If you’re thinking of starting a family, it’s time to be thinking seriously about your dental health. The relationship between your oral health prior to pregnancy and during pregnancy is becoming clearer and clearer with recent research. It’s important that you address dental health issues before pregnancy, because pregnancy may present its own challenges to your oral health.

What does the research show?

First of all, it does not support the old wives’ tale that says you’ll “lose a tooth for every pregnancy,” even though losing teeth can be an outcome of poor dental care during pregnancy due to periodontal disease. (The old wives’ tale was based on the belief that the body would dissolve a tooth to supply additional calcium needed by the developing infant.) Some research findings that support the need for “pre-family dentistry” are as follows:

• More than one study suggests a link between good oral health and fertility. Women seeking fertility treatments were more likely to have bleeding and inflammation of gums than their counterparts who were able to conceive without fertility treatment.
• Somewhere between 60% and 75% of pregnant women will experience gingivitis (often a precursor to more serious periodontal disease).  Hormones associated with pregnancy seem to increase the incidence.
• One study suggests that women with gingivitis or other more serious gum disease are three times as likely to deliver before 37 weeks. Another study suggested that those with severe gum disease were seven times more likely to deliver very early – before 32 weeks.
• Another study suggests that regardless of whether the baby is carried to term or not, it is three times more likely to have a low birth weight (and associated health risks) if the mother has gingivitis during pregnancy.

What are pregnancy tumors?

As many as 10% of pregnant women may develop “pregnancy tumors” – more properly called pyogenic granulomas.  While not cancerous, these growths on the gums can bleed easily and, in some cases, can cause enough discomfort to warrant removal. Even if removed, they may come back. They usually go away on their own after pregnancy.

What can you do before becoming pregnant?

Brush and floss regularly to avoid the plaque build-up that can cause gingivitis. Visit your family dentistry practice for regular dental checkups, and have your teeth cleaned to remove any plaque build-up.  Some information suggests that if plaque does not exist before the pregnancy, the risk of developing pregnancy gingivitis is a fraction of a percent as long as good oral hygiene habits continue during pregnancy.

If you already have inflamed or bleeding gums, see your family dentistry practice to get treatment before you become pregnant if at all possible. If your family dentist isn’t able to provide the needed treatment, he or she will refer you to a periodontist. If you’re having difficulty conceiving, getting your gums in good shape and addressing other health issues may be a less-expensive avenue to try before investing in costly fertility treatments.  Remember, good dental health before and during pregnancy affects not just your own health, but that of your baby.  If you have dental phobia, find a dentist who offers sedation dentistry and get treatment before you become pregnant. Family dentistry practices that offer sedation dentistry may be more “sensitive” and accommodating to your dental anxiety – both before and during your pregnancy.

When are you most susceptible to pregnancy gingivitis?

Risk seems to go up in the second month of pregnancy and peaks around the eighth month. Historically, many women have avoided dental procedures during pregnancy, and that can contribute to risk. This can be a very serious mistake, especially if periodontal disease does develop. One study showed that periodontal therapy reduced the risk of premature birth and low birth weights by 68 percent in women with pregnancy gingivitis. If you’re concerned about risks associated with dental treatment during pregnancy, you may want to make sure to schedule an appointment during your second trimester, or early in your third trimester. No matter what your stage of pregnancy, don’t hesitate to contact your family dentist if you sense that gum disease might be developing.

What is the relationship between gingivitis and premature delivery?

Studies continue to be conducted on this. Pregnancy results in changes to levels of estrogen and progesterone, which may affect the immune system and decrease the woman’s ability to fight off inflammation of the gums. Some studies show that pregnant women with severe periodontitis have elevated levels of prostaglandins. Prostaglandins are substances that have an effect on many different bodily functions, and are believed to have an influence on the opening of the cervix and the onset of labor contractions.

Pre-family dentistry planning is important. Getting needed dental treatment before you become pregnant is one of the best gifts you can offer your soon-to-be-conceived child.

Did you know that North Carolina ranks very near the bottom (# 47) in the nation for availability of dental care access? The news is better, however, for those looking for dental care in Raleigh. Wake County is one of eight North Carolina counties with dentist-to-patient ratios that exceed the national average. (Durham and Orange counties are also among the eight.) If you combine June 2009 figures from the North Carolina Dental Board with 2008 census figures for Raleigh, you can extrapolate that for every 1,350 residents, there is one general dentist providing dental care in Raleigh.

The low ranking for the state is a bit surprising, especially since 80% of the students admitted to the UNC School of Dentistry come from North Carolina. The dentistry school is recognized as one of the top in the nation for both education and research. (Unlike medical and law schools, schools of dentistry in the U.S. have no “official” national rankings. But UNC is one the most highly acclaimed schools in the informal rankings that appear from time to time.) It seems like a lot of graduates who were originally residents of NC must be relocating to other states in order for our statewide ranking to be that low.