Pregnancy is a responsible step that always requires preparation, and not only on the part of the woman, but also of the man. The identification and timely elimination of all factors that can cause complications and affect the development of the fetus is the main task of doctors in many specialties, including dentists. Moreover, according to the condition of the teeth and gums, it is possible not only to diagnose pregnancy in the early stages, but also to identify its pathologies and complications. Read more in MedAboutMe.
Dentistry is a diagnostic specialty
According to the state of the oral cavity, many diseases of internal organs, metabolic disorders, etc. can be diagnosed. In fact, dentistry is a diagnostic specialty. Recently, caries, as the most common dental disease, is considered secondary, that is, a consequence of certain diseases of the internal organs or metabolic disorders, but it can still be a primary pathology.
The condition of the mucous membrane is the most diagnostically significant. It reacts to the slightest changes in the work of the body, for example, to the restructuring of the hormonal background, illness. And, as you know, during pregnancy, hormones “rage”.
Did you know?
There are cases when it was the dentist who pointed out to patients about a possible pregnancy and advised them to visit a gynecologist!
The “symptoms of pregnancy” in the oral cavity include swelling of the mucous membrane, its slight pallor, swelling of the gums and frequent exacerbations of inflammatory diseases, which can be explained by a decrease in the work of local and general immunity. However, such a symptom is more often diagnosed by the end of the first trimester of pregnancy, when women are usually aware of their interesting position.
During pregnancy, it is recommended to visit the dentist every 2-3 months for the purpose of preventive examinations, hygienic and diagnostic procedures. At the appointment, an experienced doctor will be able to notice symptoms that indicate complications and pathologies of pregnancy, for example, hypocalcemia, gestational diabetes, osteoporosis, symphysitis, etc.
The use of modern methods of treatment and drugs allows dental treatment at any stage of pregnancy. But there are some limitations and features. For example, pregnancy and breastfeeding are a temporary contraindication for dental implantation. Also, in some cases, it is not advisable to carry out prosthetics during pregnancy.
Gestational Diabetes: Oral Symptoms
The first and most common symptom of diabetes is the appearance of dry mouth — xerostomia. Saliva is a natural protector of the oral cavity, and if its composition and properties are violated, the following complications arise:
- Multiple form of caries
This is due to a number of provoking factors. Firstly, insufficient production of saliva, which can no longer clean the teeth from plaque and control the reproduction of pathogenic flora. Secondly, a decrease in the functioning of the immune system, the bacteria that cause caries begin to multiply more actively. Thirdly, «oil is added to the fire» and morning sickness with bouts of vomiting.
- Systematically flowing stomatitis
Most often, candidiasis is diagnosed not only in the vagina, but also in the oral cavity. Moreover, fungal inflammation has a persistent course and reacts poorly to treatment.
- Edema of the oral mucosa
On examination, pronounced edema is noticeable, and teeth marks may be visible on the inner surface of the cheeks. But at the same time, the mucous membrane remains of a normal color or turns pale.
- Inflammation of the gums
As for caries, several predisposing factors are distinguished for gum disease: xerostomia, reduced immunity, hormonal changes. The so common gingivitis of pregnant women, which also occurs during a healthy pregnancy, can be complicated by bacterial inflammation and turn into a complication — periodontitis.
Pregnancy gingivitis is diagnosed in 70% of women, regardless of the age and course of pregnancy, that is, it can develop during its normal course without pathologies.
Signs of symphysitis in the oral cavity
Symphysitis is the most common definition of pelvic pain syndrome, which is often combined with diastasis of the symphysis pubis and occurs in women in the second half of pregnancy against the background of an imbalance in mineral metabolism.
Pain in the symphysis area is the most common, although not the only symptom. The ending «-itis» means inflammation, but its symptoms and signs are absent, so «symphysiopathy» is the most appropriate of the terms that reflect the problem.
