Online-only: Healthy gums mean healthier babies, say oral, women’s health groups
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* Natalie McGill

Because bacteria linked to gum disease can spread to newborns, periodontal care is especially important for expectant mothers, new recommendations underscore.

Pregnant women with periodontal disease are safe to seek dental treatment, and health professionals must reinforce to patients that passing the bacteria to their children could result in pre-term births or stillbirths, according to recommendations from the American Academy of Periodontology and European Federation of Periodontology.

Periodontal or gum disease occurs when bacteria causes an inflammation of the gums. If left untreated, the disease could damage bones in teeth and possibly lead to tooth decay.

“There’s a certain segment of the population that thinks that if they have any kind of periodontal or dental care when they’re pregnant that for some reason that’s forbidden (or) that that puts them at risk,” said Nancy Newhouse, DDS, MS, president of the American Academy of Periodontology, which jointly published the recommendations in April in the *Journal of Clinical Periodontology* and the *Journal of Periodontology*. “The reverse is actually true. We know it’s safe to do periodontal and dental care during pregnancy.”

Research shows that bacteria associated with periodontitis have been found in the amniotic fluid, cord blood and placenta of babies born pre-term or with low birth weights, according to the recommendations. For example, in the case of pre-term babies, bacteria such as bergeyella have been found in amniotic fluid and porphyromonas gingivalis has been found in placenta tissue, the recommendations said.

Additionally, a change in hormones during pregnancy leads to a change in gums, which makes periodontal health even more important, according to an August opinion from an American College of Obstetricians committee. Changes could include a loosening of the bone and ligaments that support teeth, erosion of enamel due to vomiting during pregnancy and pregnancy gingivitis.

The opinion suggests physicians assure pregnant women that receiving local anesthesia to treat an oral ailment or seeking treatment, such as root canals, is still safe during pregnancy.

Physicians should examine the mouths of women during regular check ups, connect with dental care professionals in their community and remind patients about proper oral care such as brushing and flossing, the opinion said.

“It doesn’t take much — whether it’s a nurse practitioner, public health practitioner — to look in their mouth,” Newhouse told *The Nation’s Health*. “Red swollen gums aren’t healthy. They don’t even look healthy. If you take your dog to the vet, one of the first things they do is look in the mouth. It’s the first thing that (a veterinarian) does, not the last thing that (a veterinarian) does.”

According to the opinion, 35 percent of U.S. women did not visit a dentist within the past year between 2007 and 2009 and 56 percent did not do so while pregnant. Some factors associated with periodontitis in women are access to care issues influenced by race and ethnicity, socioeconomic status and unhealthy behaviors, such as smoking, the recommendations said.

Newhouse said it is important for physicians to provide education for disadvantaged populations outside of a dentist’s office. That education includes understanding what health resources are available to their patients and asking women of childbearing age if they are considering pregnancy and, if so, to consider their dental health.

“We need to make sure that everybody understands that the mouth is connected to everything else and having it be healthy is just as important as everything,” Newhouse said.

For more information, visit [www.joponline.org/doi/abs/10.1902/jop.2013.1340016](http://www.joponline.org/doi/abs/10.1902/jop.2013.1340016) and [www.acog.org/Resources\_And\_Publications/Committee\_Opinions/Committee\_on\_Health\_Care\_for\_Underserved\_Women/Oral\_Health\_Care\_During\_Pregnancy\_and\_Through\_the\_Lifespan](http://www.acog.org/Resources\_And\_Publications/Committee\_Opinions/Committee\_on\_Health\_Care\_for\_Underserved\_Women/Oral\_Health\_Care\_During\_Pregnancy\_and_Through_the_Lifespan).

*   Copyright The Nation’s Health, American Public Health Association