There are times in a woman’s life that, due to hormonal changes, she is more susceptible to inflammation and periodontal disease: puberty, contraceptive use, pregnancy and menopause.

There are times in a woman’s life that, due to hormonal changes, she is more susceptible to inflammation and periodontal disease: puberty, contraceptive use, pregnancy and menopause.

Two distinct groups of periodontal diseases exist. When they affect only the gums, causing a reversible inflammatory response, it is called gingivitis. Not treating gingivitis in the presence of other factors (i.e. genetic or environmental) can cause the onset of periodontitis, which besides producing gingival inflammation, also causes a deeper destruction affecting other periodontal tissues, including the alveolar bone, dental cement and periodontal ligament.

Gingival inflammation during pregnancy is known as gingivitis gravidarum. The prevalence of gingivitis gravidarum ranges between 36 and 100% according to the literature; however, it goes down to 0.03% in women that enter pregnancy with healthy gums. This is why it is important to make sure gums are healthy or treated, if necessary, before pregnancy. Pregnancy gingivitis is brought about by hormonal changes that affect gingival blood vessels, the function of periodontal cells, bacteria in plaque and the local immune system. If proper prevention is not carried out and pregnancy gingivitis appears, gingival inflammation may be present throughout the gestational period, being more severe in the front teeth and in interproximal sites. Three months after labour, gums tend to return to their initial condition. During pregnancy granuloma gravidarum, otherwise known as pregnancy tumour can also appear. It is an exaggerated proliferative fibrovascular inflammatory response associated with a common stimulant mainly affecting the gums. It is described as a localised, nodular or ulcerated, red or reddish, black-and-blue mass, that bleeds easily and that is common among women (0.5-5%) around the second trimester of pregnancy and grows throughout the trimester, usually reaching a size of no more than 2 cm. If the pregnant woman has gingivitis or periodontitis, she will be at greater risk for pre-term labour or having a low birth-weight baby
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Recommendations

A proper oral hygiene technique (toothbrush, interproximal brushes and/or dental floss) is essential not only for reducing gingival inflammation but also for preventing possible pregnancy complications (pre-term labour or low birth-weight baby).

Regular visits to the periodontist can prevent, or help identify, gingivitis gravidarum so that it can properly be treated
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With the collaboration of:

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