Why does gingivitis occur during pregnancy?
Tens of millions of microorganisms live in the oral cavity. Slight swelling of the gums leads to an increase in periodontal pockets, which become an excellent reservoir for the life and reproduction of bacterial microflora. In addition, microorganisms do not lack nutrition, since pregnant women like to pamper themselves with sweets, and carbohydrate foods are the best substrate for the development of bacteria.
Swelling of the gums, leading to an increase in periodontal pockets, excessive salivation, an acidic environment in the mouth, an increased feeling of hunger - these features that accompany pregnancy are the main factors contributing to the rapid growth of oral microflora. And this, in turn, provokes inflammation of the gum tissue - gingivitis.
Whims or symptoms of gingivitis during pregnancy?
The first symptoms of gingivitis in pregnant women begin to appear between 8 and 12 weeks. Expectant mothers, as a rule, suffer from two forms - catarrhal and hypertrophic; ulcerative gingivitis develops less often.
Catarrhal gingivitis
This form of the disease is manifested by the formation of a fairly large amount of soft yellow plaque on the surface of the teeth, swelling of the gums, their soreness and significant bleeding when pressed with a sharp object. Catarrhal gingivitis is characterized by the spread of inflammation over the entire surface of the gums, sometimes the process affects the tissues of both the upper and lower jaws.
Hypertrophic gingivitis
The first symptoms of hypertrophic gingivitis usually appear no earlier than the twentieth week of pregnancy. Inflammation affects the lower jaw, gums in the area of incisors, canines and small molars. The hypertrophic form of gingivitis is characterized by an increase in the volume of gum tissue, an inflammatory process in it and bleeding. Gum pockets also appear - grooves formed between the tooth and gum due to the growth of gum tissue.
Ulcerative gingivitis
The most severe form of gingivitis occurs in pregnant women. It occurs against the background of serious health problems accompanying pregnancy, in the last trimester, or under the influence of stressful situations. The main signs of ulcerative gingivitis are severe itching, burning, bleeding of the gums, swelling and ulceration.
What to pay attention to
You need to understand that bleeding gums can indicate serious disorders occurring in a woman’s body. To identify pathology at an early stage of its development and quickly eliminate the causes of bleeding, you need to consult a specialist.
The first months of gestation
In the first months of pregnancy, gingivitis may develop in the catarrhal form. The area of inflammation may be limited to two or three teeth, or may spread to the entire oral cavity. The mucous membrane swells and acquires a reddish tint. The gums hurt when you press on them, that is, while brushing your teeth and chewing food. Bad breath may appear, the viscosity of saliva may change, and bleeding may occur when brushing your teeth.
Second half of pregnancy
Untreated gingivitis in a timely manner, together with concomitant reduced immunity, can lead to the development of hypertrophic inflammation of the gums. With this pathology, the gums can bleed without any impact on them, periodontal pockets increase, the gingival margin swells and can cover up to half of the tooth crown. The disease must be treated immediately.
Safe treatment of gingivitis in pregnant women
The dentist is included in the list of mandatory specialists to visit during pregnancy. He will be able to detect the disease in time and prescribe safe treatment for gingivitis. The peculiarities of therapy for pregnant women are that measures aimed at eliminating gingivitis include only the removal of tartar and plaque, anti-inflammatory therapy and the prevention of re-development of inflammation, that is, therapeutic measures only imply relief of symptoms.
The first stage of treatment that the dentist will perform will be professional teeth cleaning. Dental plaque will be removed mechanically using Air Flow or ultrasound. The idea that ultrasound, which is used in this procedure, harms the fetus is absolutely groundless: throughout pregnancy, a woman undergoes scheduled ultrasound examinations at least three times. As an anti-inflammatory therapy, the doctor will select drugs that can act as gently as possible on the vulnerable body of a pregnant woman. Their use comes down to a local effect on the gum tissue: rinsing, baths, irrigation.
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Main causes of gum disease
The main cause of gingivitis is the presence of soft microbial plaque and hard supragingival and subgingival dental plaque that occurs due to insufficient oral hygiene. If you do not start treatment in time and only “suppress” the symptoms of gingivitis with all kinds of “medicinal” pastes, gels and rinses, the inflammation can affect the periodontium, that is, develop into periodontitis.
