Pregnancy Gingivitis: Failure to Look for the Cause

A few days ago, I learned from a Crest ad that a large fraction of pregnant women, such as half, suffer from gingivitis (inflamed gums). It’s called pregnancy gingivitis. The ad recommended better dental hygiene, such as brushing your teeth more.

Thirty years from now will people think how could they [meaning us] have been that stupid? Faced with pregnancy gingivitis, they brushed their teeth more? Pregnancy gingivitis is supposedly due to “hormones” that increase during pregnancy. In other words, a health expert actually thinks — or claims to think — that pregnancy gingivitis has a different explanation than other gingivitis. Yet he doesn’t know what causes other gingivitis. For example, here is what Mayo Clinic experts say causes gingivitis. This makes no sense. But it is worse than most nonsense, since fetal health is at stake.

Several years ago, I greatly increased my flaxseed intake because I discovered it improved my balance. My gums suddenly went from red (inflamed) to pink (not inflamed), no doubt because flaxseed has lots of omega-3, which is anti-inflammatory. Gingivitis is — usually? always? — caused by too little omega-3.

My theory: pregnancy gingivitis happens because pregnant women need more omega-3 than usual. A growing brain needs lots of omega-3.  If this theory turns out to be true, the gums of pregnant women should be monitored to make sure they are getting enough omega-3. Nowadays pregnant women are given omega-3 to take but there is no test to make sure it is enough. That pregnancy gingivitis is common suggests it often isn’t enough. Actually, everyone’s gums should be checked to make sure they are getting enough omega-3.

19 Responses to “Pregnancy Gingivitis: Failure to Look for the Cause”

  1. Mark Sanders Says:

    I like to read your blog for the articles on self-experimentation. However, simply because something works for you is not scientific proof that your cure, or your explanation for your own cure, is true for everyone else. There is a list of things that go out of whack in a pregnant woman’s body, most of which resolves once the baby is delivered. This is not to say your idea is wrong, maybe it is. But just because it worked for you doesn’t mean it will work for a pregnant woman or that the Mayo Clinic should change it’s explanation of gingivitis, an explanation that makes sense to me.

  2. Seth Roberts Says:

    Many (10?) other people told me that their gingivitis went away when they took 1-2 tablespoons of flaxseed daily. Nobody told that this amount of flaxseed failed to reduce gingivitis.

    My confidence about this is not based only on the fact that something worked for me. It is also based on the fact that it worked for many other people and the research showing that omega-3 is anti-inflammatory.

    Of course, my idea about pregnancy gingivitis is just a theory, a theory that can be tested. But at least it is a theory that explains ordinary gingivitis and pregnancy gingivitis in the same way.

  3. Adam Says:

    That is funny. It seems like they just figured women’s hormones are something that changes during pregnancy and arbitrarily said that that is what causes pregnancy gingivitis. Which hormones specifically and in what way do they cause inflammation of the gingiva?

  4. Tom Metz Says:

    Self experimentation and anecdotes are, in my opinion, some of the best sources of information we have as long as what we resolve to experiment and what we try isn’t dangerous and used in place of what we know also works. Suggesting that pregnant women should take flax oil or eat more flax (it’s just a food) is not dangerous.

    Self experimentation is not even in the same league as a clinical trial yea I know. But lets look at the prospect of a clinical trial to see if pregnant women with bad gingivitis need more omega 3… who on earth would fund that study? Nature’s Bounty? Bob’s Red Mill? Colgate? Colgate would lose money if there was a connection. “Hey ladies you don’t need colgate… you need flaxseed!” Omega 3 isn’t prescription and therefore would provide no benefit to the companies with adequate money to actually fund studies. It will simply never happen.

    Mr.Heisenbug (don’t know his actual name) said on his blog that he cured his hand eczema with a specific type of probiotic. Because of this countless others with eczema have tried this probiotic with great success in curing their eczema. No clinical trials exist that establish the connection between eczema and this probiotic. The standard treatment here in the U.S. for eczema is to go to your doctor, then get a referral to a dermatologist, then get a prescription for a steroidal hand creme that’s going to have a plethora of side effects, cost your insurance an obscene amount of money and probably smell terrible. The sad thing is… the creme will always be the medical systems treatment of choice because there is much money to be made on it.

