Early last year, Phung Thi Han was admitted with natal bleeding in her sixth month of pregnancy to the popular Gia Dinh Hospital in Ho Chi Minh City.
The hospital managed to save both her and her baby, then weighing 0.7 kilograms, but the little one died several days later, weak and suffering several congenital problems including a heart condition.
Doctors found Han was suffering from gum inflammation since the second month of the pregnancy, and that it had caused the complication.
They said Han and her family were both surprised on hearing it.
Doctors said pregnant women tend to care more about nutrition intake than oral hygiene, but it is the diet change that puts them under high risk of tooth and gum diseases that have been linked to miscarriage or premature births.
They said the oral bacterium fusobacterium nucleatum that causes the periodontal diseases can travel through blood to the umbilical cord and inhibit growth of the embryo.
Han's gingivitis started with a red and swollen gum, then it bled during teeth brushing and she suffered from bad breath, which embarrassed her enough to stay at home and treat herself instead of going to hospital.
She said she did not take the inflammation seriously as she has no idea that it would impact the baby's health.
Tran Anh Tuan, deputy director of the International Obstetrics and Gynecology Hospital, one of the upscale private facilities in the city, said most of the babies born with oral disease-related premature birth do not survive.
Some babies were saved with incubators, but their immunity was still low and they tend to carry different congenital complications in their life, either to do with their lungs or hearts, Tuan said.
He said some mothers have been caught in the situation several times without being aware of the root of the problem, including Dang Thi Tuoi who went to the hospital after four miscarriages in one year.
Tuoi thought her body was too weak to nurture a baby, but when doctors checked, she said she had been suffering toothache and gingivitis for a long time.
Doctors said many mothers-to-be develop the tooth and gum disease from their second month of the pregnancy and it becomes worse until it peaks around the sixth month.
Hoang Cong Minh, director of the Nhan Sinh (Human Life) private hospital in the city, said pregnancy carries various risks to gum and teeth health.
Minh said many women suffer morning sickness during the first months of their pregnancy, and vomiting brings stomach acids to soften the teeth's enamel. These women would feel the need to brush their teeth right after vomiting, but he said that would further damage the enamel, and they should instead use some mouth rinse.
Eating habits change when women become pregnant, as they start eating more, especially food with high sugar content; and they would eat right before going to sleep and after waking up. Minh said toothache is caused by the diet change alone, while gingivitis happens also because the gum is more sensitive during pregnancy.
As pregnant women are tempted to consume various kinds of snacks, the doctor said they should choose more milk products like cheese or yoghurt, which provide calcium for both them and the embryo's growth.
He also recommended citrus fruits which can protect the enamel and clean oral bacteria by increasing the production of saliva. Sesame is also high in calcium supply.
Eggs, poultry meat and beef provide phosphorous needed for the enamel, Minh said.
He said pregnant women need regular dental examinations and dental cleaning during the pregnancy, but they should only seek dental treatments during the second trimester as the embryo is vulnerable during the first. During the third trimester, women will not feel comfortable sitting on a dentist's chair for long hours, he noted.
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