Experimental gingivitis during pregnancy and post‐partum: clinical, endocrinological, and microbiological aspects

Abstract

The purpose of this study was to assess whether an intensive oral hygiene regimen practised during pregnancy results in a clinically healthy gingival state, and to assess whether experimentally-induced gingivitis differs in severity during pregnancy as compared to post-partum. In addition, levels of black-pigmented Gram negative anaerobes at subgingival and oral mucosal sites and plasma concentrations of free estrogens and prosterone were determined. These parameters were studied during a 14-day episode of experimental gingivitis induced in the 25th week of pregnancy, and again 6 months post-partum. The subjects were selected on shallow pockets < or = 4 mm and interproximal loss of attachment not exceeding 2 mm. As a result of controlled oral hygiene, the gingival condition improved both during pregnancy and post-partum. At day 0 during pregnancy, however, gingival swelling, redness, and bleeding on probing were found to be higher than post-partum. Free plasma levels of estrogens and progesterone were found to be normal throughout the study. It was hypothesized that the increase in severity of gingival symptoms during pregnancy reflect microvascular physiologic effects of increased levels of these hormones. During pregnancy, more swelling, redness and bleeding on probing developed during experimental gingivitis than post-partum, whereas the amount of plaque was similar in both phases. This suggests that as a result of dental plaque accumulation, gingival inflammation develops superimposed on pregnancy-associated physiologic alterations. Microbiological evaluation showed that the mean proportions of Prevotella intermedia in subgingival plaque increased during experimental gingivitis performed during pregnancy, whereas no increase of this micro-organism was found post-partum.

A prospective study to investigate the relationship between periodontal disease and adverse pregnancy outcome

“…The lack of an association with bleeding on probing may have been complicated by a known association between pregnancy and increased gingival inflammation. [22][23][24][25][26] Pregnancy outcome data collection was very successful with only 2.2% of subjects missing outcome data. It is difficult to compare the population in this study with either other UK or US maternity populations, however some data are available.…”

Adhesins encoded by the gingipain genes of Porphyromonas gingivalis are responsible for co-aggregation with Prevotella intermedia

“…intermedia is detected not only in infected periodontal regions but also in the normal gingival crevice, indicating that Pre. intermedia is one of the early colonizers in periodontal niches (Loesche et Kononen, 1993;Raber-Durlacher et al, 1994;Ashimoto et al, 1996). Therefore, it is possible that Por.…”

Epulis and pyogenic granuloma with occlusal interference

“…The subgingival microbiota may also undergo changes, including an increase in Prevotella intermedia. 14,15 This condition is not observed clinically in every pregnant women, however, with poor oral hygiene like in this case a pronounced enlargement can be developed.…”