Your Oral Microbiome Affects Your Uterine Microbiome
Dental Hygiene in Pregnancy
There is already so much to consider when you are pregnant. But did you know that oral conditions such as periodontal disease are linked to adverse outcomes in pregnancy?
Please note, I feel it is important to share this information - not as a scare tactic, but purely from a place of empowerment. It is the micro choices we make every day that contribute to our overall health and the health of our children. This is a gentle invitation to recognize that you are an autonomous individual and that your health belongs to you.
Here’s what you need to know.
Oral health in pregnancy is not just important for maternal health, but is intrinsically valuable to the development of your baby. Between 14.2% and 54.8% of pregnant women suffer from periodontal disease.
Periodontal disease, otherwise known as gum disease, poses a serious threat to birth outcomes such as preterm birth, low birthweight, gestational diabetes and even preeclampsia. This is due to the fact that when plaque builds up on the teeth and is not removed, it can then calcify and become a surface for pathogens such as Porphyromonas gingivalis to attach itself. Once this occurs, biofilm of bacteria gets into the bloodstream and then travels around the mother’s body as well as to the placenta. When the periodontal bacteria enters the placenta, it can then produce toxins within the amniotic fluid which may ultimately lead to premature birth. In other words, your oral microbiome affects your uterine microbiome.
The bacteria changes the gingival flora which has been observed to increase levels of estrogen and progesterone. This can cause gum inflammation (hello bleeding gums and bad breath), and even larger, more problematic immune system responses.
Severe Periodontal disease is also associated with fetal growth restriction. This is most likely due to the fact that the mother’s body is working into overdrive trying to address the bacteria which in turn creates systemic changes within her body and in the body of the developing baby.
Due to ethical and safety concerns, further scientific research on periodontal disease was conducted on animals.
The research was startling:
“According to animal research using experimentally induced maternal periodontitis, long-term effects of periodontal disease during pregnancy include insulin resistance, effects on the central nervous system development, and the increased risk of development of lung inflammatory allergic response in the offspring. These happen due to a phenomenon known as programming, which can translate changes in the intrauterine microenviroment into physiologic and metabolic alterations in adulthood”.
There also have been epidemiological studies that indicate when there is a maternal infection present during pregnancy, there is an increased risk of central nervous system disorders within the offspring. The risks noted were autism, cerebral palsy and schizophrenia.
The research concluded that “due to maternal inflammation, the concentration of pro-inflammatory mediators such as cytokines, chemokines, antibodies, and acute-phase proteins increases in the maternal bloodstream, thus increasing the permeability of the placental barrier and the fetal blood–brain barrier, allowing the inflammatory mediators to enter the fetal brain”.
To me, it is imperative to address oral health from a bird’s eye view perspective, which includes talking about nutrition. What you eat in pregnancy has a profound impact on fetal development.
It is widely understood through clinical research that high amounts of carbohydrates as well as sugar are both implicated in periodontal disease. In fact, glucose is responsible for the formation of plaque. What you eat during pregnancy is not just what allows you to grow a healthy baby, but also prevents diseases from developing in the first place.
As I tell my clients all the time, try to focus on consuming plenty of protein and healthy fats. What is interesting about prenatal nutrition is that the protein guidelines for pregnancy keep increasing. The recommendation is roughly 75-110g of protein daily. That’s a lot! Just do your best.
In summary, dental hygiene really matters in pregnancy. Preventive measures you can take in order to protect you and your baby’s health are to floss daily, get a high quality electric toothbrush, visit the dentist for 2-3 cleanings during pregnancy, and avoid excess carbohydrates and sugar.
And if you are not pregnant but hope to be someday, it is never too early to begin implementing these practices.
Please feel free to share this with loved ones so that we can continue to promote better maternal health outcomes.
For further information on the scientific research and literature associated with Periodontal Disease in Pregnancy, please visit the links below.
Periodontitis in Pregnant Women: A Possible Link to Adverse Pregnancy Outcomes
The Role of Nutrition in Periodontal Health: An Update
Periodontology and pregnancy: An overview of biomedical and epidemiological evidence
Periodontal disease: Repercussions in pregnant woman and newborn health—A cohort study
Association between Maternal Periodontitis and Development of Systematic Diseases in Offspring