During pregnancy, women undergo the greatest hormonal and physiological changes of their lives, some of which can affect their mouths.

1. PERIODONTAL
DISEASE AND
PREGNANCY
MEDICAL DEPARTMENT DENTAID

2. ORAL HEALTH DURING PREGNANCY
During pregnancy, women undergo the greatest
hormonal and physiological changes of their lives,
some of which can affect their mouths.
These changes may include:
 An increase in cariogenic and periodontopathogenic
bacteria from changes in diet, in dental hygiene and in
salivary composition
 Changes in gingival tissue from increased vascular
permeability
 Increased sex hormones: estrogen and progesterone

3. ORAL HEALTH DURING PREGNANCY
The main oral impacts include:
 Periodontal disease (pregnancy gingivitis)
 Tooth mobility
 Caries
 Epulis gravidarum (pregnancy tumour/granuloma)
 Dental erosion
 Xerostomia
 Tooth sensitivity
 Halitosis

4. DEFINITION
 Pregnancy or gestational gingivitis
Is defined as gingival inflammation initiated by oral biofilm and exacerbated
by the increase in endogenous sex hormone levels
If left untreated, it can progress to become periodontitis
GINGIVITIS PERIODONTITIS

5.  GINGIVITIS
 Redness
 Inflammation of the gums
 Bleeding
 Reversible
 PERIODONTITIS
 Gingival recession
 Tooth mobility
 Bone loss
 Possible loss of teeth
SIGNS

6. EPIDEMIOLOGY
 60-75% prevalence of pregnancy gingivitis1
 50% of pregnant women with gingivitis BEFORE
pregnancy can become periodontitis2
 25% of pregnant women have periodontitis3
1. American Dental Association Council on Access, Prevention and Interprofessional Relations. Women’s oral health issues.
American Dental Association, 2006.
2. Silk et al. Oral health during pregnancy. Am Fam Physician. 2008;77:1139-44
3. Encuesta de Salud Oral en España 2005. RCOE 2006;11(4):409-456

7. PERIODONTAL DISEASE - PREGNANCY
Existing studies suggest that periodontal disease in pregnant
women is an added risk factor for adverse pregnancy outcomes
such as5,6,7:
 Preterm delivery (labour before 37 weeks)
 Low birth weight (<2500 g)
 Pre-eclampsia/eclampsia (pregnancy-induced hypertension,
elevated levels of protein in urine)
5. Agueda A, Ramón JM, Manau C, Guerrera A, Echeverría JJ. Periodontal Disease as a risk factor for adverse pregnancy outcomes: a prospective cohort study. J Clin Periodontol.
2008 Jan;35(1):16-22.
6. Marin C, Segura-Egea JJ, Martínez-Sahuquillo A, Bullón P. Correlation between infant birth weight and mother’s periodontal status. J Clin Periodontol. 2005 Mar;32(3):299-304.
7. Madianos PN, Bobetsis YA, Offenbacher S. Adverse pregnancy outcomes (APOs) and periodontal disease: pathogenic mechanisms. J Clin Periodontol 2013; 40 (Suppl. 14):
S170–S180.

8. BIOLOGICAL MECHANISM OF THE LINK

9. RECOMMENDATIONS
Important:
Prevention of periodontal disease before
and during pregnancy
- If you are pregnant or if you plan to become
pregnant , consult your dentist for an oral
health diagnosis
- Schedule a dental check-up for each
trimester during pregnancy to keep your oral
health in check

10. RECOMMENDATIONS
Physical control of oral biofilm in the dental office:
- Professional tartar removal: removal of
supragingival plaque and calculus
- Scaling and root planing: removal of
subgingival plaque and calculus

11. RECOMMENDATIONS
Physical control of oral biofilm at home:
- Manual or electric brushing : 2-3 times
per day, at least, 2 minutes
- Interdental hygiene: interproximal
brushes and dental floss/tape
- Oral irrigation

12. RECOMMENDATIONS
Chemical control of oral biofilm:
- Prevention of Periodontal Disease: Daily use
antiseptic with Cetylpyridinium chloride
- Treatment of Periodontal Disease : Antiseptic
that combines Chlorhexidine and Cetylpyridinium
chloride

13. CONCLUSIONS
 During pregnancy the probability of developing periodontal disease
increases
 Periodontal disease may have an impact on pregnancy and foetus
 It is vital to prevent this disease to avoid pregnancy complications
 Regular dental check-ups before and during pregnancy are basic
for controlling oral health and to have time to react if necessary

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