written by: Dr. Amanda Tavoularis, Dentably
Expectant mothers have a lot to think about when it comes to maintaining their own health, as well as the health of their soon-to-be child. Traditionally, these health maintenance needs are addressed through supplemental nutrition, as well as providing special attention to one’s diet. At the same time, though, dental care is often overlooked, despite several known links between inadequate oral care and pregnancy complications.
Though you might not expect it, pregnancy and dental care actually go hand-in-hand. This is due to a variety of health issues that may spring up as a result of periodontitis or gum disease. This condition results from an infection in your gums, which may, in turn, activate immune-responses across your entire body and cause complications for pregnant women (such as preterm labor and low birth weight).
Both of these complications are on the rise in certain parts of the industrialized world, so it is imperative that this potential contributing factor is addressed as soon as possible. Periodontitis is unpleasant in general terms and, as you’ll learn, could put you at risk for pregnancy complications.
Over my 20 years working in the field of dentistry, I have helped many women improve their dental health in order to decrease their susceptibility to these pregnancy-related risks. As such, I believe that all women who are considering starting a new family in the near future should take these oral health factors into consideration and discuss them with their healthcare providers at their earliest convenience.
What is Periodontitis?
According to the European Federation of Periodontology, periodontitis (commonly known as gum disease) is a fairly common condition wherein the patient’s gums become inflamed. Often signaled by redness, swelling, and bleeding in the affected area, periodontitis actually represents your body’s attempts to ward off an infection that has infiltrated your gum’s soft exterior.
In regular terms, periodontitis is an undesirable condition that causes oral discomfort in the short term and permanent gum damage if left untreated. Periodontitis can also lead to tooth loss in some cases due to the breakdown of the gum structure. That being said, periodontitis poses a unique degree of risk to pregnant mothers based upon an assortment of recent studies.
Connections between Periodontitis and Pregnancy
Most folks assume that oral health and general body health fall into separate realms based upon the fact that they visit separate care providers for each. But in fact, contemporary medical research has revealed that these differentiated categories can have an acute effect on one another, as evidenced in the case of periodontitis and its effects on pregnant women.
Specifically, several recent studies have drawn a critical link between the presence of periodontitis in an expectant mother with an increased risk for late-stage pregnancy complications. These risks include premature labor as well as low birth weight (even when carried to full-term). Both of these complications can have long-term impacts on the child’s health and wellbeing, making periodontitis a serious issue for pregnant women and their doctors to discuss.
One study (published in the Journal of Natural Science, Biology, and Medicine in 2010) identified a possible cause of this negative reaction. Researchers in that study concluded that “endotoxins released from [the] Gram-negative bacteria responsible for periodontal disease” may trigger an immune response that spreads throughout the body. For pregnant women, this spread may reach to their womb, leading to adverse reactions when it comes to development and delivery.
A second similar study (published in the International Journal of Applied and Basic Medical Research in 2015) identified specific aspects of the “fetomaternal immune response” as being a contributor to this undesirable connection between periodontitis and pregnancy complications. Both studies posted the belief that early detection would be an ideal method of lowering this risk factor because present research cannot conclude whether simultaneous treatment during pregnancy can lower these risks efficiently.
Recommendations for Preventing Periodontitis during Pregnancy
As with many forms of dental and oral hygiene, preventative treatment is the best way to stop a condition such as periodontitis from causing complications among pregnant women. In fact, given the time period required to clear an infection relating to periodontitis, such preventative measures may be the only method to ensure that a negative immune-response to said infection does not trigger the potential complications described above.
The American Dental Association provides several helpful recommendations when it comes to preventing the propagation of periodontitis, as well as preventing the condition from taking hold in the first place. As one might expect, regular checkups are the first line of defense against this type of condition, given the enhanced ability of oral and dental care professionals to spot the signs of periodontitis before it enters a fully-fledged state.
For most patients (pregnant women included), brushing one’s teeth with a fluoride-based toothpaste can greatly decrease the risks associated with periodontitis (and its connected pregnancy risks, in turn). The ADA also recommends flossing as part of this daily regimen in order to clear out inter-molar spaces where plaque that leads to periodontitis is more likely to build up.
Though it goes without saying in the case of pregnancy, smoking should be avoided entirely in order to decrease the likelihood of periodontitis. Similarly, a healthy diet that promotes oral health, in general, can help an individual’s gums fight off the kinds of infections that may put pregnant women at risk for unique complications.
A Dental Disconnect
At the end of the day, some of the misunderstandings about periodontitis and its impact on pregnant women can be chalked up to a disconnect between several different healthcare fields. As is expected, pregnant women are more likely to ask pregnancy-related questions to the general practitioner, while dental or oral care questions are posed to a dentist or oral hygienist. Because these two lines of questioning don’t usually cross, these noteworthy risks might be missed.
Also, even if every precaution is taken, some mothers and their developing children still may be at a heightened risk for complications. Those who find themselves in this category shouldn’t feel disheartened and should instead turn to the perspectives of other parents in a similar situation for inspiration. Even expectant fathers can learn a lot from these testimonials when it comes to coping with a high risk pregnancy in a healthy manner
Dr. Amanda Tavoularis graduated from the University of Washington School of Dentistry in 1995. Since then, her passion for dental excellence has lead her to continue her dental education at the prestigious Kois Center. For more information, visit Dentably.com.
