Gum Health & Pregnancy: What You Need to Know

I think that we can all agree that the goal of every pregnancy is to foster the healthiest baby possible. There are many ways you can create the ideal environment for your growing baby but one area that is often overlooked is your mouth. While it’s true that cavities and gum disease are more common among pregnant women, perhaps the more important thing to understand is that neglecting your oral health during pregnancy can have direct effects on the health of your unborn child. We will go into more detail below, but to put it simply, gum disease during pregnancy can lead to preterm labor and low birth weight for your baby.

My wife never had a cavity in her life until right after the birth of our first child. She went into the office expecting the praise she had received from every dentist her entire life, but instead walked out with an appointment to return for five fillings! While pregnant, the body’s resources are dominantly focused on creating and protecting the fetus. That means that the oral environment is naturally less favorable to teeth and gum health. This is compounded by the fact that many women change their eating habits during pregnancy and some women regularly vomit due to morning sicknesss. This makes the teeth more susceptible to developing cavities. 

While the cost and inconvenience of cavities alone may be enough to encourage pregnant women to improve their daily oral health routine, the more pressing concern is the health of the gums. As previously stated, this is the area of oral health that can have direct effects on your baby. To best illustrate this, let’s look at what gum disease is. I like to describe the gums around our teeth like a turtleneck. When the pocket between your tooth and the overlying turtleneck of gum tissue is 1-3mm deep, that is considered healthy, meaning your efforts to brush and floss at home can effectively clean out that pocket. With traditional gum disease, bacteria gets trapped in that turtleneck and starts to erode the bottom of the pocket, making the pocket deeper. As the pocket reaches depths of 4mm and up, your brushing and flossing become less and less effective. In those situations, you really need the help of a hygienist and their specialized instruments to flush out those pockets. 

The gum disease that develops during pregnancy (also known as pregnancy gingivitis) is slightly different than traditional gum disease. During pregnancy, excess progesterone causes the gum tissue to swell and become inflamed. So, the pocket between the turtleneck of gum tissue and the tooth gets deeper, not because the base of the pocket drops, but because the top of the turtleneck grows taller with the inflammation. We sometimes call this “false pocketing.” While the mechanism of how the pocket gets deeper is different, the health concerns are the same. A deep pocket between your teeth and the overlying gum tissue means that harmful bacteria from your mouth can enter your bloodstream and cause negative outcomes like preterm labor and low birth weight for your baby.

So now that we understand the concerns and negative outcomes of cavities and gum disease during pregnancy, let’s move on to the good news. It is all preventable! Women who go into their pregnancy with an oral health plan can usually avoid all of these negative outcomes. 

Here are some suggestions I give to all of my patients who are pregnant or are thinking about having a baby.

- Continue seeing your dentist for your 6 month cleanings. Cleanings at any point during your pregnancy are considered safe for you and your baby. Also, many insurance companies will pay for an extra cleaning during pregnancy, so it’s a great idea to take advantage of this benefit if your insurance allows it.

- Buy a Sonicare or Oral B electric toothbrush.  Not only are these electric brushes better at cleaning your teeth, they are especially good at stimulating the gum tissue and flushing out bacteria that accumulates along the gum line. *Bonus tip* If your gums are sensitive during pregnancy, you can run your toothbrush under hot water to soften the bristles.

- Buy a Slate Electric Flosser. No other product flushes out the gum pockets between your  teeth like the vibrating Gum Sweeps on the Slate Electric Flosser. The vibrating floss also stimulates the gum tissue which increases blood flow. This decreases inflammation, redness, tenderness, and bleeding while simultaneously preventing cavities from forming between the teeth.

- Brush and floss twice a day (thrice if you can). If you aren’t already, there’s no better time to build this habit than during a pregnancy. Brushing and flossing right when you wake up and right before bed are powerful lifelong habits that we should all strive to be consistent with.

- Rinse your mouth after vomiting. If you have reflux due to morning sickness, make sure you rinse your mouth with water several times right after to help reduce the negative effects of the acid on your teeth. 

- Try not to snack all day. We all know pregnancy cravings are real, but just know that every time you eat or drink something, it takes your saliva 30 - 45 minutes to get rid of the acids present in the foods you eat. If you are snacking or nursing a Diet Coke all day long, your mouth is constantly in the acidic state where cavities thrive.

- Avoid glide floss. While many people love the way glide floss slides between their tight contacts, a recent study out of Harvard found that glide floss contains a high percentage of PFAS, a chemical that has been proven to cause certain types of cancer, low birth weight, and preterm labor. Certain types of electric flossers also use glide floss, but not Slate. 😉

We understand that you have a lot on your mind with the impending arrival of your new little one, but prioritizing your oral health while pregnant benefits both you and your baby long-term. If you’re already prone to cavities, you may feel resigned to the negative effects of pregnancy on your teeth, but it doesn’t need to be that way. No matter how skilled your dentist is, your natural tooth is always going to be better than any restoration your dentist creates. So, while most of us have several functional fillings and/or crowns in our mouths, we should always be looking for ways to prevent new cavities, even while pregnant.