Understanding Pregnancy Gingivitis
and Periodontitis

Pregnancy is a physiological state that brings a wide range of changes in a woman's life, including a susceptibility to periodontal diseases, probably due to hormonal changes associated with pregnancy. The metabolism and immunology of the body are modified by hormones like progesterone and estrogen as well as other local factors. These hormones may modify the oral mucosa and lead to various periodontal diseases.
Two theories have been proposed for the action of periodontal tissues:

  • Changes in the epithelial barrier to
       bacterial insult
  • Effect on the collagen turnover

Effect of estrogen on the periodontal tissue:

  • Changes in the epithelial barrier to
       bacterial insult
  • Effect on the collagen turnover

Effect of progesterone on the periodontal tissues:

  • Increases vascular dilation and thus
       increases permeability
  • Increases the production of
  • Increases PNML and prostaglandin E2
       in the gingival cervical fluid (GCF)
  • Inhibits collagen and non-collagen
       synthesis in the periodontal ligament
       (PDL) fibroblast
  • Inhibits proliferation of human
       gingival fibroblast proliferation
  • Alters rate and pattern of collagen
       production in gingival resulting in
       reduced repair and maintenance potential

The microbial and gingival changes in pregnancy results in pregnancy Gingivitis which is characterised by erythema, edema, hyperplasia and increased pocket depth, increased bleeding and even leading to mobility of tooth. These conditions worsen if oral hygiene is poor before pregnancy.

Treatment Protocols:

  • Pre-pregnancy screening of mouth
  • Brush and floss twice daily (don't eat
       and sleep)
  • Oral screening is totally risk-free and    scaling and polishing can be done
       during all 3 trimesters

Complications of pregnancy Gingivitis:
Gingivitis can cause complications in the patient's mouth and even in the pregnancy. Periodontitis is a more advanced stage of gum disease that can spread down to the bone. If a patient develops Periodontitis, studies have shown an increased risk of preterm birth or low birth weight, among other conditions like pregnancy Gingival Tumour. Remember, the gums hold the teeth in place. If left untreated, Gingivitis and Periodontitis may eventually lead to tooth loss.

Dr. (Maj Gen) A. S. Bath

Dr. Riddhi Rathi Seth
Orthodontics &
Dentofacial Orthopaedics
Nanavati Super
Speciality Hospital