Bleeding gums during pregnancy? Hear what periodontal experts have to say

"Thank you very much! I feel much better now~" Through the handset, I can almost see the cheerful smile of Xiaoling on the phone line.

35-year-old Xiaoling usually eat sweet and sour snacks, suffered from mild periodontitis before pregnancy, daily brushing often has a slight bleeding condition, to 21 weeks of pregnancy she found that the bleeding gums are getting more and more serious, there is also a serious oral odor and obvious pain, gargling with hydrogen peroxide has not improved significantly.

Although Xiaoling also cleaned her teeth before pregnancy and removed the surface supragingival stones, there were still a large number of subgingival stones, and due to the rapid regeneration rate of the supragingival stones, a large amount of soft scale accumulated on the gingival margin, aggravating inflammation. At the same time, the hormone level continues to rise during pregnancy, which further exacerbates the degree of original inflammation, and the use of hydrogen peroxide gargling cannot eliminate the inflammation in the deep part of the periodontal pocket, and the conventional intradental bag or systemic medication may have adverse effects on the fetus.

After assessing Xiaoling's physical condition, periodontal experts used supragingival cleansing and subgingival curettage to completely remove the periodontal causative factors through physical debridement. After a month of systematic treatment, Xiaoling's bleeding gums symptoms were controlled and she could safely wait for the baby to be born.

Here to remind female friends: if the first half of pregnancy, to 1 year after childbirth, this period, called the "perinatal period", this relatively special period, to take scientific and reasonable prevention and treatment, adhere to the development of good oral cleaning habits, to avoid pregnancy, lactation to bring periodontal problems.

About "perinagnant" periodontal health management

In the "perinatal gestational period", hormone levels, psychological states, lifestyle changes will have a series of effects on women's oral health, in order to protect the health of mothers and babies, as part of perinatal health care, it is very important to pay attention to the periodontal health of women of childbearing age during this special period.

"Perinagnant" periodontal health management is three steps

Step 1: Avoid periodontal problems during pregnancy and prepare well before you get pregnant.

Before pregnancy, commonly known as the pregnancy preparation period, during this period, women's physical and mental condition is generally relatively stable, suitable for a comprehensive periodontal examination assessment. Chronic periodontitis tends to have a slow onset and is particularly overlooked by most people who have only mild occasional bleeding gums before the course of the disease progresses to a certain stage. In this period, what we need to do is to carry out appropriate treatment for the periodontal problems found in the examination and evaluation, such as routine cleaning, subgingival scraping, extraction of the stump crown that cannot be retained, necessary filling, root canal treatment, extraction of wisdom teeth that cannot be retained, etc. In our periodontal sequence treatment, these parts of the basic treatment should be completed at this stage.

Step 2: Pregnancy, self-care and aggressive treatment go hand in hand.

During pregnancy, due to the special physiological state, the timing of treatment of oral diseases during this period and the examination and treatment methods that can be taken are limited to a certain extent. Generally speaking, the second trimester of pregnancy (pregnancy 4 to 6 months) is a relatively safe and stable period, most oral treatment can be carried out normally at this stage, for pregnant women who originally have periodontitis and are regularly treated, we usually consider routine periodontal maintenance during this period, and for those expectant mothers who find obvious periodontal symptoms after pregnancy, it is relatively safe to cleanse teeth and subgingival scraping during this period.

For women with no subjective symptoms and only mild inflammatory manifestations, it is mainly to prevent education and guide daily oral care; and for patients with obvious bleeding, suppuration, pain and other uncomfortable symptoms of the gums, we will choose to carry out conventional treatment such as supingival cleansing, subgingival scraping, periodontal irrigation and other conventional treatments when the pregnant woman's body can tolerate it; for patients who have a large gingival tumor with obvious bleeding pain affecting eating, even in the third trimester, we can still take surgical resection.

Step 3: During lactation, strengthen oral hygiene maintenance and consolidate and maintain the efficacy.

Breastfeeding women often eat more times, easy to ignore, and even do not carry out normal brushing and rinsing during the puerperium, which makes this period also a high incidence of periodontal problems. But new mothers often don't see a doctor because they "don't have time" or are "afraid of taking medication to affect their children," so that they delay their illness. In fact, since periodontal basic therapy rarely involves systemic medication, routine cleansing and scraping has no effect on normal breastfeeding.

The key to "perinatal pregnancy" periodontal health management is to start from before pregnancy and start from usual. All expectant mothers who are ready to welcome their babies need to do the following 3 points from the beginning of pregnancy preparation:

1. Insist on brushing your teeth morning and evening, brush your teeth effectively, increase the number of brushing according to the frequency of eating, and use tools such as floss and gap brush to clean the adjacent surfaces of your teeth.

2. Rationally adjust the diet structure, intake of sufficient high-quality protein, dietary fiber, trace elements and vitamins.

3. Break the misunderstanding, once the oral problem is found, seek medical treatment in time, seek professional help as soon as possible, and carry out reasonable treatment and medication under the guidance of the doctor.

Source: Affiliated Stomatological Hospital of Zhejiang University School of Medicine