    As for the topic… I would think a pregnant would need more omega 3 because it is essential for brain development and well the woman is essentially developing someone else’s brain for them. According to this article… http://www.sciencedaily.com/releases/2012/06/120609152436.htm omega 3 in breast milk is important for infant development. It would make sense that, if there is a connection between gingivitis and omega 3, the gingivitis would be worse for a pregnant woman. Most American adult women are already deficient in omega 3 because of the high amount of omega 6 oils used in processed foods. A pregnant woman would have to defer their amounts of omega 3 to the developing baby thereby depleting their own stores.

    An interesting (and safe) test would be to examine food diaries of pregnant women and see if at any point they crave foods high in omega 3 (fish flax etc…)

    Love your blog Seth and, as an educator, look forward to all of your posts.

  5. Gina Says:

    You can count me among those whose gums improved with flax. I don’t do oil, but 1-2 tbsp of ground flaxseeds a day.

    How do you know it’s the omega-3 and not the lignans or something else in flax?

  6. Seth Roberts Says:

    how do I know it’s the omega-3 and not the lignans or something else?

    because the flaxseed oil I used didn’t have lignans. and plenty of research shows that omega-3 is anti-inflammatory.

  7. Amol Says:

    It is incredibly interesting to me that dosage is an incredibly important factor for generally accepted medical drugs but no one ever applies it to food. After reading your blog, I started experimenting with honey immediately after waking up and before going to bed to absolutely amazing results in sleep at night and appetite control during the day. When I tell people that I eat 60 grams of honey a day, they almost always ask as to why so much without realizing that 60grams is only 3 tablespoons. My guess would be that Omega-3/ Fish oil or Flax seeds probably fall into this category where people make random statements about dosage without any meaningful evidence, self-experimental or otherwise, to back it up.

  8. Leslie Says:

    Hi Seth, I stumbled on this interesting bit of info on cannabinoid like anti-inflammatory in flax (http://www.ncbi.nlm.nih.gov/pubmed/22706678), so perhaps that also contributes to the positive effects seen with flax?

  9. Allan Folz Says:

    I have what I think is an interesting self-experiment wrt O3 & pregnancy.

    My wife had some pretty bad post-partum depression following the birth of our first. It lasted more or less until he weaned, a little over two years.

    With our second, for the whole pregnancy there was some underlying tension whether she would experience it again. Quite fortunately and thankfully it did not. About the only difference I noted at the time was the first was a boy and born with some moderate complications during delivery while the second was a girl, no issues. I chalked it up to the complications (depression is well-known among heart-attack survivors and IVF recipients, which IVF is, IMO, by-definition a complication).

    For the third pregnancy I had “discovered” Paleo eating and so we were on a low-moderate carb diet. We were also supplementing vitamin D and a little fish oil. She was averaging 5K IU of D a day, but only about one, 1g capsule once or twice a week of the fish oil. All in all, not much fish oil as I was generally skeptical at the time of how much was really necessary for people otherwise eating traditionally healthy, home-cooked meals.

    Late in the third trimester she started experiencing a certain amount of moodiness. In and of itself, it would not be atypical for any woman in her third tri, but with my wife’s history it us more sensitive and take notice. Paying close attention (and long before discovering your blogging about self-experimentation) I eventually correlated the moodiness to those times we’d skip taking fish oil. If she didn’t take any mid-week, by Saturday it was very noticeable that her mood was down and she would be on the short-tempered side. Once I noticed the connection, and without telling her what I was doing ie. single-blind, I’d deliberately skip her mid-week one week note her weekend temper and mood. The next week I’d be sure she took a cap mid-week. Next week back to skipping. Then a week of double-dosing, 2 caps twice in the week. It had the best results yet.

    At first I was amazed. It was neat: so mechanical, like flipping a switch. But then it occurred to me that if two capsules in a week vs. one was enough to change her mood then she was obviously deficient as every mg was being put to use with no spare capacity “in the tank.” I wondered if her body was scavenging it from her own brain, kind of a sobering thought. After that she went to supplementing daily and had no mood issues through the rest of the pregnancy or while breast feeding. I can’t remember if she had the typical “baby blues” at the three day mark.

    I am convinced O3 is a vital part of nutrition for mothers both pre-natal and while nursing. I share this story about every time the subject comes up.

    I also have an interesting story about my son and fish oil, but for another time. :)

  10. Jim Says:

    In reply to Mark:
    I have always had poor gums. When I saw, years ago, Seth using flax oil to help with gums – and other bloggers saying that it helped (Marginal Revolution) I tried it. My gums were much improved. The last time I went to my dentist his comment was “Who has been taking care of my teeth?” My gums were much improved. I told him that he was taking care of my teeth – every 4 or 5 years. For me flax oil is really good. It really ups my HDL cholesterol levels also (from the 30′s to the 50-60′s).