According to statistics, in various regions of Russia, symphysiopathy is recorded in 0.3-0.7% of pregnant women. However, other figures are given in scientific publications: 45% of pregnant women and 25% of women in labor. Moreover, in 25% of expectant mothers and 7% of women in labor, this problem is of a serious nature.
According to Sokolova M.Yu., symptoms such as paresthesia, convulsions, muscle spasms, bone pain, and even gait disturbances appear in 17% of women about a few months before childbirth. In rare and severe cases, pain radiates to the lower extremities and lower back. All this can cause temporary disability of pregnant women.
So what is the reason for such a serious condition? In the course of research, it was possible to identify 2 fundamental factors:
- violation of vitamin and mineral metabolism: calcium, vitamin D, magnesium;
- the physiological process of relaxation of the connective tissue apparatus of the pelvis, which is facilitated by hormones — progesterone and relaxin.
Even a physiologically proceeding pregnancy without complications is accompanied by the intensity of all types of metabolic processes. For the normal development of the fetus and covering its own needs, increased concentrations of vitamins, minerals and other substances are necessary.
Metabolic disorders are clinically manifested by symphysiopathy in the second half of pregnancy, when the level of relaxin rises. The peak of its concentration occurs in the middle of pregnancy, when women turn to the gynecologist with the corresponding complaints.
Thanks to a scientific study, it was possible to establish that symphysiopathy also manifests itself in the oral cavity. Which, firstly, allows you to take measures to control the pain reaction, to prevent complications. Second, make a dental treatment plan, knowing what to expect.
The study involved 75 women in the second and third trimester of pregnancy with diagnosed symphysiopathy of varying severity. The scope of the study included taking an anamnesis, assessing the severity of symptoms according to the questionnaire, as well as obstetric examination, clinical and laboratory studies, ultrasound of the pubic symphysis and complications of childbirth. After analyzing the data, the following conclusions were drawn:
- in 32% of cases, smoking, coffee abuse, and underweight were predisposing and at the same time aggravating factors;
- 19% of patients were diagnosed with a multiple form of caries.
Such a widespread occurrence of caries, when almost every tooth is affected, is explained by a violation of metabolic processes, a decrease in the reabsorption of calcium and magnesium in the tubular system of the kidneys, which leads to the loss of minerals along with urine and, consequently, mineral metabolism disorders.
Rogova Natalya Mikhailovna, dentist
According to studies, the main provoking factor of symphysiopathy is urinary tract infections, which can worsen during pregnancy and lead to serious complications for the pregnant woman and the fetus.
It is known that the source of infection, which can cause an acute or exacerbation of a chronic disease, is in the oral cavity — these are carious teeth, gum disease. Given the reduced work of the immune defense, infections are easier to spread throughout the body and lead to complications.
It is possible to reduce the likelihood of complications, for this you should sanitize the oral cavity, undergo a course of preventive procedures before conception. It is worth remembering that dental treatment will take time — from several weeks to a month — everything will depend on the initial condition.
Hypocalcemia during pregnancy
Hypocalcemia is a decrease in the level of calcium in the blood below a certain level. This condition is often diagnosed during pregnancy and in women who practice breastfeeding.
Many remember or have heard that during pregnancy I wanted to gnaw on chalk. Such gastronomic desires, sometimes unusual, are nothing more than the first sign of a deficiency of certain substances in the body. If a future mother has an irresistible desire to drink liters of milk, eat kilograms of cottage cheese and eat everything with chalk — with a high percentage of probability there is not enough calcium in the body.
Early symptoms of hypocalcemia include:
- leg cramps, especially in the middle of the night;
- tendency to constipation in early pregnancy;
- increased fatigue;
- drowsiness and irritability;
- fragility of nails, hair.
If we talk about dental symptoms, they are quite diverse, but they grow like a snowball:
- the appearance of a feeling of soreness on the teeth when eating sour food;
- hyperesthesia (increased tooth sensitivity) — an acute pain reaction to cold of varying severity;
- tooth decay — they literally crumble, the enamel is chipped, coming off in layers;
- multiple form of caries;
- gum prolapse and dystrophic processes in the bone tissue of the alveolar process, which is noticeable on the radiograph.
