Leaking from every orifice? Mouth like a dilapidated old boot? Welcome to pregnancy.

I didn’t bloom during pregnancy.  I suffered badly from SPD (symphysis pubis dysfunction) or in lay terms, my fanny bone fell off.  The ligament loosening hormones meant that I constantly pulled stomach muscles, back muscles and carried like an elephant three years past her expected date of delivery.  This was all classed as ‘normal’ but unfortunate.

My scalp bleeds when I brush my hair - I must be brushing too hard.  (Note to self: If you start to feel broody, just look  at this photo and remind yourself of how rough you felt!)
My scalp bleeds when I brush my hair – I must be brushing too hard. (Note to self: If you start to feel broody, just look at this photo and your ovaries will recoil in horror.)

Patients very often come to me suffering with bleeding gums during pregnancy which is also classed as ‘normal’.  But actually, how normal is it?  It says it’s to be expected in all the pregnancy bumf, but from my point of view, surely, anything that bleeds when brushed shouldn’t be ignored.  If my scalp bled when I brushed my hair, I’d probably shit myself.

So, what are the facts about bleeding gums in pregnancy or pregnancy gingivitis as it’s known to us tooth botherers?  I’ve gone back to the books and research and this is what I’ve fathomed.  This all may get a bit science-y.  Please stick with me.

Questions to answer: #1.  Did you smoke before getting up the duff?  #2. Do you have gum disease in the family (are the elders a bit ‘long in the tooth’, gappy or clean their teeth with an effervescent tablet in a glass)? #3. Did your gums bleed before you were gestating?  #4.  When did you last have a routine examination?

If you didn’t smoke, don’t have family lacking in the dentition department, didn’t notice bleeding when brushing before fertilisation and regularly attended your dental examinations, then, you’re probably ok to class yourself as ‘normal’.

However, if you did smoke, do have family members with ivories that have gone astray and you haven’t been to the dentist for a while, then it’d be good to get the gums checked out.  The reason I bring up smoking is because it tends to disguise the symptoms of gum disease by restricting the blood flow to the gums thus, when and if you quit because you’re in the family way, you may miss take the bleeding you’re experiencing as ‘normal’.   *Spoken in a calm whisper so not to alarm*  Studies do show that maternal periodontitis (inflammation of the structures that hold the teeth in place) has a possible link with an increased risk of pre-eclampsia, intrauterine growth restriction, preterm delivery and low birthweight infants.

If you read that last paragraph and started getting palpitations – DON’T PANIC!  Let me normalise that sentence for you.  In a medical database of hundreds of thousands of papers, I couldn’t find one that mentioned death, so don’t start letting your imagination run away with itself .  We’re talking about being possibly higher risk during your pregnancy.  It’s very common to have high blood pressure if it’s your first pregnancy and that is all NORMAL!  In nearly 10 years of practising I can only remember 2 cases of true pregnancy periodontitis of which one of those cases delivered preterm. However, she also smoked heavily and was on the low socio-economic scale so probably had a number of risk factors involved.

In almost all cases, it will be just ‘normal’ pregnancy gingivitis so why bother telling you about the scary part?  Well,  in a very small proportion of ladies it won’t be ‘normal or unfortunate’ which is why it’s always best not to be complacent and dismissive of things that bleed when they shouldn’t, apart from your husband when you’ve (unfortunately) broken his nose during labour.  That’s all completely normal.

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