Pregnancy, & Early Childhood Cavities: Understanding the Connection

Dental and gum health (or lack thereof) is strongly associated with many aspects of our health including cardiovascular, glucose metabolism, reproductive, and respiratory health. During pregnancy, poor dental health and gum disease has been associated with premature labor & low birth weight babies, pre-labor rupture of membranes, and pre-eclampsia. Preterm labor and pre-labor rupture of membranes is often caused by vaginal dysbiosis and/or urogenital infections – often associated with oral dysbiosis and gum disease. Further, early childhood cavities are actually a chronic infectious disease that can be passed from parent to child (especially from mother to child via transmission of microbiota during pregnancy, birth, and early parenting).

So what can be done? 

One of the first steps in prevention of childhood cavities is balancing your own microbiota and supporting the microbiota in your baby or child. The bacterial balance (or imbalance) in your baby’s mouth will affect their likelihood of developing early childhood cavities (and influence a variety of other health-related issues). Certain strains of Streptococcus bacteria, especially S. mutans are a primary cause of tooth decay. Balancing parents and babies’ oral microflora can prevent proliferation of these bacteria and the resulting decay. While there are many aspects to preventing early childhood cavities, I’ll focus on a few tips for preventing oral dysbiosis in babies.

First, for parents who have dental issues and want to avoid passing them to children, it is essential to floss once per day after brushing and finish with an herbal mouth rinse to inhibit the growth of cariogenic (cavity-causing) bacteria.

Second, avoid antibiotic use during pregnancy, labor and in young babies unless absolutely necessary. A child’s microflora is established within the first two years of life and exposure to antibiotics can disrupt this process. Proactive strategies for the mom during pregnancy and breastfeeding as well as during the child’s first two years of life are critical to correct dysbiosis and set the child up for a healthy mouth and healthy immune system. If antibiotics must be used or if parents have signs of oral dysbiosis (cavities, bleeding gums, chronically enlarged tonsils, bad breath, GBS positive during pregnancy) rebalancing the microflora is recommended to prevent transmission to babies during or after birth. Babies who are born by cesarean are also prone to dysbiosis due to use of antibiotics during surgery and altered microflora caused by not passing through the vagina at birth. There is emerging evidence on the benefits of “seeding” the microbiome of a baby following cesarean using gauze inserted into the vagina before the surgery. Pregnant and postpartum moms can also take up to 100 billion CFUs of probiotics (focusing on both lactobacillus and bifidus strains) for a minimum of 3 months following a disruption such as antibiotic use or cesarean surgery. 

Infants exposed to antibiotics during pregnancy or birth should ideally be breastfed to help normalize the flora, and also, consider supplementing with bifidus strains of probiotics (up to 5 billion CFUs per day) formulated for infants – the powder can be mixed with breastmilk. All infants should have their gums “brushed” twice per day with a clean damp washcloth wrapped over the parent’s finger and gently massaged around all surfaces of the gums. The washcloth can be dampened with warm chamomile or fennel tea – especially good for teething infants.

General Recommendations

Here are a few other general recommendations for anyone experiencing signs of oral dysbiosis, gum inflammation or poor dental health:

Avoid/minimize sugars in the diet (especially highly refined sugars)

Stevia (the actual herb – green powder or dried green leaves – not some of the synthetic extracts on the market) not only tastes sweet but is anti-cariogenic (anti-cavity).

Floss well once per day – this one is so important and too easily ignored!

Eat lacto-fermented foods daily (and consider taking probiotics and/or gently swishing an opened up probiotic capsule mixed with a little water in the mouth)

Eat a whole foods diet rich in minerals & vitamins (especially vitamin D3, vitamin K2, calcium and phosphorus)

Receive regular dental cleanings with a holistic-oriented dentist

Consider tongue scraping in the morning

Reduce any nasal congestion in order to avoid mouth breathing which dries out the mouth and allows cariogenic and periodontogenic bacteria to flourish (consider neti-pot, decongestant herbs, and sleeping with warm-mist humidifier if mouth breathing is an issue).

(Herbs are available for pregnanant ladies at my hospital for mouth rinse to prevent cariogenic bacteria from adhering to teeth and the process of Oil Pulling is also available. Call +919825463394)

Healthy Mouth, Healthy Body: Gum Disease Can Affect Your Unborn Child

For many women, pregnancy is a time that’s part blissful… and part stressful. As your body begins a process of dramatic changes, you may start paying more attention to your overall health and well-being. That’s good!

What’s not so good is that, with all the demands of pregnancy, it can be hard to take care of every little detail. Perhaps, with everything else that’s going on, you may be tempted to slack off on your oral hygiene routine. Here’s why you shouldn’t.

You probably know that many of the physical and emotional changes in pregnancy are mediated by hormones, such as estrogen and progesterone. These chemicals, produced by the body, help regulate how cells use energy, grow and change. Hormone levels increase naturally during pregnancy; but while necessary, these high hormone levels can have a few unwanted side effects—including an increased susceptibility to gum disease. This can cause a condition, relatively common in expectant mothers, called “pregnancy gingivitis.”

Hormones aren’t solely responsible for this type of gum disease; pathogenic (disease-causing) bacteria must be present in the mouth already. Under normal circumstances, regular brushing and flossing may be enough to keep these harmful bacteria under control. In the absence of good oral hygiene, however, a sticky substance called plaque starts to build up on the surfaces of your teeth—and that’s where harmful bacteria can flourish. Put plaque bacteria together with gums that are affected by pregnancy hormones, and you’ve got a recipe for a more aggressive gum disease than normal.

