Introduction
Pregnancy is a highly crucial period in every woman's life. It entails utmost care and attention to safeguard the expectant mother's health and the developing baby in the womb. In addition, pregnancy may predispose an individual to specific ailments, most of which are associated with the volatility of the hormonal balance in the body.
The oscillatory nature of the hormones may also have manifestations in the oral cavity, which can be in the form of oral inflammations and infections. Neglected and untreated oral conditions may result in compromised maternal oral health, and, at the same time, it can bring in pregnancy complications by influencing the child's development in the mother's womb.
What Is Meant by Maternal Oral Health?
Maternal oral health points to the oral health status of a pregnant woman. It encompasses the overall condition of the mouth, the amount of tooth deposits, tooth decay, and the health of the associated oral structures. Oral health, like general health, is critical throughout an individual's life, and sometimes, oral health can flag underlying hidden health complications. However, it can have profound implications when it comes to pregnant women. A pregnant lady's oral health can impact the growing baby's health within the womb and even precipitate pregnancy-associated complications and risks. Hence, maternal oral health should be properly emphasized to safeguard the mother's and developing child's health.
What Is the Significance of Maternal Oral Health?
Maintaining oral health during pregnancy might look challenging because of the enhanced risk of oral conditions posed by altering hormone levels. An enhanced decaying of teeth often accompanies pregnancy. In addition, the gum tissues become more exposed to developing infections and destructive changes, which develop on a cellular basis. Pronounced levels of placental hormones, like progesterone and estrogen, bring about exaggerated sensitivity and reactivity of the gum tissues. Pregnancy gingivitis (swollen, sore, reddened, bleeding gums) and pregnancy tumors (gum puffiness restricted to a confined area of the gum, giving the appearance of a tumor or lump) are the common gum issues encountered during pregnancy.
Ulcer-like sores may also develop over the gum tissue, and the tissue apparatus that keeps hold of the tooth in its position also manifests weakness and deterioration.
Inceptive stages of pregnancy are often accompanied by vomiting and nausea. Studies have identified that almost 70 percent of pregnant women manifest vomiting, especially during the early stages of pregnancy. During vomiting, the stomach content is in contact with the oral structures. When exposed to the tooth structures, the acidic nature of the stomach content corrodes the tooth surface and eats away the outer enamel layer, leading to dental erosion.
Pregnancy is marked by a considerable decline in saliva flow, which can have direct reflections on tooth decay. Pregnancy-associated discomfort and food cravings make the person less focused on dental care. As a result, women tend to gather more tooth deposits, which, when coupled with hormonal discrepancies, facilitates the development of gum infections. Maternal oral hygiene can directly impact the baby's oral health status.
What Pregnancy Complications Could Arise in Response to Compromised Maternal Oral Health?
In addition to a wide spectrum of dental issues that develop in the maternal oral cavity in response to compromised oral health, it can also bring in serious pregnancy complications. Some of the frequently reported pregnancy complications in conjunction with substandard maternal oral care include the following:
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Premature Delivery: Maternal oral health complications may bring about premature birth of the child, where the baby will be delivered a bit earlier than the actual arrival date. Preterm birth is the commonly used synonym for premature delivery. Such babies cannot achieve full-term growth as they are born before reaching the entire term of pregnancy. Thirty-seven weeks are recognized as the complete duration of a pregnancy cycle, and these 37 weeks are essential for the growth and development of the baby in utero (within the womb). Skipping a few weeks of this anticipated gestation period (duration of pregnancy) can precipitate certain grave impacts on the final development of the child that is supposed to happen inside the uterus. Babies born prematurely or early are susceptible to developmental disabilities, or at times, it can even result in the baby's death, either during or post-delivery. Material oral infections and infectious agents from the mother's mouth may pass on to the child in the womb through placental connection and trigger early delivery.
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Low Birth Weight: Compromised maternal oral health can impact the baby's weight. Certain bacteria, namely Prevotella intermedia, Fusobacterium nucleatum, Treponema denticola, Porphyromonus gingivalis, and Prevotella nigrescens, are oral bacteria that are identified to be responsible for triggering premature birth and low birth weight. These bacteria are mainly associated with oral infections involving the periodontal structures (that sandwich between the tooth and the bone and aid in keeping the tooth firm and immobile). In pregnant ladies with periodontal infections, these bacteria may migrate from the maternal body to the fetal placental (connect the baby in the womb with the maternal body for nutrients and oxygen). The bacterial actions may facilitate the child's birth by wrongly creating the signal for delivery. As a result, the child will be born before the actual date, before attaining the average birth weight. Babies born with body weight below the normal limit are categorized as low birth weight babies. Low birth weight and premature babies are the two grave factors that can lead to the baby's death.
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Pre-Eclampsia: Diminishing maternal periodontal health status can directly gear up the development of pre-eclampsia, where the maternal body elicits a remarkable hike in blood pressure. It is often accompanied by puffiness over the eyes, face, and hands. The 20th week is identified to be the ideal time for the development of pre-eclampsia. Though oral health status is identified as a triggering factor for pre-eclampsia, there is no clear information concerning the mechanism underlying the same.
Conclusion
Low birth weight babies and preterm delivery are frequently encountered birth complications, accounting for many child deaths. Detrimental maternal oral health status is identified to be an apparent causative factor that can potentially bring in pregnancy complications. Hence, it is crucial to keep pregnant mothers aware of the importance of practicing oral care measures to keep themselves and the child healthy and safe. Dietary guidance and lifestyle modifications for enhancing the health of oral structures to deal with pregnancy-induced hormonal changes are also reported to be effective in checking the development of maternal or dental issues. Proper awareness among pregnant ladies can significantly reduce the incidence of pregnancy complications evoked by the expectant mother's poor oral health status.
