PREGNANCY AND ORAL HEALTH
During pregnancy, some physiological changes occur in the oral cavity. Due to the effects of hormones, especially estrogen dominance, pregnancy gingivitis and increased tooth mobility may be observed. Pregnancy gingivitis is characterized by swelling of the gums, inflammation, and an increased tendency to bleed. Additionally, during pregnancy, xerostomia (dry mouth) or, conversely, increased saliva production may be observed.
Other dental-related conditions seen during pregnancy include pregnancy tumors and dental erosions. A pregnancy tumor is a large, localized gingival overgrowth that may be nodular or ulcerated and bleeds easily. It is also known as pregnancy epulis or pregnancy granuloma and is seen in approximately 5% of pregnant women. It usually affects the anterior region of the upper jaw. It typically appears in the second trimester and grows rapidly. Its treatment is generally postponed until after delivery (Gajendra & Kumar, 2004). Dental erosions occur due to the acidic effect caused by repeated vomiting and esophageal reflux during pregnancy. Nausea and vomiting particularly affect the palatal surfaces of the upper anterior teeth. In addition, increased erosion may lead to dentin exposure and increased thermal sensitivity.
Hormonal and vascular changes during pregnancy intensify the gingival response to bacterial plaque. Progesterone increases exudation and affects prostaglandin biosynthesis in the gums. Pre-existing gum diseases such as gingivitis and periodontitis may worsen due to pregnancy hormones. It has been shown that existing periodontal diseases during pregnancy, especially periodontitis, can lead to low birth weight babies. In a study conducted by Desenayake et al. in 1998, it was found that women with periodontal disease had a sevenfold increased risk of preterm birth with low birth weight. It is believed that the relationship between periodontal disease and low birth weight is associated with increased prostaglandin levels. In addition, microorganisms associated with periodontal disease such as B. Forsythus, P. Gingivalis, A. Actinomycestemkomitans, and T. Denticola were found in higher amounts in the oral cavities of mothers who gave birth to low birth weight babies (Mills & Moses, 2002).
Individuals planning pregnancy should undergo routine dental examinations, and if there are decayed teeth, they should be treated with fillings or root canal therapy to prevent abscess formation during pregnancy and eliminate the need for treatment during this period. In this way, medication use can also be minimized. Dental diseases that flare up during pregnancy can create additional stress in early stages and may cause problems since treatments are generally limited to the second trimester. Additionally, the increase in gum diseases due to hormonal effects can cause discomfort, chewing problems, gum bleeding, and tooth mobility in patients. Therefore, treating gum diseases before pregnancy and providing patients with proper oral hygiene habits can prevent problems that may arise during this sensitive period.
Dr. Selin GENÇ KOCAAYAN
Dentist
REFERENCES
Gajendra, S., & Kumar, J. V. (2004). Oral health and pregnancy: a review. New York State Dental Journal, 70(1), 40.
Mills, L. W., & Moses, D. T. (2002). Oral health during pregnancy. MCN: The American Journal of Maternal/Child Nursing, 27(5), 275-280.