Effect of pregnancy on periodontal and dental health

Clinical studies have shown that oral tissues can be affected by pregnancy. Pregnancy-related changes are most frequent and most marked in gingival tissue. Pregnancy does not cause gingivitis, but may aggravate pre-existing disease. The most marked changes are seen in gingival vasculature. Characteristic of pregnancy gingivitis is that the gingiva is dark red, swollen, smooth and bleeds easily. Women with pregnancy gingivitis may sometimes develop localized gingival enlargements. The gingival changes usually resolve within a few months of delivery if local irritants are eliminated. The inflammatory changes are usually restricted to the gingiva and probably do not cause permanent changes in periodontal tissues more often than those in the non-pregnant state. Although it is widely believed that pregnancy is harmful to the teeth, the effect of pregnancy on the initiation or progression of caries is not clear. Previous studies, however, indicate that the teeth do not soften, i.e. no significant withdrawal of calcium or other minerals occurs in the teeth. It is mainly the environment of the tooth that is affected. The number of certain salivary cariogenic microorganisms may increase in pregnancy, concurrently with a decrease in salivary pH and buffer effect. Changes in salivary composition in late pregnancy and during lactation may temporarily predispose to dental caries and erosion. Although their underlying mechanisms of action are not fully understood, pregnancy-related changes in the oral environment may have some untoward temporary or permanent effects on oral health. Most of these effects could be avoided by practising good oral hygiene.