Maternal oral health is crucial for pregnant women. Here's why

Many women don't know this, but maternal oral health is as important as taking care of your diet or taking prenatal pills every day. Hormonal changes during pregnancy can increase bacteria in the mouth, and excess stomach acid from morning sickness and it can break down tooth enamel.

In the United States, up to 40% of pregnant women have some form of periodontal disease, according to the County of Los Angeles Public Health. 

CALÓ News spoke to Rosa Arzu, DDS, Senior Director of Medical and Dental Innovation at AltaMed Health Services, about why maternal health is important during pregnancy.

Born in Portsmouth, Virginia, Arzu moved to Guatemala City when she was six years old. She received a doctorate in dental surgery in 2000 from Francisco Marroquin University. In 2003, Dr. Arzu moved to California. 

In 2008, she was hired by AltaMed Health Services after receiving her dental certification as a dental provider for Bell Clinic. In 2009, Dr. Arzu got promoted to dental director. In her current role, she oversees the dental operations of nine dental clinics and six oral health units located in Los Angeles and Orange County.

During pregnancy, Dr. Arzu believes that prenatal care is so important because the goal is to keep moms and babies healthy. “There's been studies that show that with the hormonal changes that happen during pregnancy, there is a direct effect on the gums,” she said. “Pregnant women are more likely to have their gums swollen, and this is even if minimal plaque stays in their teeth. If we don't take care of it, it can continue to be a bigger problem, which is what's called periodontal disease.” 

Periodontal disease can affect the bones that hold teeth, and they can become loose. For Dr. Arzu, it’s important to start early, and make sure that they reinforce the behaviors and the cleaning with the right dentist's tools and resources. “Because we understand that when a woman is pregnant, she is tired,” she said. Dr. Arzu also pointed out how there are other things that affect the oral health of pregnant women, includings experiencing morning sickness because the teeth are being exposed to more acid.

Raising awareness about this topic among Latina women is crucial for Dr. Arzu. “It's definitely needed because there are so many myths in our community. I'll just give you an example that I grew up with, which is that every time you're pregnant, you're going to lose a tooth,” she said. “I just had one child, but I could definitely relate to these things that are happening because it is true that there are more situations that we're exposed to. But if you have dental care as early as you become pregnant, you don't have to lose a tooth. It's really because there's that fear of going to the dentist and that something could happen. But there's definitely a lot of evidence that it's safe to go to the dentist.”

The dental director said that it’s all safe when the anesthesia is done correctly and when the dentist takes limited x-rays with additional precautions. According to the American Congress of Obstetricians and Gynecologists, dental X-rays and teeth cleanings are safe for pregnant women. Dr. Arzu also believes that mothers should change their thinking that the visit is going to hurt them to thinking the visit is going to help them and the future of the baby.

According to the American Public Health Association report, only 46% of pregnant women in the United States report having an oral prophylaxis during pregnancy, which is a dental cleaning. It also states that some pregnant women may experience barriers that don’t allow them to receive dental care. For example, “pregnant women without dental insurance are twice as likely to skip routine preventive dental visits as those who have dental coverage.” 

Also, the same report states that “access to dental care is directly related to income level; women with low incomes are less likely than those with higher incomes to receive dental care during pregnancy.”

In 2014, 20% of mothers in Los Angeles County needed to see a dentist for a problem during their most recent pregnancy. 22% of Latina moms reported the need to see a dentist, which was the second highest among pregnant women in LA County.

Dr. Arzu also told CALÓ News that pregnant women are prone to gingivitis disease. “Hormonal changes are a big factor that affects the gums, which makes them swollen. And the reaction that normally happens is [pregnant women are]  brushing less or brushing softly because they're hurting, and to add to that, you know, pregnant women are exhausted,” she said. “So, even flossing might not be happening consistently. That's why all these risk factors will definitely increase the percentage of pregnant women with gingivitis. And it's shown that about 60% to 75% of pregnant women do have gingivitis.”

She also strongly believes that the mouth needs to be considered part of the body. “There's a lot of work to be done. There are so many misinformed medical providers that I think we just need to have a better system to integrate dental visits, and at AltaMed, we're already doing it," she said. “What you're doing right now is so beneficial for the community because we are educating [pregnant women] and raising awareness.”