According to the Centers for Disease Control and Prevention (CDC), the prevalence rate of a child having a developmental delay is 
develops an Individual Family Service Plan (ISFP). The ISFP is a road map for both the family and the ITDS to ensure that appropriate developmental goals are set and the goals are measured to ensure that progress is made. When it comes to developing the ISFP, parents are a member of the team and their input is greatly valued. As a parent, you know your child the best and can advocate for what you think your child needs. Once the plan is developed, the child and family will work with an ITDS. As your child and the family work the ITDS, progress is monitored to see whether or not your child is reaching the goals outlined in the ISFP. When children have met their goals and are meeting developmental milestones, they are able to exit out of Early Steps and no longer need the services.
Sometimes, a child may need more help once they reach their third birthday or, as a parent, you may start to have concerns about your child reaching developmental milestones after his or her third birthday. There are still several services and supports that you can access through your local public school district. For children who have received services through Early Steps and continue to need services to reach his/her developmental milestones, these children are able to transfer from Early Steps to the public school system special education program. For children between the ages of three and five, they can be evaluated by the school districts’ preschool special education services team to determine whether or not they are eligible for services. Similar to a developmental delay, a developmental disability is when a child experiences a delay in one or more of the following five areas: self-care, cognitive ability, communication skills, social/emotional development, and/or physical development. Once a child has been found eligible for a developmental 
disability, the team develops an Individual Education Plan (IEP). This plan details the child’s abilities and the goals and objectives that the special education teachers and support staff (such as speech-language pathologists, occupational therapists, physical therapists, and/or school psychologists) will be working on with the child. Typically, an IEP is reviewed and updated annually; however, if there are any concerns from the parent and/or teacher, the IEP can be reviewed more frequently. Typically, special education teachers provide regular updates to the child’s parents about how the child is doing and what is being worked on in the classroom.
watching other new mothers leave the hospital with their beautiful healthy babies. Adalyn fought a great fight and we were able to bring her home. We felt blessed to leave the hospital with her, but carried the weight in our hearts from leaving without her other half.” – Angie Bresnahan
cars with the car seats in tow and their babies in their laps. They looked exhausted but happy. I also saw a few that had an empty lap. They were exhausted… and devastated. They were leaving without their baby. After Beren’s passing, we bought a bear that we include in every single family photo to this day. It is a symbol of Beren and that he is an unforgettable member of this family.”
Handprint Kit, “I didn’t have one of these but I wish I had. Beren’s ink footprints that were taken by a Respiratory Therapist mean the world to me and I will always cherish them. Every parent counts those hands and toes once born, and with this, you can look upon something real and tangible that was theirs.”
sensitive to smells. To this day, I have Beren’s baby blanket in a Ziploc bag to cherish his smell. I really believe it to be the same with his hospital bracelet, or even lock of hair. This tin memory box locks in a lifetime of memories for me.”
Bereavement Gown, “I was ecstatic to hear that High Risk Hope receives consistent donations of Bereavement Gowns from their supporters. A few are made from vintage wedding dresses and fabrics, but all of them are made with genuine love. I think that’s comforting to know when received.”
the hospital, we were home for about 2 weeks before the Tot Trot. Even though Grayson was still on oxygen, we went and were so glad we did. We were able to reconnect with Grayson’s primary night nurse, Brandi, and his primary neonatologist, Dr. Vargas. Our family was able to see other kids who were preemies, running and playing around the Tot Trot, and it gave us continued hope Grayson will one day be following in their footsteps. To see all of the former NICU babies so happy and healthy made our hearts full. Thank you, HRH, for making this event happen. We can’t wait until this year!”
“We are so thankful for our little miracle, Henry (aka Hank), who made us parents. An unconventional pregnancy that resulted in hospital bedrest and a NICU stint for our son introduced us to High Risk Hope. Though our support system was strong, we did not know anyone who had experienced these unforeseen circumstances before and wished we had someone to rely on for advice, guidance, and perspective. We knew once our son was healthy, we wanted to join a community that provided just that. High Risk Hope and the Tot Trot have embraced our family and welcomed us into their community with open arms. This year we will participate for the second year as team ‘HANK You Very Much’ to honor and celebrate our superhero. We have invited our friends and family to join us in raising money for this cause that is so close to our hearts and we are working hard to be the top fundraising team two years in a row! The Tot Trot truly is a fun event for the whole family. I invite you to join my family and the many others as we #FightForPreemies! “
was born early. Even though we were scared we were very excited as well. There were a lot of people there to make sure she was taken care of and felt very loved. She was the most beautiful little girl I had ever seen and she still is.”
does, we don’t give nicknames or baby talk. Having gone through this twice, we want her to become educated about her and Stephen’s scary but very common journey. Nothing was their fault and nothing was Mommy’s fault, we were chosen to go through that journey together, so we never take our time together for granted.”
to oxygen and feeding tubes). I explain to them that they were born early so they had to learn how to eat and breathe and that the amazing doctors and nurses at the hospital helped them. When they see photos of other babies or kids with oxygen or monitor leads, they say, ‘Hey, I had those when I was born!’, proclaiming it as a badge of honor.”
and my blood pressure was very high. The end result was she had IUGR (intrauterine growth restriction) and would not grow until delivered. She was born at 4 lbs. 15 oz. and to this day she is still on the low end for weight, however, she follows her own curve and is a happy and healthy 9-year-old.”
everything that went on during our three-month hospital stay. That knowledge helps Hill to be empathetic towards other families of preemies and tackle challenges in his life now knowing he has already overcome one of the best and biggest challenges when he was born.”
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