Pregnancy and Oral Health: Why it Needs to Be on Your Radar
Oral health. Like never before, we’re understanding its connection to whole-body health. For the fetus, it turns out that whole-body health is influenced by the state of the mother’s mouth! Yes. Research continues to reveal new ways a mother’s oral health impacts her developing child.
How does this emerging science impact how practitioners deliver care?
For answers, we consulted with Biocidin Botanicals Scientific Advisory Board Michelle Perro, MD. She is a seasoned integrative and functional medicine practitioner specializing in pediatrics and often working with women pre-conception through birth. She is also considered an authority on complex chronic illnesses and the health impacts of GMOs and pesticides.
In an interview with Dr. Jocelyn Strand, Senior Director of Clinical Education and Research at Biocidin Botanicals, we posed some questions. Read Dr. Perro’s answers for some insights and clinical pearls about this developing area of clinical care.
Question: When working with pregnant women, do you routinely check their oral health?
Answer: Now? Yes. But historically? No. I wasn’t as aware of the effect of Mom’s oral microbiome on the fetus – then baby. That came later.
I was very aware for a very long time of the effects of things like root canals, metal amalgams (mostly mercury, but other heavy metals), periodontal disease, and cavitations on health—different topic. But then I transitioned to understanding the effects of these issues on a woman and her unborn child during pregnancy.
Which is why we have to evolve our education continually. Research is expanding our knowledge and has proven that, as practitioners, we can no longer relegate dental health to the dentist. The mouth is not separated from the rest of the body. It’s all connected.
For example, it’s only been the past five years or so that I’ve really understood and appreciated that there is a placental microbiome. The placenta is not sterile, as we all once believed.
Even more recently, I learned that the placental microbiome mirrors the mom’s oral microbiome. This is a wake-up call for practitioners! We need to zero in on Mom’s oral health! It’s imperative for setting up baby for the best immune function possible.
Question: In your practice, have you been able to identify patterns in oral health and pregnancy outcomes? Did you see that bear itself out clinically?
Answer: I saw certain patterns in moms with certain health conditions. Let me give you an example. Moms who had common autoimmune conditions – like Hashimoto’s – had more evidence of periodontal issues or oral dysbiosis. So, we want to address those issues early.
And while I don’t recommend detoxification during pregnancy, there are simple things Mom can do to improve her oral health that won’t have bad outcomes.
Bottom line: any chronic condition –– SIBO, Irritable Bowel Syndrome, heavy metal toxicity, mold exposure – alters immune function. So, beginning with the oral microbiome, we’re trying to maximize Mom’s immune function. We know that when Mom’s immune system is activated –– cytokine storms, cytokine stimulation, big inflammatory responses – it can cause problems in baby.
Question: When you’re working with pregnant women regarding oral health – whether you have a concern or are just discussing preventative or prophylactic care – how do you counsel a woman to take care of her mouth?
Answer: Every practitioner will know to focus on a good diet first and foremost. Because you need to feed these nutrients. Remember, they start in the mouth. So I recommend a few things.
I suggest a veggie-forward diet focused on alkalinization because I try and really minimize fungal overgrowth. And boy, fungi just love that acidic environment. We don’t want that acidic environment on our teeth where it erodes enamel. Alkalinization also helps minimize plaque formation – plaque being the most common biofilm.
I’m also a big fan of getting women to drink water to avoid dry mouth. Adding lemon to their water gives it a real alkalinization.
Probiotics are also important. I recommend always including fermented foods in the diet. If they don’t get enough fermented foods in their diet, I recommend probiotics so they get more spores. Because those spores are keystone species that are not degraded by stomach acid further down. But we really want to maximize probiotics, even spores in the mouth. I’m always trying to minimize pathogens like Streptococcus mutans.
And then there are the common sense things like lowering sugar intake, minimizing stress when you eat, and chewing. Chewing food thoroughly is important because chewing releases amylase and other digestive oral enzymes to begin the carbohydrate breakdown.
And, of course, there’s the dental care side. Building good oral care habits. What I love about the Biocidin Botanicals SMILE line is how it balances the oral microbiome. Because we aren’t trying to eliminate the microbial landscape. We’re rebalancing and getting rid of the pathogens. It’s a shift, not an elimination.
When someone has a severe issue, I might use things like hydrogen peroxide in water. That’s a pretty harsh solution, so I do that temporarily while I’m trying to get the organisms back in balance. And I’ll even do a DNA check. There are companies that will run an analysis of the oral microbiome to see what’s in there.
Question: What about silver amalgam fillings and root canals?
Answer: You know, like all aspects of medical practice, the dental industry did the best they could with the knowledge they had. But there were a lot of bad outcomes over the years. I believe that is changing for younger people now. Thank goodness!
For women who are already pregnant, I don’t recommend interventions around silver amalgam fillings and root canals. But for those planning to become pregnant, I have a different approach.
A woman with just a couple of silver amalgams can probably handle that. But every time you chew, mercury vapors are released. Some of us can handle it. Some of us cannot. So removing those and using a different material to fill the cavities is important.
And I recommend getting those detox pathways open before you remove amalgam fillings. So, considering the Bioclear Microbiome Detox Program is a good idea first.
As for root canals? I won’t go into it in depth because it's a big topic. I’m not a fan of root canals. I ask people to remove the root canals when possible and get implants or prosthetics.
But once you’re pregnant, we're just going to maintain the robust diversity of a non-stressed-out, beautiful, blissful pregnancy.
Question: Do you have any other clinical pearls you’d like to share on this topic?
Answer: If a patient is thinking about having a baby, that’s the best time to counsel them about their oral health.
That’s the time to develop a habit of rinsing, especially after eating, to diminish the food particles that microbes love to feed on. Cutting back on sugar is another thing. I won’t use the word “eliminate” because it seems we’re all wired for sugar intake. All of those things I mentioned previously about diet, water, chewing, and good oral care habits.
I couldn’t stress enough that if there is periodontal disease or if their hygienist says they have periodontal pockets higher than a three, I recommend using an oral irrigator. Practitioners need to recommend what they feel comfortable with, but it’s another tool in your tool chest. I use an oral irrigator – it’s what I do for myself.