Importance of Dental Care for Moms-to-be

Dental Issues In Pregnant Women Put Babies At Risk

By Colorado Public News and Cara DeGette

Enlarge image

Pamela McClain, Pres. of the American Academy of Periodontology, working on a patient. Studies have determined that poor dental hygiene & gum disease lead to many other health problems, including the potential for premature and low birthweight babies.

Dentists are warning pregnant women to take care of their teeth, for the sake of their babies.

Pregnant women with cavities and gum disease have an increased risk of having premature and low-birth weight babies. They also have a good chance of passing on their bacteria and bad habits to their children.

Over the past 10-15 years, numerous studies have determined that poor dental hygiene and gum disease lead to many other health problems, said Aurora periodontist Pamela McClain, who is president of the American Academy of Periodontology. Gum disease can lead to periodontal disease, or inflammation, infection and decay of the bone and tendons around the teeth. The studies have connected periodontal disease to increased risks for cardiovascular disease, Alzheimer’s disease and even pancreatic cancer, she said.

Research has also focused on women who are expecting.

“Many, many studies have shown that high levels of [the hormone] progesterone puts pregnant women at a higher risk and more susceptible to gum diseases,” McClain said. “Pregnant women who have periodontitis are two to four times more likely to have pre-term, low birthrate babies.”

“We all have bacteria in our mouths,” she said. However, some bacteria attach to teeth and become plaque, and if that plaque is not removed, it can lead to inflammation of the gums, or gingivitis.

Untreated, the bacteria ultimately start destroying the bones in your mouth – and that is not reversible, said McClain.

McClain said the percentage of women with poor oral hygiene giving birth to babies prematurely is relatively small. However, she notes that underweight and premature babies are far more likely to have mothers with periodontal disease. 

Women with dental problems also easily pass their germs onto their babies. Jeff Kahl, a Colorado Springs pediatric dentist, says the costs of treating children ages 0-3 years old with dental problems has skyrocketed in recent years. New mothers can easily transfer their own bacteria to their babies in a myriad of ways, including kissing them, sharing utensils – anything that enables the mother to transfer saliva to the baby.

“If we can screen pregnant women who are at the highest risk, and treat them, the probability they will transmit [bacteria] to their children is much lower,” Kahl said.

A bill being considered by the Colorado legislature this year would extend dental health care to women on Medicaid who are pregnant and have just given birth. The bill, sponsored by Sen. Jeanne Nicholson (D-Black Hawk), passed the Senate Health and Human Services committee in late March, with Democrats voting in favor and Republicans opposed.

“It’s going to be a tough road,” said Kahl, who supports the effort. “The Democrats think it's the greatest thing in the world. The Republicans we talk to think it’s great but say they have a problem with the price tag.”

The bill’s estimated cost is $3.5 million in the first year and $10.3 million next year according to legislative council staff. Bills for new programs that cost money often have a hard time in the legislature.

Kahl and McClain argue the investment would be saved over the long term by preventing future expensive dental treatments for children and their mothers. They also cite the huge savings on medical costs related to premature and low-weight babies. However, Kahl concedes that saving money by providing preventative treatments can be a tough sell.

“You’re talking about kids who aren’t even born yet,” he said.

Kahl recommends that pregnant women should make sure they are as healthy as possible, and advises would-be mothers on the following:

• As soon as possible after learning you are pregnant, get a dental check-up.
• Take care of any cavities you may have.
• Brush your teeth after eating.
• Floss your teeth daily.
• Consider using a prescription mouth rinse, with the medication Chlorhexidine, to minimize bacteria build-up in your mouth.

Dental Visits Critical for Smokers

CDC report: More smokers avoid the dentist

Adult tobacco smokers are four times more likely to develop oral health problems but much less likely than nonsmokers to go to the dentist regularly, according to a report released February 7 by the U.S. Centers for Disease Control and Prevention (CDC).

The study, which included more than 16,000 adults between the ages of 18 and 64 who participated in the 2008 National Health Interview Survey, also found that although more than a third of smokers included in the report said they have three or more dental problems, 20% said they had not been to a dentist in at least five years. Among nonsmokers and former smokers, 10% had stayed away that long.

Cost was cited as the main reason that most adults with an oral health problem did not see a dentist in the past six months; 56% of current smokers, 36% of former smokers, and 35% of never smokers said they could not afford treatment or did not have insurance.

"Overall, current smokers had a poorer oral health status and more oral health problems than either former smokers or never smokers," the report authors noted. "However, current smokers were more likely to think that their oral health problem was important."

The evidence for an association between tobacco use and oral diseases has been clearly shown in every U.S. surgeon general's report on tobacco since 1964. Tobacco use is a risk factor for oral cancers, periodontal diseases, and dental caries, among other diseases.

reported by DrBicuspid.com, Feb 2012.

