Gingivitis in Pregnancy

Introduction

• Description: Elevated hormone levels during pregnancy may induce gingival hyperplasia, pedunculated gingival growths, and pyogenic granuloma. Despite concerns directed elsewhere during pregnancy, the practitioner must watch for this common problem and address it when present. Periodontal disease has been identified as a risk factor for preterm delivery.

• Prevalence: Common (some estimate up to 90% of population affected). Pregnancy-associated pyogenic granuloma occurs in approximately 0.5%–5% of pregnant women.

• Genetics: No genetic pattern.

Etiology and Pathogenesis

• Causes: Hormonally induced hypertrophy (may occur with higher-dose combination oral contraceptives as well), inadequate plaque removal, fusiform bacillus or spirochete infection, allergic reactions.

• Risk Factors: Increased hormones (pregnancy, oral contraceptives), poor dental hygiene, mouth breathing, diabetes mellitus, human immunodeficiency virus (HIV) infection, and malocclusion.

Signs and Symptoms

• Mouth odor

• Gum swelling and redness (especially at the base of the tooth)

• Change in gum contours

• Bleeding when brushing or flossing

• Edema of interdental papillae

Diagnostic Approach