Upon learning that you're pregnant, your mind is rattled with excitement, and also a long list of advice from friends, sisters, mothers, grand mothers and doctors on the "to dos" for a healthy pregnancy and delivery of a healthy baby. And while the "to-do" list keeps growing, it's important to take all the steps necessary to ensure an on-time and safe arrival of your most precious cargo yet.

You've probably heard a few old wives' tales about pregnancy, including the one, "A tooth lost for every child." While it may seem farfetched, it actually is based loosely in fact. Your teeth and gums are affected by pregnancy, just as other tissues in your body. But, you may not be aware that the health of your gums may also affect the health of your baby-to-be.

About half of women experience pregnancy gingivitis. This condition can be uncomfortable for moms-to-be and cause swelling, bleeding, redness or tenderness in the gum tissue. Conversely, a more advanced oral health condition called periodontal disease (a serious gum infection that destroys attachment fibers and supporting bone that hold the teeth in the mouth) can affect the health of your baby. Studies have shown a relationship between periodontal disease and premature low birth weight babies. In fact, pregnant women with periodontal disease may be seven times more likely to have a baby that's born too early and too small. The likely culprit is a labor-inducing chemical found in oral bacteria called prostaglandin. Very high levels of prostaglandin are found in women with severe cases of periodontal disease.

The good news is that a periodontal evaluation and recommended treatment as part of preconception or prenatal care can help alleviate your uncomfortable oral health problems while putting your mind at ease that your oral health may not contribute to increasing your risk of having a pre-term baby.

If you're diagnosed with periodontal disease, your periodontist might recommend a common non-surgical procedure called scaling and root planning (SRP). During this procedure, your tooth-root surfaces are cleaned to remove plaque and tartar from deep periodontal pockets and to smooth the root to remove bacterial toxins. Research suggests that SRP may reduce the risk of pre-term birth in pregnant women with periodontal disease by up to 84 percent. The added bonus is that the procedure should alleviate many of the symptoms associated with pregnancy gingivitis, such as swelling and tenderness of the gums. Don't you wish this would work for your tired, achy feet, too?

So, as you make your way through the "to-dos," remember to check off a visit to the dentist or periodontist. This baby step benefits you, as well as your unborn baby.

Premature Births: The Answers Can't Come Soon Enough

According to the March of Dimes, premature births have soared to become the number one obstetric problem in the United States. Many premature babies come into the world with serious health problems. Those who survive may suffer lifelong consequences, from cerebral palsy and mental retardation to blindness.

The March of Dimes has launched a $75 million, five-year campaign to raise public awareness and reduce rates of premature birth, and increase research to find the causes. Until all of the answers are in, the March of Dimes recommends the following to reduce the risk and/or effects of premature births:

Consume a multivitamin containing 400 micrograms of the B vitamin folic acid before and in the early months of pregnancy.
Stop smoking.
Stop drinking and/or using illicit drugs, or prescription or over-the-counter drugs (including herbal preparations) not prescribed by a doctor aware of the pregnancy.
Once pregnant, get early regular prenatal care, eat a balanced diet with enough calories (usually about 300 more than a woman normally eats), and gain enough weight (25 to 35 pounds is usually recommended)
Talk to your doctor about the signs of premature labor, and what to do if you show any of the warning signs. For more information about premature births, visit www.marchofdimes.com.

AAP Patient Page, July/September 2003, Vol. 4, No. 3;