Gingivitis, if left untreated, can progress to a more serious form of gum disease called periodontitis. This is a bacterial infection that can attack not only the gums, but also the bone that supports the teeth; the loss of supporting bone can eventually lead to tooth loss. But moms aren’t the only ones who feel the effects of gum disease: A number of studies indicate that it may cause health problems in unborn children as well.

While the exact mechanism isn’t yet clear, research suggests that harmful oral bacteria can pass through the placenta into the fetus, triggering an inflammatory response. This can cause labor to begin prematurely, and may result in low birth weight. Some studies also point to a link between gum disease and a condition called pre-eclampsia—a form of dangerously high blood pressure that may occur during pregnancy.

The good news is: There are several things you can do to help keep gum disease from getting out of hand. First, try to control your diet as much as possible. Eat plenty of fruits, whole grains and vegetables, and avoid sugary treats—especially between meals. If you smoke, quit. Tobacco users are far more likely to develop gum disease than non-smokers; your gums (and your new baby) will thank you.

Be sure to keep up your regular oral hygiene routine during pregnancy. That means brushing twice a day with fluoride toothpaste, and flossing every day. But even with consistent at-home care, you still need to see your Dental Surgeon regularly—especially during pregnancy. At the dental office you’ll get a thorough cleaning, a thorough exam, and, if needed, appropriate treatment—including effective treatment for gum disease. Following your Dental Surgeon advice is the best way to make sure that your gums will stay healthy throughout your pregnancy—and to make sure you keep healthy smiling after your baby’s birth.

Is Your Breast Fed Baby at Risk for Early Childhood Caries?

It is important for Moms who breast feed their baby to know that just because a baby is breast fed, does not mean they are immune to early childhood caries.

Mother Breastfeeding Baby In NurseryTooth decay can arise when a young child nurses from the breast, because breast milk also has sugar in it.  However, breastfeeding is associated with a low risk of developing tooth decay, compared with bottle feeding. Nevertheless, breast milk does contain sugars and some infants who breast feed for long periods throughout the day or night may develop tooth decay.

For Breast-fed Babies

Avoid :  feedings that last more than 30 minutes.

Avoid :  prolonged and unrestricted night time feeding.

Avoid :  frequent, on-demand (“at-will”) feedings once the first teeth erupt.

Avoid:   nursing your child to sleep.  If your baby is breastfed, and won’t fall asleep without being nursed, try to avoid letting him/her sleep with the nipple in his/her mouth. After he/she falls asleep, remove the nipple to prevent pooling of liquid.

After each feed, wipe your child’s gums with a clean, damp gauze pad or washcloth.    You should start brushing your child’s teeth as soon as the first teeth come in.  Gently brush with a child-sized toothbrush and water.

“Lift the Lip” to check for signs of Early Childhood Caries  Once the primary teeth have erupted, parents can lift the baby’s upper lip and visually check both front and back of the four upper front teeth at least once a month.

baby-teething

Checking a child’s teeth takes only a minute. It is helpful to have one adult hold the baby while a second adult looks at the teeth. A small dental mirror can help in viewing the back surfaces of the teeth. White spots on the surface of the upper front teeth or whitish lines at the base of the teeth along the gum line are indicators of Early Childhood Caries. If a parent notices any white spots on the teeth, a dentist visit is warranted. At this stage, Early Childhood Caries may still be reversible with prompt treatment. If left unchecked, the “white spot” lesions can rapidly develop to brown spots and general decay of the teeth.

How to Prevent Baby Bottle Tooth Decay

HOW TO PREVENT EARLY CHILDHOOD CARIES 

If you must give the baby a bottle as a comfort at bedtime, it should contain only water.

If your child won’t fall asleep without the bottle and its usual beverage, gradually dilute the bottle’s contents with water over a period of two to three weeks, progressing to strictly water in the bottle.

Baby-Care-and-Cleaning-TipsAfter each feed, wipe your child’s gums with a clean, damp gauze pad or washcloth.    You should start brushing your child’s teeth as soon as the first teeth come in.  Gently brush with a child-sized toothbrush and water.  Rinsing the mouth is an option you can try with older children.

Fluoridated toothpaste can be used safely when you are sure that your child spits out all of the toothpaste after brushing. Older children can use a toothbrush with soft, nylon bristles. Use a very small amount of toothpaste (no more than the size of a pea). (You should consult the child’s dentist before considering using fluoride toothpaste).

Avoid letting your infant walk around using a bottle of milk or juice as a pacifier or security object.  Do not allow your child to sip on a bottle filled with juice, milk, or formula for long periods of time as a pacifier

Start to teach your child to drink from a cup at about six months of age. Plan to stop using a bottle by 12 to 14 months at the latest.

Always be sure your baby’s pacifier is clean. Don’t ever dip it in anything (such as sugar or honey). Don’t clean your baby’s pacifier by sucking on it yourself, a common but unhealthy practice, since you are passing bacteria from your mouth over to your baby!

Since some medications are more than 50% sugar, they can also cause cavities to form. Be sure to have your child rinse or brush after taking medications.

Inspect your baby’s teeth frequently and have them checked by your child’s doctor or a dentist.

Start dental visits by your child’s first birthday.

Disclaimer
The sole purpose of these blogs is to provide information about the tradition of ayurveda. This information is not intended for use in the diagnosis, prevention or cure of any disease. If you have any serious, acute or chronic health concern, please consult a trained doctor/health professional who can fully assess your needs and address them effectively. If you are seeking the medical advice of a trained Ayurvedic expert, call us or e mail. 
Dr Unnati Chavda 
(Promoting pregnancy wellness)