Pregnancy and oral health: Unveiling the risks and awareness for mothers-to-be

By Tarun Sai LomteMay 15 2023

In a recent study published in the journal BMC Pregnancy and Childbirth, researchers surveyed the significance of oral health in pregnancy.

Pregnancy causes hormonal changes that also affect the oral cavity. Studies have reported that signs of periodontal disease are associated with adverse pregnancy outcomes, such as preeclampsia, low birth weight, preterm birth, gestational diabetes, premature rupture membranes, and vulvovaginitis. Although plaque levels remain unchanged in pregnancy, gingival inflammation significantly increases, peaking in the third trimester and declining three months postpartum.

Special care for oral health may be considered when pregnant females crave sweet foods, affecting plaque formation patterns. Healthy diets in pregnancy can have a positive effect in reducing periodontal and gingival inflammation. Further, studies suggest that the healthy behavior of future mothers depends on various socioeconomic characteristics. Therefore, maintaining good oral health throughout pregnancy is vital for the overall health of mothers and their neonates.

Study: How much do pregnant women know about the importance of oral health in pregnancy? Questionnaire-based survey. Image Credit: Nicoleta Ionescu / Shutterstock

The study and findings

In the present study, researchers evaluated the awareness of the significance of oral health in pregnancy. A questionnaire was prepared and disseminated to mothers aged 19-44 who gave birth at gynecologic clinics. The questionnaire was designed to collect data on five demographic items and 11 items regarding oral health.

Responses were provided without seeking help from dentists to obtain real-world knowledge of females’ oral health awareness during pregnancy. Mean, median, standard deviation, and (lower and upper) quartiles were computed for continuous data. Analysis of variance (ANOVA), chi-squared test, Mann-Whiney U test, or Kruskal-Wallis test was performed to estimate statistical significance.

The team obtained responses from 200 females aged 31.9 on average. Some participants did not respond to all items in the questionnaire. The average duration of pregnancy was 38.9 weeks, based on data from 170 subjects. Most subjects (55.5%) attained higher education. Natural parturition was reported by 45% of respondents; 48.5% underwent cesarean section.

Around 40% of participants reported nausea during pregnancy. Only 20% of participants underwent dental examination when planning or preparing for pregnancy, while 38.5% had it after pregnancy confirmation. Attaining higher education was significantly correlated with undergoing a dental examination.

Nearly 20% of subjects considered this examination unnecessary because they did not have oral or dental problems, whereas 22% reported not having time or money for it. About 30% of subjects self-rated their pre-pregnancy oral health as very good; 51.5% rated it as good. Approximately 18% reported discomfort with calculus and small caries.

More prolonged pregnancy correlated with poor self-assessment of pre-pregnancy oral health. After childbirth, around 21% rated their oral health as very good, and 47% described it as good. Some participants (5%) underwent orthodontic treatment during pregnancy. However, nearly one-fourth of participants lacked awareness of the significance of oral hygiene during pregnancy.

Most participants (59.5%) understood its importance during pregnancy, while only 16.5% knew (about) it before pregnancy. Most subjects reported brushing twice daily; some reported brushing four times daily. Participants with higher education were likely to brush their teeth more frequently. Gum bleeding was reported by 37% of participants, and it correlated with nausea during pregnancy.

Around 15% of participants reported local gingival overgrowth during pregnancy, which significantly correlated with younger age. Also, it was more frequent among females who underwent cesarean section and those who had nausea during pregnancy. Complaints related to gums or teeth were significantly more common among younger subjects and those with nausea during pregnancy.

Dental hypersensitivity signs were present in 24.5% of participants. Around 31% of individuals reported dental treatment during pregnancy, which was significantly more common in younger subjects. One-third of participants reported deterioration of the oral cavity. Only 5% underwent dental extraction during pregnancy.

Conclusions

In sum, the researchers observed that several individuals were aware before their pregnancy that good oral health would positively influence the course of pregnancy, and most realized its significance during pregnancy. Nevertheless, there were around 25% who were still unaware.

The authors observed a correlation between longer pregnancy and poor self-rated pre-pregnancy oral health, particularly among those with lower educational attainment. As such, at-risk individuals should be identified and provided better care and education. Further, the impact of oral health on pregnancy management and fetal development remains elusive.