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Gum disease linked to stillbirth

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Posted: Friday, March 12, 2010 12:00 am

A newly published study from researchers at Case Western Reserve University, School of Dental Medicine reported the first documented link between a mother with pregnancy-associated gum disease to the death of her fetus. Other published studies have linked pregnancy-associated gum disease to pre-term birth, low birth weight babies, and gestational diabetes.

The primary reason for these risks is the drastic hormonal changes during pregnancy. The rise in progesterone levels causes the gums to respond to plaque in an exaggerated manner, creating a condition called gingivitis, or gum inflammation.

The Case Western University research found that a common oral bacterium, Fusobacterium nucleatum, found its way from the mother’s mouth into the blood stream, and traveled to the placenta. This bacterium commonly causes pregnancy-associated gingivitis. The researchers were able to match the bacterium in the mother’s mouth with the bacterium found in the baby’s infected lungs and stomach. With the multiple types of bacteria found in the oral cavity, our bodies’ immune systems will typically kill the bacteria prior to reaching the placenta. In this rare incident, the mother’s immune system was unable to prevent the bacteria from entering the placenta. The mother experienced an upper respiratory infection and a low-grade fever just prior to the stillbirth. The baby died from a septic infection caused by the transplanted bacteria.

Gingivitis is a common condition that manifests during the second to the eighth months of pregnancy. Gingivitis causes red, puffy or tender gums that tend to bleed when brushing. Therefore, the American Dental Association advocates regular dental exams and professional cleanings while pregnant to prevent plaque build-up and gingivitis. Dentists may even recommend more frequent cleanings during the second trimester or early third trimester to avoid gum problems.

Expecting mothers can also prevent gingivitis at home by brushing twice a day with fluoridated toothpaste, and flossing with dental floss or interdental cleaners. Flossing between teeth is a key factor in preventing gingivitis and pregnancy risks associated with gingivitis. Flossing removes the bacteria and debris from between the teeth, where the toothbrush cannot reach. The daily practice of combined flossing and brushing may significantly reduce the incidence of pregnancy-associated gingivitis and may help promote a happy, healthy pregnancy.


Dr. Rashmi (Rush) Bhatnagar, DMD, MPH, can be contacted at (480) 598-5900 or visit

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