Bad Breath in Pregnancy

There’s no denying the fact that pregnancy can be tough on the body. From bad backs to morning sickness, expectant mothers can suffer from a range of ailments.

Perhaps rather more surprisingly a number of women find that they suffer from bad breath in pregnancy. The first, and arguably most important, message is that this is not uncommon. As a result if you’ve noticed a change to your breath recently you’re far from the only woman to have such an experience.

Fortunately, once we understand the underlying causes of bad breath during pregnancy there are a range of solutions that can be applied.

The Reasons for Pregnancy Bad Breath

During pregnancy the body goes through a huge number of changes. A surprising diversity have the ability to affect one’s breath, but many of them have effective solutions.

Periodontal Disease

Possibly the most serious cause of bad breath in pregnancy comes in the form of gingivitis and periodontal disease. For the uninitiated this is defined as inflammation of the gums, whereby they may become red and swollen.

Studies suggest that there may be a number of reasons for periodontal disease during pregnancy. For one, food cravings and late-night snacking can involve significant changes to the diet, or the consumption of food at unusual times.

Secondly there is evidence that the body reacts differently to oral plaque during pregnancy, which naturally pre-disposes expecting mothers to the ailment(1).

Worryingly, periodontal disease during pregnancy doesn’t just have an effect on the breath; it has also been linked on occasion to adverse pregnancy outcomes such as low birth weight(2). Resolving such an issue should therefore be considered a priority.

Changing Hormone Levels

During pregnancy both oestrogen and progesterone increase significantly as the term develops. These rise to levels not normally experienced and are responsible for a range of essential changes to your body.

One side-impact of these rapidly-changing hormone levels are their impact on both the flow and composition of saliva. For example studies have found that the acidity of saliva (pH) decreases over time as birth approaches, before rapidly recovering in line with the birth of the child(3).

These changes in saliva can have a noticeable effect on the breath, by altering the oral chemistry, and hence the beneficial effects of saliva on controlling bacteria – and hence odour.

Morning Sickness

While the effects and severity of morning sickness differ between women, in more severe cases this can lead to breath problems. The primary issue is less about the actual taste of vomit (which can be easily brushed and rinsed away) and more about how the pH of vomit affects the fine bacterial balance in the mouth(4).

Quite simply, the more often you are ill, the more likely it is that the sulphur-producing bacteria which live in the mouth will be affected. The end result can be the release of Volatile Sulphur Compounds (VSCs) by bacteria, leading to worsening breath.

De-Mineralization

Pregnant women need to provide their growing baby with all the nutrients it requires. While many women experience the feeling of “eating for two”, it is the minerals required by growing babies which can affect the breath.

Babies require considerable volumes of calcium in order to build their skeleton, particularly in the third trimester when approximately 80% of the calcium deposits are laid down(5).

In cases where calcium supplements have been insufficient, and the baby is struggling to obtain all the necessary calcium, this mineral may sometimes be drawn from the mother’s body. This demineralization can lead to weakened teeth, and as a result an increase in the chances of tooth decay.

How to Stop Bad Breath in Pregnancy

The cures for bad breath during pregnancy will depend on the specific causes.

Some solutions are likely to be more effective than others, but by fully understanding the potential causes you’ll be better placed to rid yourself of the unpleasant experience of halitosis.

Establish a Thorough Oral Hygiene Routine

First and foremost, taking care of your teeth, gums and tongue should be a critical focus during pregnancy. No matter how carefully you look after your mouth, it pays to “up your game” when pregnant.

It is wise to speak to your dentist for specific recommendations based on your past dental history, but as a guide the following tips can be a worthwhile beginning:

Brush Regularly – Aim to brush your teeth for 2-3 minutes, at least twice a day. Brushing after any late-night snacking, sugary foods or bouts of morning sickness can also prove beneficial.

Use Alcohol-Free Mouthwash – Many standard mouthwashes merely mask the smell, and contain alcohol which can actually dry out the mouth. The end result is that some mouth washes may actually do more harm than good. A good quality anti-bacterial mouth rinse like this one will not help to reduce dry mouth syndrome, but can also fight the bacteria which cause bad breath.

Clean Your Tongue – The sulphur-producing bacteria which can lead to bad breath are most commonly experienced in the tongue. Investing time in cleaning your tongue thoroughly can also help to reduce the effects of bad breath in pregnancy.

Maintain Frequent Dentist Visits

Due to the increased likelihood of periodontal disease and tooth decay in pregnancy regular check-ups at your dentist are recommended. An experienced dentist will be able to identify the early signs of any problems and suggest clinically-effective solutions.

Drink Plenty of Fluids

Saliva helps to fight odour-causing bacteria, but vomiting and hormonal changes can dry out the mouth. Regularly sipping fresh water throughout the day can help to moisten the mouth, removing the problems associated with a dry mouth.

Avoid Late-Night Snacking

Cravings are part-and-parcel of many pregnancies, but they can encourage you to eat sweeter foods than you normally would, or to visit the fridge late at night before collapsing exhausted back into bed.

If possible, try to minimize snacking and be sure to carefully brush your teeth afterwards to avoid encouraging bad breath.

Proper Calcium Supplementation

Lastly, speak to your healthcare provider to ensure that you are getting the necessary calcium in your diet; especially in the latter stages of pregnancy. Recalcifying toothpastes may be beneficial for ensuring your teeth have the necessary protection.


References:

  • (1) Coventry, J et al. 2000. Periodontal disease. MBJ 321(7252), pp 36-39. Available at: www.ncbi.nlm.nih.gov
  • (2) Dasanayake, A et al. 2008. Maternal periodontal disease, pregnancy, and neonatal outcomes. American Journal of Maternal Child Nursing 33(1), pp 45-49. Available at: www.journals.lww.com
  • (3) Laine, M at al. 1988. Pregnancy-related changes in human whole saliva. Oral Biology 33(12), pp 913-917. Available at: www.sciencedirect.com
  • (4) Bad breath can make your pregnancy stink. Available at: www.babymed.com
  • (5) Kovacs, C and Kronenberg, H. 2011. Maternal-fetal calcium and bone metabolism during pregnancy, puerperium, and lactation. Endocrine Reviews (18)6. Available at: www.press.endocrine.org/