Pregnancy makes your teeth fall out

[tx oms]

Yes, I was sitting at the nurses station on the peds floor as part of my med school pediatrics rotation when I got in on this discussion.

A pediatrics and orthopeadics attending were lecturing the medical students on the importance of vitamin supplementation. They said that a pregnant woman needs calcium supplementation "so her teeth won't fall out".

I got into the conversation late and thought they were joking so I said, "What? Are you serious? Pregnancy doesn't cause calcium loss from teeth" in a shocked tone. I thought one of them knew I was also an oral surgery resident but apparently not b/c they both seemed surprised that a medical student would question them. I ended up listening to a five minute diatribe on the need for vitamin supplementation.

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[Dr. Pedo]

Yes, I was sitting at the nurses station on the peds floor as part of my med school pediatrics rotation when I got in on this discussion.

A pediatrics and orthopeadics attending were lecturing the medical students on the importance of vitamin supplementation. They said that a pregnant woman needs calcium supplementation "so her teeth won't fall out".

I got into the conversation late and thought they were joking so I said, "What? Are you serious? Pregnancy doesn't cause calcium loss from teeth" in a shocked tone. I thought one of them knew I was also an oral surgery resident but apparently not b/c they both seemed surprised that a medical student would question them. I ended up listening to a five minute diatribe on the need for vitamin supplementation.

Were they serious?

 

[3rdMolarRoller]

I know this is true "out in the country" where women in their 30's have few teeth remaining. Studies show pregnant women usually get some form of gingivitis from the hormones being released in their bodies. If they keep up with oral care they shouldn't have a problem, but if they don't it can lead to perio disease and then you know the story from there.

 

[aphistis]

Yes, I was sitting at the nurses station on the peds floor as part of my med school pediatrics rotation when I got in on this discussion.

A pediatrics and orthopeadics attending were lecturing the medical students on the importance of vitamin supplementation. They said that a pregnant woman needs calcium supplementation "so her teeth won't fall out".

I got into the conversation late and thought they were joking so I said, "What? Are you serious? Pregnancy doesn't cause calcium loss from teeth" in a shocked tone. I thought one of them knew I was also an oral surgery resident but apparently not b/c they both seemed surprised that a medical student would question them. I ended up listening to a five minute diatribe on the need for vitamin supplementation.

Did you press them on it?

 

[sdog]

I know this is true "out in the country" where women in their 30's have few teeth remaining. Studies show pregnant women usually get some form of gingivitis from the hormones being released in their bodies. If they keep up with oral care they shouldn't have a problem, but if they don't it can lead to perio disease and then you know the story from there.

Yes, pregnancy induced gingivitis is actually quite common, but 1) does not necessarily lead to periodontitis (there are many other causative factors) and 2) has nothing to do with dental caries which is the disease most women claim they "caught" by becoming pregnant- the version I hear most often is that "pregnancy leaches all the calcium from the teeth and then the teeth rot" which, as we all know, is a ridiculous story..........

 

[tx oms]

Yes, the attending physicians were serious, and no, I did not press them on it. It's not wise to argue with your bosses, even if they're ignorant. There claim was not related to gingivitis but akin to the old wives' tale that fetal calcium requirements will cause leeching of calcium from the mother's teeth. If there is any doubt, this is absolutely false.

 

[dentite001]

There could be a grain of truth in it. Usually mothers alter their diet to accomodate their growing baby. If the mother is poor and can't afford proper nutrition, her body could suffer at the expense of her child. However, poor teeth would only be a symptom of many underlying health problems.

 

[aphistis]

There could be a grain of truth in it. Usually mothers alter their diet to accomodate their growing baby. If the mother is poor and can't afford proper nutrition, her body could suffer at the expense of her child. However, poor teeth would only be a symptom of many underlying health problems.

It's already been said, even in this very thread. Pregnancy does NOT result in any sort of leaching, or resorption, or anything like that, of calcium from the teeth--specifically enamel. For anyone still doubting, I ask you to come up with a plausible mechanism for the process, considering enamel is completely acellular & avascular. C'mon, just try. 😉

 

[airvent]

This is from an old childrens book my grandma used to read to me:

During pregnancy there is a special need for good oral hygiene because pregnancy may exaggerate the body's normal response to dental plaque. This is because four basic hormones vital to the continuation of pregnancy are produced in large quantities during the gestation period. This hormonal increase exaggerates the way the gum tissues react to the bacteria in plaque, resulting in an increased likelihood that a pregnant women will develop gum disease if her daily plaque control is not adequate. It is important to note, that it is the plaque, and not the increased hormone levels that is the major cause of pregnancy gingivitis.

