Gum disease in pregnancy

If you’re squeamish about going to the dentist, you might want to reconsider given new research that links gum disease with a higher risk of giving birth to a premature baby. A recent US study found that those with gum disease were over three times more likely to give birth prematurely than mums-to-be with good oral health. They also had a one in four chance of giving birth before 35 weeks. Other studies also have shown an association between gum disease and early birth, but others haven’t. Previous research also has suggested a link between gum disease and pre-eclampsia. So should you worry about it at a time when you’re likely to have a hundred and one things on your mind?

What is gum disease?

Gum disease is an infection of the gums and bones that’s caused by plaque, a sticky substance that forms when bacteria reacts with the sugary foods you eat. It sticks to the teeth, forming a film that can build up if you don’t floss and brush your teeth regularly and/or thoroughly. The bacteria present in plaque contains toxins that irritate the gums, causing inflammation. Pregnant women are particularly susceptible because pregnancy hormones and the increased blood volume that occurs in pregnancy cause the gums to become more sensitive and more likely to react to irritation. Pregnancy also lowers the immune system, compromising your body’s ability to resist infection.

It isn’t clear how gum disease affects pregnancy, but it’s thought that it may increase the levels of prostaglandin and tumour necrosis factor, both chemicals that can trigger labour. Experts also theorize that the oral bacteria involved may spread from mum to baby via the placenta or that inflammation in the gums may signal chronic inflammation throughout the body, that eventually spreads to the uterus to trigger labour.

In the study, researchers followed 872 women, who were between six and 20 weeks pregnant. Of that group, 160 women who had gum disease were treated and later evaluated to see whether the treatment had been successful. About seven percent of the women without gum disease gave birth before 35 weeks – but the rate was 23.4 percent among those who had gum disease.

Could gum disease affect your pregnancy?

Some UK experts have been cautious about the research, noting that the differences could relate back to a poorer lifestyle habits in general among the women who gave birth early – for example, they may have eaten an unhealthy diet, smoked or drank alcohol to excess. However, Dr Nigel Carter, chief executive of the British Dental Health Foundation, said that the research adds to the growing evidence around links between gum disease and preterm babies, and that it provides further strong evidence that pregnant women should take care of their oral health in order to reduce as far as possible their chance of a preterm birth.

Annette Briley, consultant midwife with the pregnancy research charity Tommy’s, agrees, and points out that when you’re pregnant you get free dental care that continues for a year after your baby’s birth. “It is therefore good to go to the dentist early in pregnancy and ensure that your mouth, teeth and gums are as healthy as they can be,” she said, although she notes that many factors can cause preterm and that many women who don’t have gum disease may still have their babies early.

Spotting the signs of gum disease

Gum disease often can be painless, and pregnant women are often told to expect some minor bleeding from their gums when they brush, due to the gums being more sensitive at this time. However, if you have gum disease you may notice that your gums appear redder than normal, and that they are sore. Bleeding when flossing and brushing can be a sign, as can persistent bad breath. You may also notice more saliva than usual though this is a common pregnancy symptoms and isn’t anything to worry about.

It’s a good idea to visit your dentist for a thorough exam before you get pregnant, so that any problems can be addressed. If you’re already pregnant, take advantage of your free NHS dental care—dental treatment won’t affect your baby at all, and the study found that those women who were successfully treated for their gum disease were less likely to give birth early. Protect yourself from gum disease by flossing and brushing your teeth thoroughly twice a day, and by eating a healthy diet that doesn’t contain too many sugary foods.

The information in this feature is intended for educational purposes only. If you have any concerns about your health, the health of your child or the health of someone you know, please consult with a doctor or other healthcare professional.

Last Modified: 19/03/2010