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Pregnancy hormones increase your risk of gingivitis (swollen gums) and even periodontal disease. What do you need to know about the symptoms, and your treatment options should you encounter them?

What is pregnancy gingivitis?

When you receive the exciting news that you are going to become a parent, your tooth and gum health is probably the last thing on your mind! As if there weren't enough to worry about, most people don't realize that pregnancy increases your susceptibility to gum disease so it is another thing to add to your list.

Unfortunately, swollen, sore and even bleeding gums and gingivitis are more common in pregnancy. Pregnancy is a time of hormonal turmoil which can result in many unwanted issues: increases in the levels of both progesterone and estrogen have a number of consequences including increased blood flow. While this is essential for a healthy pregnancy, the downside can be more sensitive and swollen gums and impaired immunity, especially in response to bacteria. This creates the ideal climate for gum disease as the bacteria can multiply and lead to the formation of plaque and tartar and ultimately periodontal infections. In the worst cases, there may be tooth decay and ultimately loss.

Pregnancy gingivitis typically develops and peaks in the second and third trimester and the signs to watch out for include red, swollen, tender, bleeding or receding gums; discomfort or pain when chewing or general tooth sensitivity, and loose teeth.

Dental care habits to adopt in pregnancy

There are a number of things you can do to help manage swollen gums and reduce the risk of serious complications from pregnancy gingivitis, if you are unlikely to suffer with it.

  • The key is to brush your teeth regularly (twice daily and especially after vomiting, if you suffer from pregnancy nausea) using a soft toothbrush and a fluoride toothpaste.
  • Salt rinses (one teaspoon of salt to one cup of water), rinsing with bicarbonate of soda to neutralize acid after vomiting and flossing can also be of enormous benefit.
  • Replacing your toothbrush every three months and having regular dental and hygiene check-ups is also important.

Dietary habits that support gum health

A diet that is rich in whole, natural foods and low in starchy, processed and sugary elements is key for good oral hygiene, as sugar (even from natural sources) increases the risk of gum disease and tooth decay. This approach is a good one to follow in general as it will also benefit your baby's growth and development as well as your general health during this time.

Focusing on a number of key nutrients can also be beneficial to supporting bone and gum regeneration:

  • Co-enzyme Q10 - found in meat, organ and muscle meats, oily fish, legumes and some fruits and vegetables
  • Omega-3 oils from nuts and seeds, plant oils and oily fish
  • Collagen - from gelatin and bone broth, egg whites, sulphur and citrus foods
  • Vitamin C - high in foods such as crucifers and leafy greens, thyme and parsley, citrus fruits
  • Catechins - found in green tea, cacao and berries
  • Beta Carotene – found in orange-colored fruits and vegetables

Treatments for pregnancy gingivitis

Sometimes women can develop a severe case of gingivitis (in spite of good dental hygiene) and this can require oral antibiotics to treat the infection. Typically a thorough professional clean will be the first step and your dentist may also prescribe a special mouthwash to treat the disease. However in severe cases surgery is sometimes required.

It is important to seek advice from your dentist if you’ve noticed any changes in your teeth or gums, especially as on rare occasions (approximately 5 percent of women), women can develop a soft overgrowth of tissue on the gums known as  “pregnancy tumors”. These should not cause alarm as they are typically benign and resolve after you give birth, however they can be removed should they cause bleeding or discomfort.

Complications of pregnancy gingivitis

While pregnancy gingivitis is common, it can worsen in severity and lead to periodontitis. This severe form of the disease can spread beyond the gum and affect all the surrounding structures including the bone. It has been associated with premature birth and low birth weight and because periodontitis is associated with low level inflammation, it is thought to be implicated in pre-eclampsia.

However, these worse-case scenarios are rare and with good diet and dental hygiene, most people are unlikely to be affected. The good news is that following delivery, gums usually return to normal; but should this not be the case, your dentist will be on hand to offer advice.

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