Swelling of the gums is usually first seen in the second month of pregnancy and generally reaches a peak by the middle of the last trimester. It can remain that way for 3-6 months after delivery. The seriousness of the gingivitis can range from mild to severe depending on the gum problems existing before pregnancy. Pregnancy generally worsens preexisting gum problems, sometimes dramatically

 

[tx oms]

There could be a grain of truth in it. Usually mothers alter their diet to accomodate their growing baby. If the mother is poor and can't afford proper nutrition, her body could suffer at the expense of her child. However, poor teeth would only be a symptom of many underlying health problems.

Aphistis is correct, there is no mechanism for this to occur. The only way the body could release calcium from teeth would be through internal absorption. I have never heard anyone claim they have internal tooth resorption secondary to pregnancy, nor am I aware of any such case reports.

The claim by patients and my attendings is that the caries are a result of the body attempting to raise calcium levels for the baby. Caries is an infection, whether in a pregnant woman or a midget. The body doesn't give itself an infection to raise calcium levels. Calcium metabolism is well documented in any physiology book and the teeth are never cited as an intrensic source of calcium for the body.

The truth is the women in question are blaming pregnancy, rather than their toothbrush allergy, for their caries.

 

[DrTacoElf]

It's already been said, even in this very thread. Pregnancy does NOT result in any sort of leaching, or resorption, or anything like that, of calcium from the teeth--specifically enamel. For anyone still doubting, I ask you to come up with a plausible mechanism for the process, considering enamel is completely acellular & avascular. C'mon, just try. 😉

what about leeching from the alveolar processes?

 

[tx oms]

what about leeching from the alveolar processes?

ATTENTION: This thread is in regards to caries, not periodontal issues.

 

[aphistis]

what about leeching from the alveolar processes?

Tx oms got it spot-on. The teeth and bones are *not* interchangeable tissues, folks. They serve totally different purposes.

Furthermore, some posters in this thread are confusing perio disease & caries. Caries is a 100% infectious process resulting from lactic acid & other saccharide metabolites produced by the offending bacteria.

Perio is a mixed condition--partly infectious, but also substantially autoimmune. The bacteria in plaque (especially the gram-neg ones) are down in the gingival sulci having themselves a merry old time releasing all sorts of toxins and recruiting all sorts of inflammatory cells & cytokines. The neutrophils & other leukocytes go nuts releasing destructive enzymes to destroy the invaders, but the problem is they also ruin healthy tissue. It goes on from there, but that level of detail isn't really necessary here...

...because like tx oms said, the original question was about *caries*, which affects fully-mature dental hard tissues that are completely unaffected by pregnancy.

 

[dentite001]

I'm still not completely convinced. If Vitamin C deficiencies (scurvy) can cause teeth to loosen, why can't other minerals have an effect. Medicine should teach you that you can't isolate parts of the body. Regardless, suplementation of any kind is unnecessary if the mother is able to adjust her diet.

 

[Biogirl361]

I heard once that the hormonal changes during pregnancy cause a shift in the balance between benign and acidogenic bacteria towards the acidogenic ones, which leads to more caries and the mom thinking her teeth have "gotten soft". What do you say?

 

[tx oms]

I'm still not completely convinced. If Vitamin C deficiencies (scurvy) can cause teeth to loosen, why can't other minerals have an effect. Medicine should teach you that you can't isolate parts of the body. Regardless, suplementation of any kind is unnecessary if the mother is able to adjust her diet.

Medicine also teaches pathophysiology. Scurvy is a periodontal disease. As I stated above, we're talking about caries. It is physiologically unsupportable to claim that the body removes calcium from teeth during pregnancy therefore leading to caries and/or soft teeth and therefore tooth loss. I have done a literature search on this topic and found nothing.

I heard once that the hormonal changes during pregnancy cause a shift in the balance between benign and acidogenic bacteria towards the acidogenic ones, which leads to more caries and the mom thinking her teeth have "gotten soft". What do you say?

First, as the hormone thing has been brought up several times, can anyone here tell me what the "hormones" are during pregnancy? Specifically, which ones we are talking about? Which ones affect the oral flora and how? People talk about "hormones", but what does that mean? I know you're just throwing out ideas, but we can't base science on stuff we've "heard".

 

[DrTacoElf]

well human chorionic gonadotropin is introduced for sure.

 

[tx oms]

From www.ada.org FAQ on pregnancy:

Does a woman lose calcium from her teeth during pregnancy?

It is a myth that calcium is lost from the mother’s teeth during pregnancy. The calcium your baby needs is provided by your diet, not by your teeth. If dietary calcium is inadequate, however, your body will provide this mineral from stores in your bones. An adequate intake of dairy products – the primary source of calcium – or the supplements your obstetrician may recommend will help ensure that you get all the calcium you need during your pregnancy.

