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If you’re pregnant and have some gum recession you may be wondering what caused it and how you can prevent it from getting worse. There are many causes of receding gums, but if your gums are also red, shiny and swollen your gum recession is probably due to periodontitis, an advanced form of periodontal disease.
Periodontal disease is very common in the general population, around 47% of adults (1) have some degree of the disease. Hormonal changes during pregnancy make you more susceptible to gingivitis, the precursor to periodontitis. As well as causing gum recession, periodontitis has been linked with adverse pregnancy outcomes.
The aim of this post is to explain
- How periodontitis causes your gum recession
- The consequences of periodontitis for your general health and the outcome of your pregnancy
- How you can prevent and treat pregnancy-related gum recession
Knowledge is power where beating gum disease is concerned. Gum Disease: Solved online education tool arms you with the information to understand why you have gum disease and how you can beat it in only 10 minutes per day at home, without the need for costly and ineffective dental visits.
What Is Gum Recession?
Gum recession happens slowly and often goes unnoticed. You may become aware that your teeth look a little longer than they used to, they may be more sensitive and you may feel a ridge on the tooth just above the gum tissue.
What Causes Gum Recession During Pregnancy?
Gum recession can occur before, during and after pregnancy. No one cause is specific to pregnancy. Causes include oral piercing, aggressive tooth brushing and gum disease.
If you have red, shiny and swollen gums, periodontal disease is probably the cause of your gum recession.
How Pregnancy Affects Gum Health
Hormonal changes during pregnancy have a huge effect on the mouth. Around 60-75% of pregnant women develop swollen and inflamed gum tissue. Hormonal changes during your menstrual cycle and puberty can also affect your gum health.
Why Do Gums Become Swollen During Pregnancy?
High estrogen and progesterone levels during pregnancy predispose women to developing red, swollen and inflamed gum tissue referred to as gingivitis.
Gingivitis is triggered by plaque bacteria and exacerbated by changes in hormones during pregnancy.
When Does Pregnancy Gingivitis Start?
Pregnancy gingivitis commonly develops between 2 and 8 months and may peak during the third trimester.
The consequence of Pregnancy Gingivitis
Usually, within a few months of delivery, pregnancy gingivitis reverses. However, when plaque bacteria is not effectively disrupted twice a day with tooth brushing, periodontitis, a more severe form of periodontal disease can develop.
Periodontitis
Untreated gingivitis progresses to periodontitis, which results in the irritation and destruction of the alveolar bone that supports the teeth and gum tissue. As bone is lost, the height of the bone shrinks and the gums pull back, they are said to have receded. Teeth can become loose and fall out.
These effects are caused by some strains of bacteria found in plaque that irritate the gums as well as the body’s immune response against the bacteria. The bacteria along with immune cells involved in the inflammatory response are able to travel in the bloodstream throughout the body. The bacteria and inflammatory mediators can cause diseases and chronic conditions such as cardiovascular disease in the rest of the body.
Periodontitis is a relatively common clinical condition, occurring in more than 30% of people in some populations (2) and is found in between 5% and 20% of pregnant women (3).
Periodontitis and Adverse Pregnancy Outcomes
Periodontitis has been linked with gestational diabetes mellitus and adverse pregnancy outcomes (4). Poor pregnancy outcomes include
- Premature birth (birth before 37 weeks)
- Low birth weight
- Pre-eclampsia
Why Periodontal Disease has An Adverse Effect on Pregnancy.
Research suggests that oral bacteria enter the bloodstream and colonize the fetus and the placenta. However, the exact mechanism that leads to adverse outcomes is not fully understood.
One theory suggests that periodontal disease elevates prostaglandins levels. Prostaglandins are produced naturally by the body during labor. They dilate the cervix and cause contractions to occur. Elevated levels caused by periodontitis are thought to result in premature delivery.
Periodontitis is an inflammatory condition. Research has linked this inflammation with other inflammatory conditions which take place in the body such as cardiovascular disease. C-reactive protein has been linked with heart disease and more recently with preterm birth and pre-eclampsia.
Human Chorionic Gonadotropin (hCG) which rises during pregnancy affects the immune system, sometimes leaving you more vulnerable to colds and the flu (5). The reduced immunity may partially explain why the effect of plaque bacteria on the gums is exacerbated.
