouthwashes.

• Floss your teeth thoroughly each day. Flossing removes plaque between your teeth and helps massage your gums. Waxed and unwaxed floss are both fine.

• You may need more frequent dental exams when you're pregnant. Even if you're not having problems with your teeth or gums, schedule an appointment to have your teeth checked and cleaned at least once during your nine months. Dental X-rays can be performed without risk to the baby.

• Good nutrition can help keep your teeth and gums healthy and strong. Vitamins C and B-12 are particularly important for oral health.

■ Medical care for gum disease

If you have severe gum disease, have it treated promptly to avoid problems with your pregnancy. Contact your dentist and your health care provider if you have signs and symptoms of periodontitis:

• Swollen or recessed gums

• An unpleasant taste in your mouth

• Pain in one of your teeth, especially with hot, cold or sweet foods

• Drainage of pus around one or more teeth

Treatment for severe gum disease may include special cleaning techniques and antibiotics. In some cases, surgery may be necessary. If you need major dental work while pregnant, you'll want to thoroughly discuss your options with both your dentist and your regular health care provider to ensure safety.

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