 

[aphistis]

well human chorionic gonadotropin is introduced for sure.

Two major obstacles to this line of thought:

First, sensitivity. When you're talking hormones, you're dealing with substances that are present in infintessimal concentrations in the blood--a "major spike" in blood hormone levels frequently means you have to change your unit of measurement to nanomoles/liter instead of picomoles. In order to posit that hormonal changes are responsible for a change in caries ecology, you'd be saying that strep & lactobacilli are directly responsive to human sex & reproductive hormones. That'd be easy to test for, and like tx oms said, there's nothing in the literature even suggesting that happens. But even before you get to that point...

2. ...you have to propose a mechanism for how the hormone could even get to the bacteria in the first place. The only possibility, even theoretically, would be for it to be secreted in saliva--and before everyone starts shouting "Eureka!", you're talking about a phenomenally unlikely process from a variety of perspectives.

Bottom line, the periodontal hypothesis has been thoroughly investigated and broadly supported in the literature, while the caries hypothesis y'all are suggesting has no empirical support anywhere. Perio disease and caries are not the same, folks; if you're going to be dentists, that's one of the first things you need to realize.

 

[Biogirl361]

Two major obstacles to this line of thought:

First, sensitivity. When you're talking hormones, you're dealing with substances that are present in infintessimal concentrations in the blood--a "major spike" in blood hormone levels frequently means you have to change your unit of measurement to nanomoles/liter instead of picomoles. In order to posit that hormonal changes are responsible for a change in caries ecology, you'd be saying that strep & lactobacilli are directly responsive to human sex & reproductive hormones. That'd be easy to test for, and like tx oms said, there's nothing in the literature even suggesting that happens. But even before you get to that point...

2. ...you have to propose a mechanism for how the hormone could even get to the bacteria in the first place. The only possibility, even theoretically, would be for it to be secreted in saliva--and before everyone starts shouting "Eureka!", you're talking about a phenomenally unlikely process from a variety of perspectives.

Bottom line, the periodontal hypothesis has been thoroughly investigated and broadly supported in the literature, while the caries hypothesis y'all are suggesting has no empirical support anywhere. Perio disease and caries are not the same, folks; if you're going to be dentists, that's one of the first things you need to realize.

hmm... maybe the extra plaque buildup from the gum disease promotes extra bacteria staying in the mouth and decaying the teeth? just putting out ideas, as someone has already pointed out..

 

[aphistis]

hmm... maybe the extra plaque buildup from the gum disease promotes extra bacteria staying in the mouth and decaying the teeth? just putting out ideas, as someone has already pointed out..

Sorry, nope. Remember, gravid (pregnancy-related) perio is caused by the body's ramped-up inflammatory response. She's still got the same critters living in her sulci as before she was pregnant, she's just responding to them more intensely. As I explained in an earlier post in this thread, this aggravated immune response is what's primarily responsible for the damage, because it damages healthy tissue at the same time as it's destroying pathogenic bacteria. No increase in plaque is necessary.

 

[eleannaDDS]

I actually just finished a review of some of the lit out there about the implications of pregnancy on dental health for this paper I wrote... it came in great timing for this thread! 😀

The major hormone spikes during the course of pregnancy involve estrogen, progesterone and hCG... leading to hormone-mediated inflammatory changes in the gingiva. The pregnant woman has a heightened response to local etiological factors (i.e. dental plaque), which may cause "pregnancy gingivitis".

In regards to caries, I haven't found any evidence to support any theory that pregnant women get "soft teeth". Calcium phosphate in hard dental tissues is not a mineral source for the rest of the body. Any increased incidence of dental caries is most likely related to poor diet and a higher intake of cariogenic foods. I haven't experienced it myself, but maybe one day when I'm pregnant I'll have those odd food cravings too 😛

There are some reports of "loose teeth", but generally the "soft, loose teeth" bit is an old wives' tale. There is a theory, though, that tooth mobility may also be related to a nutritional deficiency (possibly vitamin C, as dentite001 mentioned)...

About those old wives' tales, my grandmother used to say that a pregnant woman with a rounder belly carried a girl... I didn't even bother asking!!!


eleanna

 

[toofache32]

...and 2) has nothing to do with dental caries which is the disease most women claim they "caught" by becoming pregnant....

Off the subject...but I actually had a patient tell me she "came down" with a little hemophilia, but then it "went away."

 

[toofache32]

About those old wives' tales, my grandmother used to say that a pregnant woman with a rounder belly carried a girl... I didn't even bother asking!!!