Alexander Vysotsky, dentist
Symptoms characteristic of hypocalcemia are not specific, but it is always a reason to visit a dentist and find out the cause. Calcium deficiency is dangerous not only for the health of the mother, but also for the fetus.
In the absence of timely treatment, the density of the vascular wall may be disturbed, which leads to a violation of blood coagulation. The risk of miscarriage and premature birth increases.
On the part of the fetus, complications are no less dangerous and sometimes fatal. A lack of calcium can cause serious malformations and developmental anomalies, problems with the musculoskeletal system, as well as dental problems in the future.
Osteoporosis during pregnancy
Osteoporosis during pregnancy is rare, but still possible. This disease is characterized by a decrease in bone density, which can cause frequent fractures and other complications.
Predisposing factors that can lead to the development of osteoporosis during pregnancy include underweight, thyroid dysfunction, menstrual irregularities before pregnancy, bad habits, and increased physical activity.
The first symptoms of osteoporosis appear in the oral cavity, but sometimes they are not so easy to notice, because they disguise themselves as other diseases. Violation of bone density leads to its loss, which is noticeable in the jaws.
Patients may notice gingival prolapse, exposure of the necks of the teeth, while increased sensitivity and their mobility may be absent. Due to the increase in calcium requirements, dystrophic processes in the area of the alveolar ridge can have a rapidly progressive character. And even after pregnancy, recovery does not occur, a long and complex treatment is required, and in some cases even a combination of therapeutic and surgical.
Another symptom of osteoporosis will be pathological abrasion of teeth. Gradually, if no measures are taken, the teeth become even, as if under a ruler. The bumps are smoothed out, and the chewing surface becomes like a take-off area. Such changes gradually lead to even more serious problems: dysfunction of the temporomandibular joint, chronic headaches, loss of teeth, etc.
Diagnose allergies by the state of the oral cavity
Allergy manifestations in the oral cavity are diverse, and the symptoms largely depend on its form and cause. For example, drug allergy is more often manifested by catarrhal stomatitis, glossitis and cheilitis. Women complain of itching, burning of the mucous membrane in the tongue and lips. On examination, red, edematous mucosa is noticeable, on the tongue — atrophy of the papillae.
There is also a contact type of allergy that occurs after dental treatment, and the cause is drugs, prosthesis materials, and hygiene products. Symptoms include swelling of the mucosa, the appearance of redness, point erosion. Subjective sensations can be reduced to itching, burning in the mucosa.
Everything in the body is interconnected, and any disease is manifested not only by local symptoms, but also affects the entire body. The oral cavity can be called the place where the first symptoms of numerous pathologies can appear. And, as you know, timely diagnosis is the key to successful treatment and prevention of complications, which is especially important during pregnancy.
Inflammation of the gums, caries, its complications and bone tissue atrophy can be independent pathologies, as well as a consequence of certain diseases.
Therefore, when these symptoms appear, you need to consult a specialist and draw up a treatment plan. Given all of the above, we can safely say: a healthy oral cavity — a healthy pregnancy.
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Risk of Periodontitis
A test developed by the American Academy of Periodontology will help you find out how high your risk of periodontitis is.
Evaluation of the effect of Calcemin on clinical symptoms and the level of bone resorption markers in symphysiopathy in women in the third trimester of pregnancy. / Mozgovaya E.V. , Kucherenko M.A. , Gzgzyan A.M. // breast cancer. mother and child — 31.01.2011 — #1
A new look at the causes of symphysiopathy in pregnant women and the search for effective methods of treatment. / Mozgovaya E. V., Dedul A. G., Oparina T. I. and others. // JOURNAL OF OBSTETRICS AND WOMEN’S DISEASES — 2010 — VOLUME 59
Prevention of dental diseases in women with physiological and pregnancy complicated by preeclampsia. / Yamshchikova E.E. // Abstract dis. cand. honey. Sciences. Moscow — 2010