Dr. Notes:

Because cost is cited as a major factor for smokers and their reluctance to visit the dentist for regular check-ups, I thought I would present some facts.

The average cost for a pack of cigarettes in the state of Minnesota is $6.53.  That’s 33¢ per cigarette.  According to the American Lung Association, the average smoker inhales 3/4 pack, or 15 cigarettes, per day.  After doing the math you'd find that the annual cost for a smoker’s habit totals $1787 plus change.

Now consider this.  The average annual cost of routine dental care (includes 3 cleanings, exams and routine radiographs) would be around $275.  Again, if you crunch the numbers you would find that if the average smoker were to reduce cigarette consumption by 3 cigarettes per day, they could easily afford the out-of-pocket expense of routine dental care.  And these numbers don’t consider the inclusion of dental insurance, which 80% of smokers have, yet don’t utilize.

Our job as a dental office is to address and treat oral health.  We don't give lectures and we don't judge people based on their choices in life, especially their decision to smoke.  But we will provide guidance and advice for those who do.  Regular dental care is crucial for smokers if they wish to minimize the long term effects of their smoking habit.  Routine cleanings and exams can do a lot to help prevent a wide range of problems that smokers are predisposed to and help proactively identify the development of long-term complications that can result from oral tobacco use.

What Does Your Mouth Have to Say About Your Health?

Oral Health Can Provide Clues to Total Body Wellness for Patients

Cardiologists might not check your teeth and gums, but maybe they should start. Mounting evidence suggests a quick peek in the mouth may reveal a whole lot about your general health.

PICTURES: Foul mouth: what yucky signs say about your health

The lips, mouth, teeth and breath can signal medical problems and diseases beyond the plaque, gum disease and gingivitis diagnosed in the dentist's chair. Plaque buildup between teeth due to lax brushing and flossing is very different from plaque that builds up in arteries and causes heart attacks - but the toxins in mouth plaque stimulate a chronic inflammatory response linked to diseases like heart disease.

"The mouth is the gateway to the heart and there's clearly a link between poor dental health and cardiovascular conditions," says Dr. Kevin Marzo, Chief of Cardiology at Winthrop University Hospital in Mineola, New York. For example, he says, cardiac medications you put under your tongue travel quickly through the bloodstream. That means bacteria can too.

"The bacteria that cause dental plaque may promote inflammation in the body beyond the mouth including the lining of the blood vessels, increasing the risk for cardiovascular disease including heart attacks," says Marzo.

Research has shown when people with active gum disease are treated, their arteries actually get healthier. Some experts suggest managing inflammation in the mouth may reduce other inflammatory-related health issues, including arthritis - even wrinkles and aging. Besides heart disease, gum disease has been linked to respiratory diseases, stroke, and osteoporosis.

The mouth can also give doctors clues about a person's sexual health. Warts in the mouth that resemble cauliflower clusters may signal the human papillomavirus, or HPV, one of the most common sexually transmitted infections.

"I see them on the lips, tongue or roof of the mouth," says Dr. Susan Pugliese, Clinical Assistant Professor Division of Oral Medicine and Dentistry Department of Surgery at SUNY Downstate. "And I'm seeing them more frequently in patients over 50 who are dating." Pugliese says this age group may not connect what's going on in their mouth to their sex lives.

HPV is also a driver of oral cancer: the National Cancer Institute, estimates 65 percent of the approximately 8,000 cancers of the tonsils and base of the tongue seen in the U.S. in 2010 were from HPV infections; 80 per cent were in men. Cancers may appear as ulcers on the lips, inside of the cheeks, tongue or back of throat that don't heal, or white patches that don't slough off. A biopsy is typically recommended for suspicious warts or lesions in the mouth and throat.

HIV is often first detected in the mouth, as a bright red outline around the teeth, or as a white coating that can be scraped off the tongue, known as thrush. The coating signals an overgrowth of Candida, the same fungus that causes yeast infections in women and jock itch in men. The white coating can also signal glucose levels are out of whack, poorly managed diabetes or fluctuating hormones. It can also be harmless, signaling a sensitivity to additives in toothpaste, such as tartar control agents. Dentists may recommend an HIV test for young patients presenting with Candida who have other risk factors.

A person's breath also provides health clues. Bad breath may signal serious conditions that require medical attention such as respiratory infections, diabetes, acid reflux and kidney and liver problems. Dry mouth? That's sometimes caused by medications, such as antidepressants, anti-inflammatories, and heart drugs. Drinking water or chewing on fibrous foods such as celery may help.

Good oral hygiene is the best way to prevent gum disease and keep your mouth healthy. Healthy gums hug the teeth and don't pull away, have bounce, and don't bleed from brushing or flossing.

But while a clean, well-cared for mouth can promote good health, it can also disguise serious health problems... so don't skip regular visits to the doctor, and dentist.