Morning Sickness and Oral Health

I'll never forget the day my wife told me that we were expecting our first child. She had to speak quickly as she was not feeling well. She had morning sickness. Her discomfiture continued for months. Odd things seemed to make her feel uncomfortable. Smells, driving on certain roads, the soundtrack of Les Miserables, all had a strong effect. My wife and I learned many techniques to help her cope with feeling so sick over the next two months.

What causes morning sickness? What can women and their significant others do to help them feel better? What does any of this have to do with oral health?

When a woman is pregnant, there are many complex changes to her body and its condition. Of course there are the obvious physical changes. There is weight gain of 30 or more pounds. The child growing inside the uterus pushes against all of the abdominal structures including the bladder and stomach.

Healthy pregnancies rely on a flood of hormones. Hormones are chemicals that the body produces to regulate how the body works. The level of human chorionic gonadotropin (HCG) rises early in pregnancy. HCG may cause the early feeling of nausea and resultant emesis (vomiting) of the first trimester.

HCG induces the ovaries to produce another hormone - progesterone - until the placenta takes over that responsibility at about 10 weeks. Progesterone relaxes smooth muscle. That prevents the uterus from contracting and expelling the fetus early. Smooth muscle pushes food through the esophagus, stomach and intestine. High levels of progesterone slow that passage. Also, the esophageal sphincter, the valve that prevents stomach contents from pushing back up into the esophagus, is made of smooth muscle. Slow emptying of the stomach, weakening of the esophageal sphincter, and constriction of the stomach by a growing uterus work in concert to increase gastric reflux and emesis.