“Gain a child, lose a tooth” – Phillip Silver – Solvay
Featured Products Promotional FeaturesPosted by: Dental Design 11th July 2019
Most people have heard the old adage “gain a child, lose a tooth”, but like many other old wives’ tales, the notion that tooth loss is a natural consequence of pregnancy is not something that has been taken very seriously. Nevertheless, over recent years, researchers have demonstrated that there are links between pregnancy and oral health problems that seem to offer this so called “myth” some validity.
The periodontal health of pregnant women has been studied since the 1960s and although pregnancy does not actually cause gum disease, female hormones including oestrogen and progesterone are elevated during pregnancy, which can modulate oral microbial organisms including putative periodontal pathogens.[1]In response, gingival tissues become more sensitive to the effects of plaque bacteria and the body’s response to toxins can become exaggerated leading todark red, swollen gums thatbleed easily. Research confirms that approximately 40% of women will develop some form of periodontal disease during pregnancy, although it generally reduces during the ninth month and usually settles after delivery.1,[2],[3]Nevertheless, pregnancy can aggravate or exacerbate any pre-existing periodontal conditions, possibly extending their progression and severity and leading to undesirable oral health effects such as tooth mobility or loss.[4],[5]Indeed, repeated pregnancies may result in more frequent outbreaks of gingivitis that may lead to tooth loss in women with periodontitis.[6]
During the first trimester of pregnancy many women experience morning sickness. In fact, it is estimated that 70 to 80 per cent of pregnant women experience nausea and vomiting.[7]Some also experience gastroesophageal reflux disease or (GERD) in the latter stages of pregnancy as hormones slow down the digestive system and the lower oesophageal sphincter becomes relaxed. As the uterus grows and puts pressure on the stomach, gastric acids may be forced back up into the oesophagus and into the oral cavity. Recurrent vomiting, GERD or both increases the acidity of the oral environment, which can enhance the growth of carious pathogens and demineralisation leaving the teeth more prone to caries and dental erosion.[8]In addition, research indicates that changes in the composition of the salivaduringlate pregnancy and during lactation mayalsopredispose pregnant ladies to dental caries and erosion.[9]
Going back to the old wives’ tale, further evidence that having children could be detrimental to oral health exists. For example, studies conducted in Sweden in the 1980s with a large cohort of women found that the number of teeth they retained at the age of 70 decreased in relation to the number of children that they had given birth to.[10]Furthermore, an increased risk of being completely edentulous was identified as the number of children they had increased.[11]In 2008, a study of 2,635 American women showed that parity (number of children) was related to tooth loss.9Although thespecific reasons for this were not fully explained, the professor that lead the study suggested that along with the biological changes that occur during pregnancy and child birth, behavioural changes could also be a factor in tooth loss. For instance: women may postpone seeking dental treatment due to financial concerns about having children or, caring for more children may lead mothers to reduce the time devoted to their own oral health.[12]
As we know, a good home oral hygiene routine combined with regular visits to the dental practice can help women to avoid dental disease and tooth loss both during and after pregnancy. However, if tooth decay or periodontal disease progresses or is left untreated, there is the chance that reparative treatment may no longer be viable. In these cases, tooth replacement may be the only option in order to restore the smile and function but also to stop the remaining teeth from drifting. For some a bridge or a dental implant may be the ideal solution but for many mothers, a removable partial denture may be more convenient and cost effective.
Patients can opt for the traditional metal-based or flexible removable partial dentures (RPDs) but now Solvay Dental 360®have custom-developed Ultaire®AKP. This new generation polymer fits seamlessly into the digital workflow to provide accuracy with a highly retentive, comfortable fit and patients can enjoy a lightweight RPD that is biocompatible, long lasting and metal free.
Of course, it is hoped that most expectant mothers are able to keep their teeth intact throughout pregnancy and beyond. Certainly, with access to modern dental care they are better informed and more fortunate than the ‘old wives’ of previous generations. Additionally, as more research is uncovered and our knowledge expands, dental professionals are better able to support these patients with oral health instruction and advice to help them to maintain the health of their teeth and gums as well as their children’s.
To book a Solvay Dental 360®Professional Lunch and Learn or to find more information about Ultaire®AKP and Dentivera®milling discs,
please visit www.solvaydental360.com
References
[1]Kornman K. et al. The subgingival microbial flora during pregnancy. J Periodontol 1980;15 (2):111-122. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1600-0765.1980.tb00265.x{Accessed 24th April 2019]
[2]Lieff S, et al. The oral conditions and pregnancy study: periodontal status of a cohort of pregnant women. J Periodontol 2004;75:116-126.
http://www.ncbi.nlm.nih.gov/pubmed/15025223[Accessed 24th April 2019]
[3]Wu M et al. Relationship between gingival inflammation and pregnancy. Mediators Inflamm. 2015; 2015: 623427.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4385665/[Accessed 24th April 2019]
[4]Vogt M et al. Factors associated with the prevalence of periodontal disease in low-risk pregnant women. Reprod Health. 2012; 9: 3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3283460/[Accessed 24th April 2019]
[5]Naseem M. et al. Oral health challenges in pregnant women: Recommendations for dental care professionals. The Saudi Journal for Dental research (2006) 7;138-146. https://www.sciencedirect.com/science/article/pii/S2352003515000404[Accessed 24th April 2019]
[6]Russell S. Exploring potential pathways between parity and tooth loss among American woman. Am J Public Health. 2008 July; 98(7): 1263–1270.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2424105/[Accessed 24th April 2019]
[7]Lee N.M et al. Nausea and vomiting of pregnancy. Gastroenterol Clin North Am. 2011 Jun; 40(2): 309–vii.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3676933/
[Accessed 24th April 2019]
[8]Naseem M. et al. Oral health challenges in pregnant women: Recommendations for dental care professionals. The Saudi Journal for Dental research (2006) 7;138-146. https://www.sciencedirect.com/science/article/pii/S2352003515000404[Accessed 24th April 2019]
[9]Laine M.A. Effect of pregnancy on periodontal and dental health. Acta Odontol Scand. 2002 Oct;60(5):257-64.https://www.ncbi.nlm.nih.gov/pubmed/12418714[Accessed 24th April 2019]
[10]Rundgren A. et al. Dental health and parity in three 70-year-old cohorts. Community Dent Oral Epidemiol. 1987 Jun;15(3):134-6. https://www.ncbi.nlm.nih.gov/pubmed/3474097/
[Accessed 24thApril 2019]
[11]Halling A. et al. The number of children, use of oral contraceptives and menopausal status in relation to the number of remaining teeth and the periodontal bone height. A population study of women in Gothenburg, Sweden. Community Dent Health. 1989 Mar;6(1):39-45. https://www.ncbi.nlm.nih.gov/pubmed/2720476[Accessed 24th April 2019]
[12]New York University. “Pregnancies Linked To Tooth Loss.” ScienceDaily. ScienceDaily, 30 May 2008. https://www.sciencedaily.com/releases/2008/05/080529162934.htm
[Accessed 24thApril 2019]
