Introduction

If you're an expectant mother or you've made the decision to start a family, you already know that life will never be the same. The first changes start during pregnancy, when your body begins to experience hormonal changes that can affect your health and the health of your baby. Read on to find out what changes can take place in your mouth and eyes while you're pregnant, how they impact your vision and your oral health and what can be done about it.

Oral Health

During pregnancy, an expectant mother's changes in hormones increases the risk of developing oral health issues. The hormonal changes your body undergoes, particularly estrogen increases, trigger changes in the plaque or sticky film buildup of bacteria on your teeth, making you more susceptible to cavities, gum disease and pregnancy tumors. So, when you're pregnant, it's more important than ever to keep your mouth, teeth, and gums clean and healthy. Here are the most common oral health problems which can occur during pregnancy:

Cavities (tooth decay)

There's evidence that pregnant women are more at risk for cavities or tooth decay than men. The changes in hormones women experience during pregnancy can significantly reduce the amount of saliva flow, which is needed to wash away bad bacteria. As a result, more bacteria-containing plaque buildup on their teeth, putting them at higher risk for tooth decay.

Evidence is also available showing that women crave more sweets and carbohydrates during the third trimester of their pregnancy. This increased sugar and carbohydrate intake creates more plaque that builds up and attacks the tooth's protective layer of enamel. In addition, consistent bouts of morning sickness produce more stomach acids that attack enamel.

Gingivitis and pregnancy

Gingivitis is the earliest stage of gum disease where your gums become swollen or bleed. It's usually painless, with no permanent damage to tissues or bone. It's estimated that one out of two people have swollen or bleeding gums at any given time. Mild gingivitis is easily corrected with regular brushing and flossing and a trip to the dentist to make sure your gums return to good health.

Increased levels of the hormone progesterone during pregnancy are thought to be the culprit that triggers gingivitis during pregnancy. The symptoms of the swelling and bleeding of gums are so common for women during pregnancy; 40 percent of pregnant women experience swelling and bleeding of gums due to hormonal changes in pregnancy, usually in the last trimester. The condition is largely painless and it's reversible when caught early, so you'll want to pay attention to this complete list of symptoms and seek treatment as soon as they occur: 

  • Bad breath
  • Swollen and tender gums
  • Dark or dusky red color of gums
  • Bleeding gums when you brush or floss
  • Receding gums

Periodontitis and pregnancy

When gingivitis progresses, it turns into more advanced stages of gum disease. The most common form -- and the most destructive -- is the chronic inflammatory gum disease, periodontitis. According to the CDC, 47.2 percent of Americans have mild, moderate or severe periodontitis. Although the symptoms may be painless, gums start to pull away from the bone and recession takes place. If left untreated, bone loss can occur and spaces between teeth can appear. Teeth become thinner and darker as inner structures within the tooth start to die.

A recent study has shown that periodontitis is associated with premature births and low birth weight. Infections due to periodontitis and other advanced stages of gum disease present in the mother's body cause pathogens to be released into the mother's blood stream that could play a role in triggering early births and other birth complications.

Bottom line for gum disease

Although more research studies need to take place for doctors and scientists to say for certain that gum disease directly causes adverse pregnancy outcomes, if you notice any signs of gum disease, consult your dentist and your obstetrician so that the condition can be treated and halted. If you see signs of gingivitis when you're trying to get pregnant or while you're pregnant, you'll want to schedule an appointment with your dentist and obstetrician and let them know what's going on with your mouth. The presence of gum disease is believed to be connected to complications such as pre-eclampsia, early delivery and low birth weight.

Pregnancy tumors

Pregnancy tumors can form on your gums, lips, and in the mouth during pregnancy. They are always benign, but they can look alarming. They show up as small, round raised lumps on the gums, inside the lips, or on or around the external part of the mouth. They can appear on other parts of the body as well. They are reddish or purple in color and are prone to bleeding. Although they're not cancerous and usually disappear shortly after the baby is born, your doctors may want to rule out dangerous tumors by having them removed. By keeping up with your brushing, flossing and dental checkups during pregnancy, research suggests that you may be able to reduce the number of bacteria believed to be associated with pregnancy tumors.

Facial cellulitis 

It's estimated that one in four women of reproductive age are going to be more cavity prone during their pregnancy. When tooth decay goes untreated, it can result in a painful and serious condition called facial cellulitis, where an area of inflamed, painful skin irritation appears around the mouth. Here are some more facts about this condition:

  • Facial cellulitis is caused by infections of the layers of the skin on the face by harmful bacteria such as streptococcus, which have seeped through a crack in the skin.
  • Cellulitis usually appears on the legs, but can appear on the face, especially when triggered by untreated tooth decay.
  • When untreated, cellulitis can lead to very serious and life-threatening conditions such as blood infections, bone infections (including infection of the jaw bone), infection of the lymph vessels and even gangrene.
  • Facial cellulitis is considered dangerous for women and their babies during pregnancy, so expectant mothers who have acute facial cellulitis are usually hospitalized.

Periodontal disease and cardiovascular disease:

There appears to be a link between periodontal disease and cardiovascular disease. In other words, people who have periodontal infections have the harmful bacteria in their mouths that cause periodontal disease and those individuals are more likely to have some form of cardiovascular disease.

