Pregnancy Tumors: Causes, Symptoms and Periodontal Care

Tumors And Pregnancy

Pregnancy tumor is not a neoplasm but an inflammatory response to local irritation and is modified by patient condition. It appears after first trimester but may be early also.

Pregnancy Tumor Clinical Features

• The lesion appears as discrete, mushroom-like flattened spherical mass that protrude from interdental papilla or gingival margin and is attached by pedunculated base.
• Pregnancy tumor tends to expand laterally and pressure applied from tongue as well as cheek enhances the flattned appearance of pregnancy tumor.
• The color is dusky red or magenta with smooth-glistering surface which exhibits numerous deep red, pinpoint markings.
• Consistency is semifirm, but has varying degrees of softess and friability.
• It is painless.

Pregnancy Tumor Etiopathogenesis

• Due to increased levels of progesterone and estrogen.
• Hormonal changes include changes in vascular permeability which leads to gingival edema and an increased inflammatory response to dental plaque.
• Subgingival microbiota undergoes changes which includes increase in Prevotella intermedia.

Pregnancy Tumor Histopathology

• Both marginal and tumor-like enlargement consists of central mass of connective tissue, periphery of which is outlined by stratified squamous epithelium.
• Connective tissue consists of numerous engorged capillaries and between the capillary network, there is presence of firous stroma with varying degrees of edema and leukocytic infitration.
• Epithelium thickening is present with varying degrees of extra- and intracellular edema. Epithelium also shows prominent rete pegs.

Pregnancy Tumor Management

The aim of periodontal therapy for pregnant patient is to minimize potential exaggerated inflammatory response related to hormonal alteration.

• Meticulous plaque control, scaling and root planning, polishing should be nonemergent periodontal procedures performed.
• Second trimester is the safest time in which treatment is performed.
• In conditions like ‘supine hypertensive syndrome’ which occur during third trimester, in this appointment should be short and patient should change her position frequently.
• Fully reclining position should be avoided as far as possible.
• Medication and radiographs are avoided.
• In case of marginal and inter-dental enlargement scaling and curettge is done.
• In case of tumor-like enlargement, surgical excision is done which is postponed until postpartum. During pregnancy, if it causes problem in mastication, it is removed on patient’s desire.’