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A Pregnant Pause

Too many expectant mothers skip essential dental visits, new research finds

SUNDAY, Aug. 26, 2001 (HealthDayNews) -- Many women don't get proper dental care while pregnant -- even if they're suffering from a dental problem, new research shows.

According to a study in a recent issue of the Journal of the American Dental Association, data on 9,040 pregnant women from four states showed that fewer than 35 percent sought dental care during their pregnancies.

And only about half the women surveyed in three of the states, New Mexico, Illinois and Louisiana, reported seeking dental care even though they had dental problems.

The American Dental Association (ADA) recommends that pregnant women eat a balanced diet, brush their teeth thoroughly with an ADA-accepted fluoride toothpaste at least twice daily, floss at least once a day, and schedule regular dental visits and periodic professional teeth cleanings.

So what's the harm if they skip dental visits during pregnancy?

The ADA says previous research has "documented the effects of hormones on the oral health of pregnant women. Changes in estrogen and progesterone levels affect the nature of the body's response to the bacteria responsible for causing periodontal infections. These infections may pose a threat to the placenta and fetus, increasing the likelihood of pre-term delivery," according to the new research.

There's also the question of periodontal disease, says Dr. Marjorie Jeffcoat, chairwoman of the department of periodontics at the University of Alabama School of Dentistry, and co-author of the study.

"If the patient has it, it may get worse during that period," she says.

There are a number of reasons why women won't seek dental care while pregnant, Jeffcoat says.

"It can be issues ranging from access to just not knowing when to go for what dental issues," she says.

The study found the most common reasons for not seeking dental care, even if the women experienced dental problems, included:

  • Type of prenatal insurance. Women on Medicaid were 24 percent to 53 percent less likely to seek dental care.
  • Timing of the start of prenatal care. Women in New Mexico who began their prenatal care after the first trimester were 53 percent less likely to seek dental care. Illinois women and Louisiana women who started their prenatal care after the first trimester were 44 percent and 42 percent, respectively, less likely to seek dental care.
  • Income. Women with an annual household income of less than $20,000 were far less likely to seek dental care.

The data was obtained through the 1997-98 Pregnancy Risk Assessment Monitoring System, a survey of women who recently gave birth.

Michael McGuire, president of the American Academy of Periodontology, says periodontal disease is something that's treated safely, pregnant or not.

"With most periodontal problems, you can make a tremendous impact non-surgically with a good, thorough cleaning," McGuire says. "And if surgical intervention is medically necessary, it can usually at least be postponed to a proper point in the pregnancy or postponed until after the patient delivers."

"Women should not be worried about having dental evaluations when they're pregnant," he adds. "They should look at a periodontal evaluation as a normal part of prenatal care."

What To Do

Read more about women and gum disease at this American Academy of Periodontology site.

Or visit the American Dental Association's section on Women and Oral Health Care.

SOURCES: Interviews with Marjorie Jeffcoat, D.M.D., chairwoman, department of periodontics, University of Alabama School of Dentistry, Birmingham; Michael McGuire, president, American Academy of Periodontology, Chicago; American Academy of Periodontology press release; study from the July 2001 Journal of the American Dental Association
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