Pregnancy can affect oral health in several ways. Increased hormone levels during pregnancy can cause gingivitis, gingival enlargement, and pregnancy tumors. Pregnant women are also more prone to dental erosion from vomiting. Periodontal disease has been linked to adverse pregnancy outcomes like preterm birth and preeclampsia. It is important for pregnant women to practice good oral hygiene and see a dentist, as periodontal treatment during pregnancy is considered safe during the second and third trimesters. Proper nutrition, limiting snacks, and dental visits can help support oral health during pregnancy.

1. DEPARTMENT OF PERIODONTOLOGY
PREGNANCY AND ORAL HEALTH
BY; RENJU RAJU
CRRI

2. INTRODUCTION
The Nature has given a larger
responsibility for the women in
terms of bearing a child and
having a profound influence on
the child in early part of his or
her life
Pregnancy will affect nearly
every apsect of a womens life
and Oral health is no exception

3. COMMON ORAL HEALTH
CONCERNS DURING
PREGNANCY

4. • The main systemic changes occur in the cardiovascular, haematologic,
respiratory, renal, gastrointestinal, endocrine, and genitourinary
systems.Increased levels of hormones and bacteria
• Elevation of the coagulation factors V, VII, VIII, X and XII, and reduction of
the factors XI and XIII, with an increased fibrinolytic activity to
compensate for the increased clotting tendency.
• Gingival and saliva contain hormones
• Cause gum to swell and bleed easily.
Bacteria use hormones for energy and grow easily
Decreased immune response limits

5. Pregnancy induced gingivitis and
Enlargement:
It is seen usually in the second month of pregnancy.
• Red edges, swollen or puffy, tender, bleed easily during
brushing. it is due to increased levels of Eostrogen and
Progesterone.
• Increased number of P.gingivalis, P.intermedia and
bacteriodes are also evident.Elevated levels of the
circulating oestrogen, which cause an increased capillary
permeability, predispose the pregnant women to gingivitis
and gingival hyperplasia.

7. ● Pregnancy granuloma or Pregnancy
Tumor: usually seen in the labial inter
papillary region.
● Its a red colored lesion of varying size.
● May break and form crust over.
● Typically in 2nd or 3rd trimester
● Usually subsides after pregnancy

9. Dental erosion:
● Frequent exposure to stomach acids
during vomiting is the main cause.
Especially the lingual surfaces of
Maxillary Anteriors
● - Xerostomia, Caries, Heart burn etc
are also seen

10. Gestational Diabetes: Arises in rare cases
where mother cannot meet the added
insulin demands of pregnancy. Presenting in
the third trimester with few
symptoms.Periodontal therapy decreases the
inflammation and improves insulin sensitivity
thus improving the glycemic control.

11. Periodontal disease and pregnancy
outcome:
● P.gingivalis originating from
periodontal infection may results in
abnormal pregnancy outcomes in this
model. cytokines including IL-1, TNF-
Alpha and IL-6 stimulate increased
Prostaglandin production from the
amnion and the decidua which leads to
the onset of protein labor.
This gives direct evidemce that
periodontal infection can affect the fetal
environment and pregnancy outcomes.

12. Women with greater clinical attachment
loss are more prone to have NLBW infants.
One potential mechanism by which
periodontal disease could affect pregnancy
outside is via the systemic dissemination of
periodontal pathogens. Women who had
LBWinfants had significantly higher levels
of Aggregatibacter,
Actinomycetemccmitans, Tannerella
forsynthia, P.gingivalis and Treponema
denticola in their subgingival plaque. Also
had higher GCF(Gingival crevicular fluid),
PGE2 and IL-1

13. Preclampsia: Periodontal
disease may increase the risk
of preclampsia. This
hypertensive disorder affects
about 5-10% of pregnancies.
Etiology involving vascular
changes in the placenta.
It is clear thats scaling and
root planning provided during
pregnancy (2nd and 3rd
Trimesters) of gestation are
safe.

14. TREATMENT DURING
PREGNANCY
it is best to receive any routine treatments during
your second trimester, as the foetus is at its most
sensitive during the first, and it may be
uncomfortable to sit in the dentist’s chair in the
final stages of pregnancy.

15. TREATMENT FOR ACID
EXPOSURE
Dont brush immediately after
vomiting, wait for atleast 15 min
and rinse the mouth with water.
Oral hygiene; Patient should visit
the dentist before planning for
pregnancy and get treated all the
existing dental diseases.
Brushing and flossing
Xylitol gum
Routine dental visit

16. Prevention: Nutrition for Oral Health
• Eat well-balanced meals
• B vitamins, especially folate (folic acid) B vitamins
• Vitamin C
• Calcium
• Snack smart
• Avoid starchy or high carbohydrate, Raw fruits and
vegetables, Dairy products

17. Diet planing should be done with the help of The
Dentist, Gynaecologist, and Nutritionist.

18. THANK YOU

19. REFERENCES:
-Carranza's Clinical Periodontology 2nd Edition
-JCRR Publications- Dental considerations in pregnancy- A critical
review on the oral care.
-Dental Pulse 12th Edition
-Dr Sai Naveen pilli MDS lectures on Oral Health and Pregnancy
-Medknow Publications-Oral Pregnancy Tumor