Gingivitis of microbial etiology is the most common cause of the generalized form of periodontitis. And local forms of this disease, affecting areas only near one or two teeth, arise mainly due to traumatic factors (occlusion characteristics, defects in old fillings, exposure to dentures, and so on).
Why do gums bleed during pregnancy?
If a woman has sore gums during pregnancy, most likely there is an inflammatory process due to gingivitis or periodontitis. Unfortunately, during this period all diseases develop much faster. If before gingivitis manifested itself only as slight redness, then during pregnancy the gums already “bleed” (as our patients say), swell, hurt, and secrete exudate.
Gums hurt and bleed during pregnancy, primarily because bacteria aggressively multiply in the oral cavity, the inflammatory process becomes more intense due to changes in hormonal levels. As a result, chronic diseases become more active, changes occur in the composition of saliva, immunity sharply decreases, and normal blood supply to the gums is disrupted. The impact of toxicosis cannot be discounted.
But the main reason for gum inflammation during pregnancy is a change in eating habits. And this is not only the desire to eat sweet, starchy and sour foods, but also the diet in general. Many women in this position have an increased appetite: they practice frequent snacking throughout the day, usually in the form of buns, cookies, and cakes.
Food debris gets stuck between the teeth, and if they are not removed immediately after eating, the digestion process starts (acid begins to act). A fertile nutrient medium causes increased proliferation of bacteria, which a weakened immune system and saliva of altered composition are unable to suppress.
Bacteria release waste products, inflammation appears - and your gums become red and swollen: this happens very quickly during pregnancy. In the place where food constantly remains between the teeth, the gum first becomes loose and inflamed, the inflamed soft tissues no longer adhere tightly to the tooth, and a so-called periodontal pocket appears. Food gets into it, which again helps to intensify the inflammatory process directly inside the soft tissues, that is, between the gum and tooth. Over time, hard deposits (“tartar”) form in the periodontal pockets, which subsequently prevents the periodontal tissues from normalizing; recovery is impossible without the help of a dentist.
It cannot be said that only women who neglect brushing their teeth and using dental floss “bleed” their gums during pregnancy, but for them this process occurs much faster and more aggressively.
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How does the disease develop during pregnancy?
Most women's gums begin to bleed already during the first half of pregnancy, at 2-3 months. During this period, pregnant women often have swollen gums (due to swelling of the marginal part and gingival papillae), the mucous membranes turn red and then take on a bluish tint, and pain is observed (especially when brushing teeth). This form of gingivitis is called catarrhal.
During this period, many women begin to spare themselves, that is, brush their teeth less and less. As a result, the situation gets worse: soft microbial plaque accumulates faster, making the symptoms of the disease even more pronounced.
In the second half of pregnancy, complaints that the gums are swollen become even more common. This is not surprising: the catarrhal form of gingivitis, which occurred earlier, is complemented by the hypertrophic one. Over the teeth, including the front teeth, unsightly formations appear in the form of swelling and growths (granulations). This is not only not beautiful, but dangerous. Granulations contain billions of bacteria, they are abundantly supplied with blood, which means they are a source of infection, blood from which enters almost all organs and systems of the body.
Gingivitis itself is unpleasant, but not critical for a pregnant woman. But the source of infection located in the oral cavity becomes chronic, which means it already affects the entire body, although the mother may not directly notice it.
Another thing is worse: as mentioned above, gingivitis without adequate treatment can turn into periodontitis, and this is not only pain, odor, bleeding and discomfort, but also a direct path to early tooth loss. And the more widespread the process, the more microorganisms and their toxins are constantly in the mother’s body.
If a pregnant woman’s gums become inflamed, it means that pathological processes have begun. But they can be stopped by contacting a dentist or periodontist in time, and the sooner the better.
Treatment of gum disease during pregnancy
The reason that gums bleed during pregnancy in most cases is the catarrhal form of gingivitis, which develops against the background of insufficient oral hygiene when eating habits change. An additional provoking factor is changes in hormonal levels and decreased immunity.