These old wives' tales make me sick. When my wife was pregnant, one of her friends actually said, "strawberries made me sick when I was pregnant and I had a boy...so if they make you sick you'll probably have a boy, too."

Of course they read all the latest medical journals like Redbook, Ladies Home Journal, Cosmo....

 

[aphistis]

These old wives' tales make me sick. When my wife was pregnant, one of her friends actually said, "strawberries made me sick when I was pregnant and I had a boy...so if they make you sick you'll probably have a boy, too."

Of course they read all the latest medical journals like Redbook, Ladies Home Journal, Cosmo....

(incidentally, this thread is really padding my post count tonight. Woo-haa.)

 

[ItsGavinC]

ATTENTION: This thread is in regards to caries, not periodontal issues.

Hmm. I thought it was just about "teeth falling out during pregnancy," which would have more of a directive from periodontal issues than caries.

 

[ItsGavinC]

Perio disease and caries are not the same, folks; if you're going to be dentists, that's one of the first things you need to realize.

Excellent point (I know you've made it many times in this very thread). Newbies often get confused on this subject matter since the two can go hand in hand. That doesn't mean that they are mutually inclusive, however, much less that they are one and the same.

 

[eleannaDDS]

Off the subject...but I actually had a patient tell me she "came down" with a little hemophilia, but then it "went away."

Last year I had a walk-in patient for an extraction who told me he had hepatitis B a few years ago, but that he doesn't have it anymore

 

[dentaldaddy]

I'm still not completely convinced. If Vitamin C deficiencies (scurvy) can cause teeth to loosen, why can't other minerals have an effect. Medicine should teach you that you can't isolate parts of the body. Regardless, suplementation of any kind is unnecessary if the mother is able to adjust her diet.

After having her 4th child, my grandmothers teeth got loose and fell out.

So I agree with this !

 

[TucsonDDS]

My father-inlaws teeth fell out after his 4th kid was born also, almost 10 years to the day. Actually his hair even turned grey and he had a bowel obstruction. Do you guys think having children had anything to do with it???

 

[aphistis]

My father-inlaws teeth fell out after his 4th kid was born also, almost 10 years to the day. Actually his hair even turned grey and he had a bowel obstruction. Do you guys think having children had anything to do with it???

Nicely done.

 

[Darksunshine]

My father-inlaws teeth fell out after his 4th kid was born also, almost 10 years to the day. Actually his hair even turned grey and he had a bowel obstruction. Do you guys think having children had anything to do with it???

haahahahahaha, I love your sense of humor and I agree ..... People are so silly.

 

[tx oms]

Last year I had a walk-in patient for an extraction who told me he had hepatitis B a few years ago, but that he doesn't have it anymore

Are you saying everyone who contracts HBV becomes a carrier? Remember, being positive for surface antibodies does not equal being a carrier. Thanks for you support above, but I'm calling BS on this.

 

[SLIMDEETS]

Yes, I was sitting at the nurses station on the peds floor as part of my med school pediatrics rotation when I got in on this discussion.

A pediatrics and orthopeadics attending were lecturing the medical students on the importance of vitamin supplementation. They said that a pregnant woman needs calcium supplementation "so her teeth won't fall out".

I got into the conversation late and thought they were joking so I said, "What? Are you serious? Pregnancy doesn't cause calcium loss from teeth" in a shocked tone. I thought one of them knew I was also an oral surgery resident but apparently not b/c they both seemed surprised that a medical student would question them. I ended up listening to a five minute diatribe on the need for vitamin supplementation.

Biochem 101, they must have missed that class.....

 

[aphistis]

Are you saying everyone who contracts HBV becomes a carrier? Remember, being positive for surface antibodies does not equal being a carrier. Thanks for you support above, but I'm calling BS on this.

Ditto. 90-95% of acutely infected hep B patients eliminate the virus from their bodies; only 5-10% progress to chronic disease.

Reference: http://www.hepb.org/02-0128.hepb

 

[eleannaDDS]

Last year I had a walk-in patient for an extraction who told me he had hepatitis B a few years ago, but that he doesn't have it anymore

The patient was actually told he had a chronic infection at that time, and when he had his blood tested subsequent to that. He seemed to think that it "went away" in between blood tests. We followed up at some walk-in clinics he went to when we were investigating his med history.

Sorry guys, I didn't re-read my post... if I did, I'd probably have realized that it didn't make sense. Anyways, this guy had a myriad of med conditions he wasn't treating. I felt poorly then b/c sometimes you can't do much when you see people deteriorating except to advise them to seek regular medical consultation for their problems. Their health is in their hands.

Thanks for the posts guys, and for catching that