Pregnancy and Periodontal Disease

Pregnancy is accompanied by an increase in the levels of both progesterone and estrogen which, by the third trimester, reaches levels 10-30 times that seen during the typical menstrual cycle.9 Changes in the gingiva include an increase in pregnancy gingivitis that usually starts during the second to third month of pregnancy and increases in severity through the eighth month, where it decreases along with the abrupt decrease in hormone secretion.10 Studies have shown a prevalence of 35% to 100% depending on the study.10-12 It is characterized by swelling, bleeding, tenderness, and redness of the gum tissues.

In some cases, pregnant women may notice the formation of large, isolated growths or lumps in between or around teeth. These are often called pregnancy tumors, but are not cancerous.13 They tend to be associated with areas of irritation, such as plaque or calculus, and the alteration in hormonal levels exaggerates the tissue response. Treatment should be delayed until after childbirth but is often not necessary since the lesions will decrease post-partum.

A very recent study has also found an important association between periodontal disease and the incidence of preterm, low birth weight infants.14 In fact, the presence of a periodontal infection can increase the likelihood of a child born too early and too small by seven times. This increases the risk for future health problems and disabilities. The American Academy of Periodontology recommends a periodontal evaluation be included as part of pre-natal care.

It is important to note that women taking oral contraceptives have been found to have similar gingival changes as those that affect pregnant women.15 Prevention is again the best way to avoid red, swollen gums when taking oral contraceptives so good home care and regular dental visits are recommended. Women taking oral contraceptives need to also be aware that certain medications, such as antibiotics, have the ability to impair a contraceptive's effectiveness.16 Consultation with a dentist, periodontist, physician, or pharmacist is important prior to taking any prescribed medication while on oral contraceptive therapy.

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Article References

Guest Article by Eduardo R. Lorenzana, DDS, MS
Web Site: http://www.advancedperiodontics.com 

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