Why good oral care may help reduce adverse pregnancy outcomes

The importance of good oral health should not be underestimated. Your mouth is often thought of as ‘the gateway to your body’ and ‘the mirror of your health,’ as it can indicate so much about your overall health. In 2021, the World Health Organization even adopted an important resolution which underpins that maintaining a healthy mouth can reduce your chances of developing wider health issues.

Taking care of your teeth and gums is important at any stage in life. A 2019 review article in the Journal of Dental Research found that periodontitis – a severe form of gum infection that typically develops from milder inflammation of the gums (gingivitis) – has been associated with over 50 health conditions, including cardiovascular disease and diabetes. For pregnant women, the article also reported an additional consideration, pointing to an association between periodontitis and adverse pregnancy outcomes, including low fetal birth weight, preterm delivery, and excessively high maternal blood pressure (preeclampsia) [1].

The risk to pregnancy is supported by preliminary data from a randomized controlled pilot study in the USA involving 67 pregnant women with poor periodontal status who underwent non-surgical dental scaling and root planing (dental hygiene deep cleaning) during pregnancy, while also being given a Philips Sonicare electric toothbrush to use at home. The preliminary results suggest a 3.8-fold decrease in the rate of preterm delivery and a reduction in several molecular markers of systemic (whole-body) inflammation [2].

In addition to supporting this pilot study, Philips is also supporting an ongoing public health initiative [3] to improve maternal-fetal outcomes in 8 counties in the Appalachian region of West Virginia, USA –  a rural area where women are at high risk of not receiving comprehensive perinatal healthcare. This public health initiative includes supportive services targeted at improving maternal well-being during pregnancy, including oral health education/screening, dental cleaning, periodontal screening and recording (PSR), and a Sonicare toothbrush. Women in the perinatal care program who reported brushing twice daily with a Philips Sonicare toothbrush had improved birth outcomes compared to those who brushed less than twice a day [4].

Starting pregnancy with healthy teeth and gums is clearly very important, but women also need to watch out for any deterioration in their oral health during pregnancy. Hormonal changes associated with pregnancy can increase the stickiness of the bacteria-containing film (dental plaque) that coats the teeth, with a corresponding increase in the oral bacteria that cause gum inflammation. This so-called ‘pregnancy gingivitis’ has been shown to affect 60-75% of pregnant women [5] and in some cases can progress to periodontitis, increasing their risk of adverse pregnancy outcomes and other health conditions [6]. That makes it even more important to maintain oral health and keep a close check on things.

Pregnant women suffering from morning sickness should also rinse their mouth with water after vomiting, and then wait at least an hour before brushing [7]. Immediate brushing simply spreads acid reflux around the mouth, increasing the extent to which it can eat into the tooth enamel, whereas rinsing with water immediately dilutes and expels the acid.

Dental professionals say that brushing well for two minutes twice a day and regular dental check-ups are the best ways to combat the build-up of dental plaque and prevent pregnancy gingivitis [8]. Nevertheless, there are additional steps that pregnant women can take to maintain good oral health, such as regular flossing or switching from a manual to a power toothbrush. For the best oral care, Philips recommends our most advanced electric toothbrush with SenseIQ technology, designed to sense, adapt, and care for a personalized brushing routine.

For the sake of your own and your baby’s health, maintaining healthy teeth and gums is an impactful step that every pregnant woman can take.

[1] Beck JD, Papapanou PN, Philips KH, Offenbacher S. Periodontal Medicine: 100 Years of Progress. J Dent Res. 2019 Sep;98(10):1053-1062. doi: 10.1177/0022034519846113. PMID: 31429666.
[2] Offenbacher S, Lin D, Strauss R, McKaig R, Irving J, Barros SP, Moss K, Barrow DA, Hefti A, Beck JD. Effects of periodontal therapy during pregnancy on periodontal status, biologic parameters, and pregnancy outcomes: a pilot study. J Periodontol. 2006 Dec;77(12):2011-24. doi: 10.1902/jop.2006.060047. PMID: 17209786
[3] West Virginia Healthy Start/HAPI Project: Helping Appalachian Parents and Infants
[4] Wiener RC, Waters C. Personal Oral Infection Control, Low Birthweight, and Preterm Births in Appalachia West Virginia: A Cross-Sectional Study. Adv Prev Med. 2018 Aug 7;2018:9618507. doi: 10.1155/2018/9618507. PMID: 30174960; PMCID: PMC6106793.
[5] Steinberg BJ. Women's oral health issues. J Dent Educ. 1999;63(3):271-275.
[6] Sanz M, Kornman K; working group 3 of the joint EFP/AAP workshop. Periodontitis and adverse pregnancy outcomes: consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases. J Periodontol. 2013;84(4 Suppl):S164-S169. doi:10.1902/jop.2013.1340016
[7] https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/bleeding-gums/
[8] https://www.nhsinform.scot/ready-steady-baby/pregnancy/looking-after-yourself-and-your-baby/looking-after-your-teeth-and-gums-in-pregnancy