PERIODONTAL DISEASE AND PREGNANCY

MEDICAL DEPARTMENT DENTAID

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

ORAL HEALTH DURING PREGNANCY

Periodontal disease (pregnancy gingivitis)

Tooth mobility

Caries

Epulis gravidarum (pregnancy tumour/granuloma)

Dental erosion

Xerostomia

Tooth sensitivity

Halitosis

The main oral impacts include:

ORAL HEALTH DURING PREGNANCY

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

DEFINITION

GINGIVITIS PERIODONTITIS

GINGIVITIS

Redness Inflammation of the gums Bleeding Reversible

PERIODONTITIS

Gingival recession Tooth mobility Bone loss Possible loss of teeth

SIGNS

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;77:1139-443. Encuesta de Salud Oral en España 2005. RCOE 2006;11(4):409-456

EPIDEMIOLOGY

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.

PERIODONTAL DISEASE - PREGNANCY

BIOLOGICAL MECHANISM OF THE LINK

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

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

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

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

RECOMMENDATIONS

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 basicfor controlling oral health and to have time to react if necessary

For more information visit:

www.vitis.es/embarazo-encias/vas-a-ser-mama