Gingivitis in pregnancy

Abstract

Introduction: Changes in female sex hormone levels during pregnancy are related to the increased sensitivity to gingival inflammation. This phenomenon, also named pregnancy-related gingivitis, Gingivitis Gravidarum, usually occurs with an association of dental plaque, and develops more severe forms, in comparison to plaque-induced gingivitis in non-pregnant women. Purpose and Objectives: Determining the prevalence and severity of gingival inflammation at different period of gestation, estimating Oral Hygiene Indexes. Materials and methods: The study was based on the examination of periodontal state of 30 pregnant women (1 8 -3 5 years old). The sample was divided according to the trimesters into 3 subgroups: Group 1: includes 6 women at 1st trimester. • Group 2: includes 11 women at 2nd trimester. • Group 3: includes 13 women at 3rd trimester. A questionnaire was taken from all pregnant women. The examination was done in a dental clinic using periodontal probe and dental mirror, estimating oral hygiene index "OHI" G. Green, J. Wermillion, gingival index by Loe H. and Silness, papillary bleeding index (Mtihlemann). Results: It was revealed that the prevalence of gingivitis was 63,3 % (19 persons) in the studied sample. It was determined that the severity of the inflammation is exacerbating during the 2nd month of pregnancy reaching a peak at the 8th month. Gingival bleeding occurred in 52,6% of cases in the first trimester, and in 47,4 % in the second trimester. The results showed that 31,5% of the total sample had gingival recession and that the affected teeth are upper and lower incisors and canines. Regarding the tooth surface, it appears that facial surface was more affected than the gingival or palatal surfaces. The prevalence of plaque was 73% among all subgroups with nonsignificant differences. The direct relationship between the frequency of brushing and the incidence of gingivitis gravidarum shows that the condition can be minimized by better oral hygiene. The pregnant women were instructed to use a dentifrice with 0.30% triclosan, an antimicrobial compound. Self-performed tooth brushing with a triclosan/copolymer-containing toothpaste improves the daily plaque control and reduces the gingivitis formation significantly. Conclusion: The importance of local factors in gingivitis in pregnancy cannot be minimized, but the role played by systemic disturbances due to changes in hormonal balance must be considered. The local treatment in a preventive oral hygiene program from early pregnancy is very important to prevent further progression of any inflammation.