PREGNANCY AND THIRD MOLAR PROBLEMS

Many women will give a history of developing problems with their teeth and gums during pregnancy. There are certain types of problems that we see that have been studied such as progression of gum disease during pregnancy, but these are not consistent nor universal. There does appear to be a certain genetic predisposition to this but clearly, hormonal changes cause tissue fragility leading to increased risks of viral concerns (such as aphthous sores) and general periodontal inflammation (such as sore, red gums and bacterial infections). This is even noted during menses for certain individuals.

The article that I am reviewing (J Oral Maxillofac Surg 65:1739-1745, 2007) showed that there were increased periodontal problems around wisdom teeth during pregnancy. There are a combination of factors here. Wisdom teeth by themselves, especially if there is a continuity defect at the site (an opening or gap along the gum line on the adjacent tooth to the third molar area) often have an inflammatory reaction taking place. This is a normal way that teeth erupt into the mouth if there is space. The sack around the impacted tooth undergoes a reaction with increased fluid production (expansion of the sack) and then an opening of the sack to the oral cavity allowing the tooth to come through. When there is not enough space as is often the case with third molars, this exists as just an opening or tract into which germs and debris can enter into the site and cause related problems.

Pregnancy appears to enhance this process. It is likely a combination of factors (general health, nutrition, hormonal affects, stress, fragility of the tissues, as well as dental concerns) which lead to the increase in gum problems around these sites.

For me it goes back to basic dental care for wisdom teeth. Get them out at an early age before all of these problems can occur. By the way, I can treat the pregnant patient. It is safer the later in the term of pregnancy and we work with your obstetrician for the best and safest care.