Prevention: Keeping your mouth healthy during pregnancy

Because hormonal changes can have such a big impact on your mouth, teeth and gums, there are some things you'll want to keep in mind before and during pregnancy: 

  • Whenever possible, get any dental procedures done before you decide to get pregnant.
  • Inform your dentist immediately when you become pregnant, as there are some procedures and treatments which they will want to avoid when you are expecting a baby.
  • Continue with your dental checkups throughout your pregnancy and keep your dentist and obstetrician well-informed of any changes in your oral health.
  • Keep up with your daily routine dental care, including brushing twice a day with an ADA approved toothpaste and flossing.
  • Check with your dentist and doctor about whether you should use a dental wash or rinse during your pregnancy.
  • Once you're pregnant or decide to get pregnant, schedule an appointment with your dentist to do a thorough examination of your teeth, gums and mouth to make sure that you're entering your pregnancy with a clean bill of oral health.

Eye Health

Not only do hormones changes during your pregnancy affect not just your oral health, but they affect your vision as well. Here are some common conditions to expect, as well as indications of when it's time to seek some help:

Increased severity of existing conditions

If you experienced certain conditions affecting the eyes before you got pregnant (such as diabetes or glaucoma), your symptoms could increase during pregnancy. Let your doctor know of any eye condition(s) and any change in its symptoms so that they can treat any problems as they occur.

Distorted or impaired vision

Hormonal changes during pregnancy frequently cause expectant mothers to retain water. When that happens, fluid can build up behind the eye or within the eyeball. The shape of the cornea changes and the way light passes through the eye becomes modified, causing your vision to be distorted or impaired. At this point, your prescription glasses won't help, and your contact lenses may not fit right. These changes are usually temporary, but they make it difficult for doctors to measure the eye accurately—so it's not recommended that you get new glasses prescriptions or contact lenses during pregnancy. Corrective eye surgery during pregnancy isn't recommended either.

Itchy, irritated eyes

Your eyes may frequently feel itchy and irritated because of all the hormonal changes. Usually these symptoms can be easily treated with artificial tears or other over-the counter products. Be sure to report these and any other eye problems to your eye doctor and your obstetrician first before going out and selecting an over-the-counter product yourself. They'll need to keep track of any changes in your vision and they'll recommend which over-the-counter product you should use.

Light sensitivity, blurry eyes

While all these changes are occurring, you may find that your eyes are more sensitive to light and that you get increased headaches from the sun's glare. Mirrored sunglasses may help protect you when your eyes are at their most sensitive. You may suffer from blurry sight as well but remember that these problems are temporary and will resolve after giving birth.

Migraines with aurora 

Blurry eyes are also a sign of migraines. Changes in hormones during pregnancy, particularly estrogen, can trigger migraines—even if you've never had a migraine before. If you did have migraines before, they could get worse, better or even disappear. During pregnancy, you can also get a migraine that is accompanied by flashes and rays of lights, frequently called migraines with aurora. If these appear, you'll want to treat them by lying down in a darkened room with a warm, moist cloth over your eyes.

Dry eye

Hormone changes can impact the number of tears that your tear ducts release, so it's not uncommon to experience dry eye during pregnancy. You can usually relieve this problem by getting an over-the-counter eye drop to moisten your eyes. Consult with your doctor to see what they recommend.

Corneal edema

Along with dry eye, you can experience the swelling of your cornea, otherwise known as corneal edema, during pregnancy. The cornea swells up, and if you wear contact lenses, it can get uncomfortable to wear them. If that happens, try to have a pair of glasses handy.

Pre-eclampsia, eclampsia

Pre-eclampsia is a common but serious medical condition that occurs when the pregnant woman experiences high blood pressure. Other symptoms that accompany this serious condition may include visual changes such as blurred vision and swelling of hands and feet. The condition usually occurs late in the pregnancy, which is why it is common that expectant mothers diagnosed with pre-eclampsia are put on bed rest. If you have any symptoms of pre-eclampsia, let your doctor know immediately.

Diabetes

Some women get very high blood sugar when they are pregnant, even if they never had a problem with glucose levels before. This condition is called gestational diabetes. If you've never had diabetes before and you show signs of gestational diabetes, the symptoms are usually temporary and disappear after the baby is born. However, your glucose levels must be controlled during pregnancy so that your health and your baby's health are not put at risk. If you already had diabetes before you became pregnant, the symptoms may get worse. Either way, keep all your doctors informed when you note the appearance of diabetes or a change in its condition during pregnancy.

By controlling their blood sugar, women can take active steps to help avoid complications during the birth and problems with the baby's health afterwards. The Mayo Clinic gives a list of reminders on what expectant mothers can do to control gestational diabetes:

  • Eat healthy foods.
  • Exercise.
  • Take any medications for the condition as prescribed.
  • Be aware that you run the risk of developing type 2 diabetes if you experience gestational diabetes during pregnancy.
  • Continue working with your healthcare team after you give birth to control your blood sugar levels.
  • If possible, before you get pregnant, have your doctor assess your risk of developing gestational diabetes.

Keeping up with your oral and vision health during pregnancy

Your body undergoes a lot of hormonal changes during pregnancy which can impact both your oral and visual health -- and the health of your baby. It's important to make sure that you get a full evaluation from your dentist and eye doctor as soon as you know that you're pregnant or trying to get pregnant, that you're keeping up with your dental and eye checkups and that you report any changes with your vision or with your mouth to all the members of your health care team. They'll monitor your health throughout your pregnancy to ensure that both you and your baby are happy and healthy.

Want more on how oral health impacts your pregnancy?

Download our guide on pregnancy and periodontal disease.