  11. sam Says:

    the esteemed chris kresser is not that keen on flaxseed oil. he prefers fish oil.
    http://chriskresser.com/why-fish-stomps-flax-as-a-source-of-omega-3

  12. Tom Metz Says:

    To Allan,

    Wow that appears to be quite a connection between the Omega 3 and depression during or after pregnancy. Through such an idea we can ask the question- is Omega 3 deficiency during pregnancy the primary cause of postpartum depression? A pretty significant reality if true seeing that postpartum depression is very common. Now if there was only a way to connect the postpartum depression to gingivitis. That would be pretty wild.

  13. Allan Folz Says:

    Tom, I really think it is.

    I also think it extends well beyond pregnancy. I wonder how many pre-adolescent boys struggling with ADHD and teenage boys struggling with depression, and so many of them on one big pharma prescription or another, really are suffering from an O3 deficiency.

  14. Seth Roberts Says:

    yet flaxseed oil works. and does not have mercury contamination problems.

  15. Allan Folz Says:

    I don’t have an opinion on flax vs. fish. At the time I didn’t even know there was an efficacy debate. We were taking a fish-based supplement because it was most readily available. Heck, even among fish oils there’s a huge debate between molecularly distilled esters and the natural triglycerides. I don’t know which is necessarily better, except that the distilled esters did work for us. So, I call it omega-3 at let folks decide which they want to take.

    Now that I”m thinking about it, yes, I should do a self-experiment — put the family on flax for a month and see if anyone can notice a difference.

    Unfortunately, I don’t have any pregnant or nursing mothers for a real test.

  16. Bill Johnson Says:

    My wife’s been Oil pulling for several years now and during pregnancy she does it even more than usual. She finds it very effective in avoiding this mouth problem. How about giving it a try for all mothers there.

  17. Cord Says:

    The state of medical knowledge about pregnancy is shameful. We basically haven’t progressed much beyond “hysteria” when it comes to diagnosing and treating woman-specific medical problems.

    I’m working on my second pregnancy. Gingivitis is not a malady I have encountered so far, but I do take cod liver oil and eat a ton of eggs (pastured, from my own flock).

    The one that gets me is the chronic constipation. Every pregnancy guide will tell you that constipation is common in pregnancy, and there are lots of cute theories about how this is adaptive because it helps you extract the most possible nutrients from your food. Not a whisper about what happens to me: total cessation of gut motility from the day before the positive test until 18 months after the birth of the baby. People who say “just eat more fiber” (like my OB) make me livid. Whatever is causing this, it’s NOT adaptive to be dependent on Milk of Magnesia for two years with each kid. I actually got a blockage with my first pregnancy, and the thought of doing that again terrifies me.

    I was determined to find an answer this time around, but my OB was no help, and even the internet is extremely squeamish about recommending *anything* for pregnant ladies other than an extra pillow and a sedate walk. I tried a chewable probiotic, with no results. Then tried the Jarro-dophilus (whose thick shelled capsules are supposed to make it past the stomach intact), and later added potato starch with it ala Free the Animal, and things are not entirely back to normal, but lo and behold, I am off the milk of magnesia!!

    All this says to me that the problem may be hormone related, but if it were just “hormones”, a probiotic wouldn’t fix it– it’s got to have something to do with gut health, and probably gut flora. Pregnant or not, intractable constipation is not normal and not healthy. So why doesn’t my OB know about this? Why do all mainstream sources of pregnancy info shrug this problem off as “just hormones” and recommend totally ineffective solutions?

  18. Seth Roberts Says:

    I agree. Calling it “hormones” makes no sense. You might try steel-cut oatmeal, that’s a good source of fiber.

  19. Terri Says:

    As a medical doctor taking time to read on nutrition, GI health, food intolerances, and pregnancy for myself and my own issues, I have learned way more than I ever did before. But at least I have the tools to make sense of what I am reading so I won’t complain much. I don’t have gingivitis, but I have definitely realized that many of us females head into pregnancy deficient in omega 3, iodine, vitamin d, vitamin k2, magnesium, and micronutrients. Sadly, my own OB didn’t even take time to make sure I was on a decent prenatal vitamin. On flax vs seafood vs supplement, I think each person has to find their own way. I have the commenter Cord’s issue, and flax, despite trying it, made the GI motility much worse. Seafood is feel good food for me.