Hormonal Influences on Gingival Tissue in Pregnant Women
Gingivitis in pregnancy occurs as a result of increased circulating levels of progesterone and it effects the gingival microvasculature. Gingival inflammation irritated by plaque biofilm and exacerbated hormonal changes in the second and third trimesters is referred to as pregnancy gingivitis (Neild-Gehrig, Jill S.). The increase in growth of selective periodontal pathogens in the subgingival biofilm triggers plaque-induced gingivitis.
High levels of progesterone during pregnancy can cause many factors to increase bacterial growth. Elevated progesterone levels enhance capillary permeability and dilation, resulting in increased gingival exudate (Neild-Gehrig, Jill S.). Having high levels of progesterone can also suppress the immune response to dental plaque biofilm causing depressed response of PMN chemotaxis and phagocytosis.
Diagnostic factors: Pregnant women, gingival inflammation, dark red gingiva, smooth and shiny gingiva, bleeding on probe, crevicular fluid flow is increased, bulbous interdental papilla. When cases get extreme, some bulbous interdental papilla can over grow and be known as pregnancy-associated pyogenic granuloma also known as pregnancy tumor.
Etiology of the disease: A systemic factor involving hormonal variations and bacteria.
Pathogens associated with pregnancy gingivitis are bacteriodes intermedius, P. intermedia and fusobacterium.
AAP Classification: Dental plaque-induced gingival disease. IA
Prevalence: Common in pregnant women.
The Dental Hygienist should stress the importance of pregnancy and how it effects the gingiva. Expressing to keeping plaque levels very low by giving the patient oral hygiene instructions is important. Explain to the patient that professional dental care is very important and to keep in contact.
Treatment: Pregnancy tumors may have to be surgical removed if they don't not go away after pregnancy. To help treat or reduce plaque induced gingivitis during pregnancy the patient can be instruction good oral hygiene instructions, frequent dental visits, antimicrobial rinses and Xylitol containing products.
Maintenance recommendations: effective brushing, interdental aids, at home fluoride care, twice a day antimicrobial rinse, Xylitol containing products, nutritional counseling. Frequent dental visits are important to maintain a health oral cavity.
High levels of progesterone during pregnancy can cause many factors to increase bacterial growth. Elevated progesterone levels enhance capillary permeability and dilation, resulting in increased gingival exudate (Neild-Gehrig, Jill S.). Having high levels of progesterone can also suppress the immune response to dental plaque biofilm causing depressed response of PMN chemotaxis and phagocytosis.
Diagnostic factors: Pregnant women, gingival inflammation, dark red gingiva, smooth and shiny gingiva, bleeding on probe, crevicular fluid flow is increased, bulbous interdental papilla. When cases get extreme, some bulbous interdental papilla can over grow and be known as pregnancy-associated pyogenic granuloma also known as pregnancy tumor.
Etiology of the disease: A systemic factor involving hormonal variations and bacteria.
Pathogens associated with pregnancy gingivitis are bacteriodes intermedius, P. intermedia and fusobacterium.
AAP Classification: Dental plaque-induced gingival disease. IA
Prevalence: Common in pregnant women.
The Dental Hygienist should stress the importance of pregnancy and how it effects the gingiva. Expressing to keeping plaque levels very low by giving the patient oral hygiene instructions is important. Explain to the patient that professional dental care is very important and to keep in contact.
Treatment: Pregnancy tumors may have to be surgical removed if they don't not go away after pregnancy. To help treat or reduce plaque induced gingivitis during pregnancy the patient can be instruction good oral hygiene instructions, frequent dental visits, antimicrobial rinses and Xylitol containing products.
Maintenance recommendations: effective brushing, interdental aids, at home fluoride care, twice a day antimicrobial rinse, Xylitol containing products, nutritional counseling. Frequent dental visits are important to maintain a health oral cavity.
Images from Google Image.com
Neild-Gehrig, Jill S., and Donald E. Willmann. Foundations of Periodontics
for the DentalHygienist. PA: 2001, 2011.
Sooriyamoorthy, M., & Gower, D. (1989). Hormonal influences on gingival tissue: relationship to
periodontal disease. Ebscohost, 16(4), 201-208. Retrieved from influences on gingival tissue:
relationship to periodontal disease. Ebscohost, 16(4), 201-208. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=2654195&site=ehost-live
for the DentalHygienist. PA: 2001, 2011.
Sooriyamoorthy, M., & Gower, D. (1989). Hormonal influences on gingival tissue: relationship to
periodontal disease. Ebscohost, 16(4), 201-208. Retrieved from influences on gingival tissue:
relationship to periodontal disease. Ebscohost, 16(4), 201-208. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=2654195&site=ehost-live