How to treat gums for pregnant women in this case? The complex of measures for the treatment of gingivitis includes three main components:
- Removal of hard deposits
(“tartar”). It was once believed that during pregnancy exclusively manual mechanical methods of removing deposits were indicated. Now the opinion of periodontists on this matter has changed dramatically: ultrasonic cleaning has come to the fore. It is absolutely safe (remember: a woman undergoes an ultrasound scan at least three times during pregnancy) and is less traumatic than mechanical cleaning. In the absence of contraindications, Air Flow technology is also used to remove pigment plaque. This allows you to further prevent the formation of tartar. Professional hygiene for pregnant women (in full) can be carried out at 10-12 weeks of pregnancy. In the first trimester, you should also visit the dentist for a medical examination and, if necessary, gentle cleaning with a brush and paste. - Anti-inflammatory therapy
. Therapy, usually lasting 10 days, is prescribed after removal of deposits. It includes antiseptic rinses and applications with special medicinal gels. Decoctions and infusions of herbs that do not contain alcohol (for example, chamomile, eucalyptus, sage, oak bark), chlorhexidine solution, and fluoride-containing compounds that simultaneously strengthen teeth are used as rinses. All procedures are carried out two or three times a day, after brushing your teeth: first brushing your teeth, then rinsing (at least a minute), and finally application (that is, you just need to smear the gums with gel). - Training in oral hygiene rules
. The doctor gives recommendations regarding the choice of toothbrush and toothpaste, and teaches how to properly use dental floss and irrigator. The condition of teeth and gums throughout pregnancy and after it depends on compliance with his recommendations.
You should not self-medicate; there are a lot of articles and advice on the Internet on how and with what to treat this or that form of stomatitis, gingivitis or periodontitis. It is important to remember that even the best and most useful article cannot replace a visit to the dentist. The doctor not only examines the oral cavity, but also asks the pregnant woman the “right” questions aimed at identifying risk factors in her specific situation.
The doctor can assess when, why and how often professional hygiene is necessary. Is just cleaning and recommendations enough or is it necessary to polish teeth (fillings) to eliminate traumatic factors, as well as the risks of increased formation of dental plaque.
When conducting an examination, the dentist must pay attention to the condition of the periodontium, and if there are periodontal pockets, he will promptly treat them and, possibly, treat them, which is almost impossible to do at home.
Mild forms of gum disease can resolve spontaneously after childbirth and the feeding period, when the body has fully recovered and normal immunity has returned. However, practice shows that during nine months of pregnancy and another six months to a year of lactation, the gums are no longer just “slightly inflamed,” but have undergone serious pathological changes, which means that the process has become chronic, which is a more serious disease, so you should postpone going to The dentist shouldn’t wait until later.
Severe forms of periodontitis may even require surgical treatment, which is a serious intervention. It is not performed during pregnancy, postponing the operation until planned delivery, but this does not mean that treatment is not necessary during pregnancy. The doctor selects conservative treatment methods to reduce symptoms and curb the process.
Prevention of gum inflammation in pregnant women
To avoid gum inflammation during pregnancy, you need to undergo a complete sanitation of the oral cavity at the planning stage.
During pregnancy, you need to follow a dietary regime and try to avoid constant snacking. After any meal, you must brush your teeth and use a irrigator. It is better to choose a brush and paste according to the dentist’s recommendations.
Dental floss and an irrigator will be faithful assistants in the fight for the health of teeth and gums: a special device for washing the interdental spaces and other hard-to-reach areas of the oral cavity. It also massages the gums perfectly, but it is important not to overdo it.
Remember that professional teeth cleaning during pregnancy is carried out at least once every 3-4 months. Come to the “Our Dentist” clinic for a free consultation, without expecting clinical manifestations of diseases of the teeth and gums: preventive measures are always preferable to therapy, and even more so, surgery, from all points of view!
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Author of the material: Chief Dentistry Doctor “Our Dentist” Oleg Nikolevich Sharmay.
Recommendations to help avoid problems
In order not to become one of the pregnant women suffering from gingivitis (and, according to statistics, there are more than 60%), you must adhere to simple rules.
- Carry out the necessary hygiene procedures regularly: brush your teeth using a toothbrush with soft bristles, and do this as thoroughly as possible, use floss and antiseptic rinses.
- Avoid excessive amounts of sweets and consume sweets, chocolate and cakes in moderation. It is strongly recommended to refrain from chewing toffee and caramel, since the remains of viscous delicacies can accumulate in the periodontal space of swollen gums, provoking particularly active proliferation of microorganisms.
- Eat more vegetables and fruits, paying special attention to foods containing vitamin C.
Treatment of gingivitis in pregnant women cannot be postponed until later. Occurring due to changes in hormonal status and the growth of microbial microflora, it provokes even more active proliferation of bacteria, which in the most severe cases can cause intrauterine infection of the fetus.