Treating Pregnancy-Related Gum Recession
Unfortunately, any gum recession cannot be reversed naturally but you can prevent it and any underlying periodontitis from getting any worse by developing and maintaining outstanding oral hygiene and making some lifestyle changes.
Develop Outstanding Oral Health
It’s essential that the plaque bacteria that lead to periodontitis and gum recession are disrupted daily. This can be achieved by
- Brushing the teeth twice a day
- Using a fluoride toothpaste
- Studies have shown that electronic toothbrushes are better at disrupting plaque bacteria than manual brushes.
- Cleaning the interdental spaces with the revolutionary gum pocket brush, interdental brushes or dental floss.
Eat A Healthy Diet
Eating a nutrient-rich diet that is low in sugar and saturated fat will have a positive effect on your oral health as well as your general health and that of your baby.
Smoking Cessation
Smoking is one of the leading causes of periodontitis in the general population and has been linked with poor pregnancy outcomes. Quitting smoking will be good for you and your baby.
Will Treating Periodontitis Have A Positive Effect on My Pregnancy?
If you have periodontal disease, either gingivitis or periodontitis, prior to conception it’s essential to treat it as soon as possible.
Some research has shown that the adverse pregnancy outcomes associated with periodontitis may not be reduced with treatment during pregnancy (6).
Scientists think that oral bacteria associated with periodontitis travel through the bloodstream to the placenta and fetus (7). It may cause inflammatory, structural and genetic alterations to the placenta that increase the risk of adverse pregnancy outcomes.
Once the bacteria have reached the fetus and placenta any periodontal treatment may be ineffective at reducing the negative outcomes associated with periodontitis (8).
Although it may not be possible to reverse the effects already caused on your pregnancy it’s still essential to treat the periodontitis as this will prevent further bacteria from travelling to the fetus and it will have a positive effect on your oral and general health.
When To See The Dentist?
The oral health and pregnancy project recommends that women visit their dentist when in the early stages of pregnancy and ideally when planning to become pregnant for a periodontal check-up (9)
How Can I Stop My Gums From Receding During Pregnancy?
The best way to prevent receding gums is to prevent periodontitis. This can be achieved by gently brushing the teeth twice daily to disrupt the plaque bacteria.
You may find that even when practising proper oral-hygiene that gingival inflammation increases during pregnancy. But disrupting the plaque each day will be beneficial to your oral and general health.
Sources
- https://www.cdc.gov/oralhealth/conditions/periodontal-disease.html
- Macones GA, Parry S, Nelson DB, Strauss JF, Ludmir J, Cohen AW, et al. Treatment of localized periodontal disease in pregnancy does not reduce the occurrence of preterm birth: results from the Periodontal Infections and Prematurity Study (PIPS). Am J Obstet Gynecol2010;202:147,e1-8 Available here: https://pubmed.ncbi.nlm.nih.gov/20113691/
- Laine MA. Effect of pregnancy on periodontal and dental health. Acta Odontol Scand2002;60:257-64. Available here: https://pubmed.ncbi.nlm.nih.gov/12418714/
- Daalderop LA, Wieland BV, Tomsin K, Reyes L, Kramer BW, Vanterpool SF, Been JV. Periodontal Disease and Pregnancy Outcomes: Overview of Systematic Reviews. JDR Clin Trans Res. 2018 Jan;3(1):10-27. doi: 10.1177/2380084417731097. Epub 2017 Sep 25. PMID: 30370334; PMCID: PMC6191679. Available here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6191679/
- Estrogen, Progesterone & More Hormones During Pregnancy – What To Expect
- Polyzos N P, Polyzos I P, Zavos A, Valachis A, Mauri D, Papanikolaou E G et al. Obstetric outcomes after treatment of periodontal disease during pregnancy: systematic review and meta-analysis BMJ 2010; 341 :c7017 doi:10.1136/bmj.c7017. Available here: https://pubmed.ncbi.nlm.nih.gov/23631578/
- Ide M, Papapanou PN. Epidemiology of association between maternal periodontal disease and adverse pregnancy outcomes–systematic review. J Periodontol. 2013 Apr;84(4 Suppl):S181-94. doi: 10.1902/jop.2013.134009. PMID: 23631578. Available here: https://pubmed.ncbi.nlm.nih.gov/23631578/
- Treating periodontal disease during pregnancy – efp.org
- Oral health and pregnancy frequently asked questions – bsperio.org