THE RELATIONSHIP BETWEEN

ORAL HEALTH AND PREGNANCY

Recommendations
for women
European
Federation of
Periodontology
Recommendations for women

Introduction

During pregnancy, increased hormonal levels can affect the way that the body reacts to dental plaque
and this can lead to swollen and bleeding gums (gingivitis) and to the more serious form of gum disease
known as periodontitis.

Associations between periodontal diseases and adverse pregnancy outcomes have been demonstrated
– a pregnant woman with poor gum health may have a greater risk of suffering from pre-eclampsia, of
giving birth prematurely, and of giving birth to an underweight child.

Specific oral-hygiene regimens and professional periodontal treatment have been shown to be safe
when carried out on pregnant women, and efficient in reducing gingival inflammation and in enabling
periodontal health to be maintained during pregnancy.

Current scientific understanding suggests that periodontal therapy might be more effective in reducing
the risk of adverse pregnancy outcomes if it takes place before conception.

The following recommendations for women who are pregnant, or who are planning to have a baby,
have been drawn up by expert periodontal specialists.

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 European Federation of Periodontology

Recommendations for women

Knowledge of symptoms:
Women during pregnancy should have knowledge of the obvious signs of oral disease and should try
to perform a self-evaluation to look for inflammatory changes of the gingiva or the presence of gingival
bleeding. Other signs or symptoms – such as pain during mastication, oral halitosis, increased gingival
recession, or tooth mobility – should alert women to the need to seek immediate oral care.

Gingival changes:
Gingival inflammatory changes are frequent during pregnancy but that they are not physiological in
nature. If such changes appear, they should be appropriately diagnosed and treated by an oral-health
professional.

Prevention:
Even in the absence of any sign of disease, pregnant women should seek an oral-health consultation –
with their dentist or dental hygienist – as soon as possible for appropriate preventive measures. During
this visit, they should ask the oral-health professional about the appropriate oral-hygiene measures
and tools they should use during their pregnancy.

Periodontal disease:
If a periodontal disease is diagnosed, pregnant women should know that both gingivitis and periodontitis
can be treated safely during pregnancy. They should be informed that the risks of no treatment are
significantly higher that the minimal trauma that might occur during therapy.

Periodontal treatment:
Periodontal interventions have been shown to be effective in improving the periodontal status of
pregnant women and pose no risk to general health. Pregnant women should also be aware that
periodontal treatment (scaling and root planing) should be avoided in the first trimester and should be
performed preferably during the second trimester.

X-rays and anaesthesia:

Pregnant women should be aware that dental X-rays can be undertaken and local anesthesia can be
delivered without additional risk either to the mother or the foetus.

Painkillers and antibiotics:

Pregnant women should be aware that the use of common painkillers and of systemic antibiotics
during periodontal treatment is generally safe. However, tetracyclines should be avoided.

Periodontal health and pregnancy complications:

Pregnant women and women who plan to become pregnant should be aware that there may be a
connection between their periodontal status, their overall health, and possible pregnancy complications.
For this reason, periodontal treatment may be necessary, in which case it should be performed before
conception or in the second trimester. Moreover, as adverse pregnancy outcomes and periodontitis
share some important risk factors (e.g. smoking) pregnant women should be aware of the importance
of healthy lifestyle habits.

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Recommendations for women

Oral Health and Pregnancy:

the project

The aim of the Oral Health and Pregnancy project, a collaboration

between the European Federation of Periodontology (EFP) and
Oral-B, is to promote women’s oral health during pregnancy
through guidelines for patients and for healthcare professionals.

The importance of oral health during pregnancy cannot be

underestimated. Scientific studies have shown connections
between gum disease and adverse pregnancy outcomes such as
premature birth, low birth weight, and pre-eclampsia.

The Oral Health and Pregnancy project offers the site

oralhealthandpregnancy.efp.org wich is full of advice – based
on the latest scientific evidence – about the steps that need to be
taken to ensure good oral health in pregnant women. The portal
includes written, graphical, and video material in three areas:

• The importance of women’s oral health during pregnancy;

• The links between periodontal diseases and pregnancy;
• Preventing and treating periodontal disease during pregnancy.

At the heart of the Oral Health and Pregnancy portal are sets
of guidelines about oral health in pregnant women for dentists,
dental hygienists, other health professionals, and for women
themselves. These guidelines have been drawn up by some of the
world’s leading experts in periodontal science and are based on
the results of numerous scientific studies.

The project will also provide a toolkit for the 30 national societies
of periodontology which are members of the EFP to enable them
to run their own campaigns on oral health and pregnancy,
whether through similar portals or through the production and
distribution of leaflets based on the guidelines. This toolkit will
enable the important information contained in the guidelines to
reach health professionals and women across Europe in local
languages and adapted to local needs.

oralhealthandpregnancy.efp.org

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 European Federation of Periodontology

A joint
EFP - Oral-B project

The European Federation of Periodontology (EFP) is the leading

global voice on gum health and gum disease and the driving
force behind EuroPerio – the most important international
periodontal congress – and Perio Workshop, a world-leading
meeting on periodontal science. The EFP also edits the Journal of
Clinical Periodontology, one of the most authoritative scientific
publications in this field.

The EFP comprises 30 national societies of periodontology in

Europe, northern Africa, Caucasia, and the Middle East, which
together represent about 14,000 periodontists, dentists,
researchers, and other members of the dental team focused on
improving periodontal science and practice.

www.efp.org

Oral-B is the worldwide leader in the over $5 billion tooth-brush

market. Part of the Procter & Gamble Company, the brand
includes manual and electric toothbrushes for children and
adults, oral irrigators, interdental products such as dental floss,
together with toothpastes and mouth rinses. Oral-B manual
toothbrushes are used by more dentists than any other brand in
the USA and many international markets.

Oral B has been an EFP partner since 2009 and has participated
in many EFP events, including EuroPerio7 (2012) and EuroPerio8
(2015) as a Diamond sponsor, the EFP Postgraduate Symposium
in 2013 and 2015, and the European Workshop in Periodontology
in 2014. The company will be a Diamond Sponsor of EuroPerio9,
which takes place in Amsterdam in June 2018.

www.dentalcare.com

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 Make sure
that gum disease
does not become an issue
during pregnancy

Visit our site:

oralhealthandpregnancy.efp.org
 oralhealthandpregnancy.efp.org

The EFP thanks Oral-B for its support and its unrestricted grant.