As if the swelling belly (and ankles) weren’t enough, haywire hormones in pregnancy can lead to all sorts of unexpected symptoms - not least, bleeding gums.

Up to 70% of pregnant women suffer from bleeding gums caused by gingivitis and, while this is a symptom many of us tend to ignore, it can lead to tooth loss, and has even been associated with adverse pregnancy outcomes.

We spoke to Dr Laura Delgado Rodriguez, general dentist & implantologist at Dr Roze & Associates Dental Clinic,  about the signs of gingivitis, why it’s more dangerous than people realise, and what we can do to prevent and treat it…

What is gingivitis and what are the symptoms?

Gingivitis is the mildest form of gum (periodontal) disease. It causes the gums to become red, irritated, swollen, and bleed easily.

There is usually little or no discomfort to begin with. Signs and symptoms of gingivitis include:

• Swollen or puffy gums

• Dusky red or dark red gums

• Gums that bleed easily when you brush or floss

• Bad breath

• Receding gums

• Tender gums

Women during pregnancy should have knowledge of the obvious signs of oral disease and should try to perform a self-evaluation to look for inflammatory changes of the gingiva (gums) or the presence of gingival bleeding. Other signs or symptoms such as pain while chewing, oral halitosis (bad breath), increased gingival recession, or tooth mobility should alert women to the need to seek immediate oral care.

The good news is that gingivitis is reversible with professional treatment and good oral home care.

What causes it in general?

The most common cause of gingivitis is poor oral hygiene.

Factors that may contribute to gingivitis include, diabetes, smoking, aging, genetic predisposition, systemic diseases and conditions, stress, inadequate nutrition, puberty, hormonal fluctuations, pregnancy, substance abuse, HIV infection, and certain medication use.

Why are you more likely to get it when pregnant?

During pregnancy, increased hormonal levels can affect the way that the body reacts to dental plaque, promoting an inflammatory response, and this can lead to swollen and bleeding gums (gingivitis) and to the more serious form of gum disease known as periodontitis. Gingivitis due to plague build-up and swelling of gums is more common at this time. Also, due to increased acid with morning sickness, you can experience a higher rate of tooth erosion.

Is it dangerous?

It's important to take gingivitis seriously and treat it promptly. Gingivitis can lead to much more serious gum disease called periodontitis and tooth loss.

Associations between periodontal diseases and adverse pregnancy outcomes have been demonstrated. A pregnant woman with poor gum health may have a greater risk of suffering from pre-eclampsia, of giving birth prematurely, and of giving birth to an underweight child.

Untreated dental disease can lead to pain, infections and unnecessary exposure to medications, any of which could harm the developing fetus. Poor oral health also can affect the nutritional intake of expectant mothers, which is essential for fetal growth and survival.

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How can you prevent getting it when pregnant?

Good oral health habits, such as brushing at least twice a day, flossing daily and getting regular dental checkups, can help prevent and reverse gingivitis.

Even in the absence of any sign of disease, pregnant women should seek an oral-health consultation with their dentist or dental hygienist as soon as possible for appropriate preventive measures. During this visit, they should ask the oral-health professional about the appropriate oral-hygiene measures and tools they should use during their pregnancy.

How can you treat it when pregnant?

If a periodontal disease is diagnosed, pregnant women should know that both gingivitis and periodontitis can be treated safely during pregnancy. They should be informed that the risks of no treatment are significantly higher that the minimal trauma that might occur during therapy.

Specific oral-hygiene regimens and professional periodontal treatment – including deep-cleaning techniques such as scaling and root planning - have been shown to be safe when carried out on pregnant women, and efficient in reducing gingival inflammation and in enabling periodontal health to be maintained during pregnancy.

Will it go away by itself post-pregnancy anyway?

In the cases of women who already have periodontitis, the clinical situation will worsen.

Both a specific localised lesion (pregnancy epulis, a form of swelling) and a more generalised one (pregnancy gingivitis) are associated with pregnancy, although women usually revert to health after delivery but not without a good oral care routine at home.

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