Effects Of Sex Hormones On The Gingiva In Pregnancy

Pregnancy itself does not cause gingival disease.

Gingival disease in pregnancy is caused by bacterial plaque.
Pregnancy accentuates the gingival response to plaque and modifies the resultant clinical picture.
Pregnancy affects the severity of previous inflamed areas; it does not alter healthy gingiva.
Impressions of increased incidence may be created by the aggravation of previously inflamed but unnoticed areas.
Tooth mobility, pocket depth, and gingival fluid are increased in pregnancy.
The severity of gingivitis is increased during pregnancy beginning in the second or third month.
Patients with slight chronic gingivitis that attracted no particular attention before the pregnancy become aware of the gingiva because previously inflamed areas become enlarged, edematous, and more notably discolored.
Patients with little or no noticeable gingival bleeding before pregnancy become concerned about an increased tendency to bleed.
Gingivitis becomes more severe by the 8 th month and decreases during the 9 th month of pregnancy.
The correlation between gingivitis and the quantity of plaque is greater after parturition than during pregnancy, which suggests that pregnancy introduces other factors that aggravates the gingival response to local factors.

Pronounced ease of bleeding is the most striking clinicalfeature. The gingiva is inflamed and varies in color from bright red to bluish red. Marginal and interdental gingivae are edematous, pit on pressure, appear smooth and shiny, soft and pliable and present raspberry like appearance.
Gingival changes are usually painless unless complicated by acute infection. In some cases, the inflamed gingiva forms “tumor-like” masses, referred to as pregnancy gingivitis.
Aggravation of gingivitis in pregnancy has been attributed principally to the increased levels of progesterone, which produce dilation and tortuosity of the gingival microvasculature, circulatory stasis, and increased susceptibility to mechanical irritation, all of which favor leakage of fluid into the perivascular tissues.
A marked increase in estrogen and progesterone occurs during pregnancy, with a reduction after parturition.
The severity of gingivitis varies with the hormonal levels in pregnancy.
It has also been suggested that the accentuation of gingivitis in pregnancy occurs in two peaks: during the first trimester, when there is overproduction of gonadotropins, and during the third trimester, when estrogen and progesterone levels are highest.
Destruction of gingival mast cells by the increased sex hormones and the resultant release of histamine and proteolytic enzymes may also contribute to the exaggerated inflammatory response to local factors.

Reader Interactions