Risk of Gingivitis (Periodontal Disease, Dental Plaque) During Pregnancy
The American diet and the constant drip of sugar allows little time for the natural repair of teeth. All day, it's a cycle of acidic erosion and repair -- or at least, it should be -- but our constant sucking on hard candy and guzzling sodas with high fructose syrups leaves little time for repair.
During pregnancy, your gums are more susceptible to the damaging effects of plaque. The problem is compounded if you have morning sickness — nausea and vomiting may make it hard to brush your teeth regularly. Maternal periodontal disease has been associated with an increased risk of preterm birth and low birth weight. One theory linking periodontitis to pregnancy outcomes posits that oral bacteria seed the placenta, membranes, or amniotic fluid through blood-borne routes, eliciting an inflammatory cascade that precipitates preterm labor.
Pregnancy itself does not causes gingivitis nor it alter healthy gingiva, but-
1. Accentuate the gingival response to bacterial plaque and modifies the resulted clinical pictures. No notable changes occur in the gingiva during pregnancy in the absence of local irritants.
2. Beside this, it also induces other factors that aggravate the gingival response to
(i) Microbiological change:
In pregnancy—> increase estradiol and progesterone—>Subgingival flora change to more anaerobic one e.g. increase bacteroids intermedius which is a cause of gingivitis.
(ii) Local irritants response:
In pregnancy—> a) increase estrogen & progesterone—> increase gingiva is a target for female sex hormone.
—> b) dilatation and tortusity of gingival vasculature—» so ,increase bleeding .
(iii) Circulatory stasis.
(iv) Increase susceptibility to mechanical irritation.
- Due to the above changes there is leakage of fluid into perivascular tissue —> Inflammation causes.
- In pregnancy —> Increase sex hormone —> destruction of gingival mast cells. —>Release of histamine and proteolytic enzyme —>inflammatory response to local irritants.
- In pregnancy —»depression of maternal T lymphocytes response altered tissue response to plaque.
- Site: Marginal and interdental gingiva
- Size: Gingiva become edematous, pit on pressure
- Shape: Sometimes rose berry like appearance or sometimes form discrete like mass referred to pregnancy tumor.
- Color: Bright red to bluish due to pronounced vascularity.
- Surface: Smooth, shiny and pliable.
- Consistency: Soft and edematous.
- Bleeding: Bleeds spontaneously or slight provocation.
- Pain: Painless until infected.
Study suggested that chronic periodontal infection increases the risk of developing preeclampsia in pregnant women.he results also suggest that maternal chronic periodontal disease is a risk factor for low birthweight babies among preeclamptic mothers compared to those women who did not have preeclampsia.
While it has been shown that pregnancy raises the risk of gingivitis (gum disease), the gingivitis usually goes away after the birth of the child. But if a woman has repeated pregnancies and more frequent outbreaks of gingivitis, she may develop periodontal disease, which if left untreated can eventually cause tooth loss.
Clinical changes in tissues of the periodontium have been identified during periods of hormonal fluctuations such as puberty, the menstrual cycle, pregnancy, menopause, contraceptives and ovulation induction drugs in women."Many dentists are reluctant to treat pregnant women, and women who have to care for more children may have less time to visit the dentist. Mothers with several children may be more likely to eat the "junk food" that their kids are eating.
The Food and Drug Administration (FDA) recently approved a new prescription treatment for gingivitis, a common gum disease that affects most adults at some point in their lives. The Decapinol Oral Rinse treats gingivitis by reducing the number of bacteria that attach to tooth surfaces and cause dental plaque. Decapinol is approved for use in persons 12 years of age or older when routine oral hygiene is not adequate to prevent gingivitis. Decapinol is not recommended for use by pregnant women.
Researchers studied a compound known as lansoprazole, part of a family of compounds known as benzimidazoles that already have a range of uses, primarily controlling stomach hyperacidity and killing Helicobacter pylori (the bacteria responsible for stomach ulcers). Now, the compounds are brandishing potent antimicrobial actions that interfere with the dirty work of other types of bacteria that cause plaque buildup and gingivitis.