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Dental manifestations of pregnancy

Pirie et al.¹ should be commended for presenting such an interesting and useful review. Many obstetricians know little about dental problems in pregnancy and how susceptible and vulnerable dental and periodontal tissues can be from the increased levels of estrogen and progesterone.

We have noticed that many pregnant women, particularly those born outside the United Kingdom, are not aware of the importance of good dental hygiene habits during pregnancy. We would like to share the results of a prospective survey on self-reported oral hygiene habits, dental attendance and attitudes in pregnancy in a sample of immigrant women in North London. Data collected included past dental attendance, reasons for attendance and information about age, parity and socioeconomic group.

In total, 206 women completed the survey within 3 days of delivery, 74.2% of the women were not born in the UK and 38.3% were black African. The majority reported good oral hygiene habits such as brushing their teeth twice a day (73.7%) and using mouthwash (51%). However, their dental attendance was poor and the average time since their last visit to a dentist was 1.8±1.61 years. Although regular visits to the dentist by pregnant women are important to identify subclinical conditions such as gingivitis, which can be painless,¹ only 33% visited a dentist in the index pregnancy and half of them required treatment. 14.6% reported that they would not visit a dentist because they ‘did not think they needed to’.

Of the women questioned, 26% did not know about the availability of free dental care during pregnancy and for 12 months afterwards. Fifteen percent of mothers had had more than one pregnancy and yet were still unaware of the free dental care provided. Gum problems, such as bleeding when brushing the teeth, were reported by 43.7% of the women. Pregnancy did little to change the women's attitudes to dental care and there appears to be no difference in attitudes of immigrant and British-born pregnant women in this region.

When questioned, 36.4% felt that the condition of their teeth had deteriorated during pregnancy. Most of these women had hyperemesis or reflux gastritis and 4% attributed the ‘destruction’ of their teeth to gastric acid regurgitation. Interestingly, Pirie at al. made reference to hyperemesis gravidarum in their article.

We agree that efforts must be made to improve the uptake of dental care, as periodontal disease has been shown to represent a clinically significant risk factor for preterm low birthweight and preterm delivery.^2,3 Oral health promotion should include education of women and their healthcare providers on how to prevent and identify oral diseases.

Yaroslava Turok, MBBS, Clinical Attachee¹, Esther Hullah, Fourth-Year Medical Student², Raj Saha, MRCOG, Specialist Registrar³ and Wai Yoong, MD MRCOG, Consultant⁴

^1. North Middlesex Hospital, London, UK wai.yoong{at}nmh.nhs.uk
^2. North Middlesex Hospital, London, UK
^3. North Middlesex Hospital, London, UK
^4. North Middlesex Hospital, London, UK

References

1. Pirie M, Cooke I, Linden G, Irwin C. Dental manifestations of pregnancy. The Obstetrician & Gynaecologist 2007;9;1:21–26. doi:10.1576/toag.9.1.021.27292
2. Offenbacher S, Boggess KA, Murtha AP, Jared HL, Lieff S, McKaig RG, et al. Progressive periodontal disease and risk of very preterm delivery. Obstet Gynecol 2006;107:29–36.[Medline]
3. Jeffcoat MK, Geurs NC, Reddy MS, Cliver SP, Goldenberg RL, Hauth JC. Periodontal infection and preterm birth: results of a prospective study. J Am Dent Assoc 2001;132:875–80.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Turok, Y. Articles by Yoong, W. Search for Related Content PubMed Articles by Turok, Y. Articles by Yoong, W.