Pregnancy and Your Mouth
By Sheila "Mama Gums" Wolf, RDH

Being pregnant has its unique oral challenges. Because of the radical increases in the levels of estrogen and progesterone in progressively greater concentrations throughout pregnancy, the expectant mother's gum tissues become more vulnerable to infection. Fifty to seventy-five percent of all pregnant women experience an unpleasant and often painful condition of the gums called pregnancy gingivitis. This inflammation and infection not only affects the mouth, but also can have far-reaching consequences to the mother's whole body health, her pregnancy, and her unborn child.

As a dental hygienist, I can recall, on at least three separate occasions, having had the privilege of breaking the news of a young woman's pregnancy from my side of the dental chair. I use the word "privilege" with my tongue planted firmly in my cheek, however. After all, the diagnosis was only determined because of the patient's distinctively red, tender, and very swollen gums. Ouch!

Talk about taking the good news with the bad.

You may even have gum disease already; its symptoms are not always obvious and it afflicts as many as four out of five people. Growing evidence links gum infections with increased risk of premature and underweight births -- not to mention heart attack, stroke, diabetes, ulcers and other serious systemic problems. Pregnant women who have gum infections are more prone to having a baby that is born too early and too small. Fortunately, with the right self-care, this does not have to affect you.

A new perspective on tooth brushing

You need to transform the relationship you have probably had your entire life with the cleaning of your teeth. If you are like me, when you think of cleaning, you probably think of dirt. I clean the dirt off my car. Your mouth is not dirty like your car, your windows, or your kitchen floor. It doesn't have dust and grime. Rather, your mouth contains a tiny world of living bacteria, a very complex society of microorganisms, not unlike your own community in the ways its residents work together and support each other's activities. There are over 400 different kinds of tiny and varied species of germ life, so small they can only be viewed with a microscope or identified from bacterial cultures in a laboratory. This collection of microbes is composed of billions of teeny-tiny microscopic "bugs," some good, some bad. Left to themselves and undisturbed, the bad bugs can develop into disease-causing plaques or biofilms that live on your teeth, their roots, and the areas around them, under your gums. If not controlled, specific bugs may cause periodontitis, the infection that breaks down your teeth and the supporting structures that hold your teeth in your jaws.

Today, we know that tooth decay, gum diseases, abscesses, pus, and bone loss are all caused by bacterial infections. Brushing and flossing, the traditional means of mechanically cleaning your teeth, are just not enough. If they were, three-quarters of the population of the United States would not have gum diseases and the systemic illnesses associated with these types of infections. You must learn to control the harmful germ-life that affects the wellness of your mouth, your body, and your unborn child, both chemically and mechanically.

Dr. Paul H. Keyes, a former Senior Researcher at the National Institutes of Health, advises, "You must disorganize, disperse, detoxify and disinfect the bacterial biofilms that colonize on the surfaces of the teeth."

According to Dr. Keyes, "The therapeutic value of toothbrushing is attained not only by its potential to mechanically remove food particles and bacterial plaques, but also its ability to deliver antibacterial agents to the surfaces of your teeth and gums which have not been adequately 'debugged' by the mechanical measures you have used."

So, from now on, I want you to think about self-care methods that will decontaminate, disinfect and "de-bug" your teeth. It is from this new perspective that I am going to introduce you to anti-bacterial oral hygiene that will ensure excellent dental health.

From the beginning, you may have been bombarded with a flurry of conflicting instructions on how to perform this toothbrushing ritual. Is it up and down? Side to side? Medium bristle? Hard? Soft? And, the biggest question of all: What in the heck is that little Hershey's Kiss-shaped thing on the end of the brush? But, no matter how you learned to brush, the simple fact is that you should keep brushing. Brush to disinfect rather than just clean.

As a disinfectant, baking soda (sodium bicarbonate) mixed with a tiny bit of salt, and hydrogen peroxide are hard to beat. When mixed as a paste, it will detoxify and disinfect the bacterial biofilms that colonize on the crowns and roots of your teeth and your gums. The easiest way to use this combination is to dip your wet toothbrush into a capful of peroxide to moisten the bristles. Then, dip the brush into the baking soda. The powder will adhere to the moistened bristles and can be applied with the brush along the gum line, or even lightly worked under the gums with the little Hershey's Kiss-shaped doodad on the end of the toothbrush. If the taste is objectionable, a little mouthwash can be added to the peroxide. Another approach is to apply any toothpaste you like, and then dip the brush into some baking soda.


Sheila Wolf, known affectionately as Mama Gums, has been practicing dental hygiene for 32 years. Working at the leading edge of nonsurgical periodontal care, her mission is to educate and empower people to take control of their own mouths. She has brought her message to places as far apart as California and Connecticut, Israel, Africa, and the hills of Kentucky. Her latest project is her book, Pregnancy and Oral Health: The critical connection between your mouth and your baby, due to be published this summer. Sheila can be reached at (619) 287-3151 or at


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