What is Pregnancy Gingivitis?

The first signs of the disease usually appear during the second month of pregnancy and reach a peak in the eighth month. The condition normally retreats after birth, unless there are other aggravating factors beyond pregnancy.

The symptoms that could indicate a pregnancy gingivitis problem are the same as those of normal gingivitis. These include:

• Red, puffy, very tender or swollen gums
• Bleeding gums during brushing or flossing
• Persistent bad breath or foul taste

If any of these symptoms is present, it is important to visit your dentist for consultation as soon as possible. In some cases, bleeding gums are an early pregnancy sign, before any other more known pregnancy symptoms.

The rise in the hormones production (especially the increased level of progesterone) and poor oral hygiene play the major roles in developing symptoms of pregnancy gingivitis.

The gingival tissues resistance to infection is reduced during pregnancy. Hormonal changes increase the blood flow by 30% to 50%. The body cells also retain much more fluid during pregnancy. As a result of fluid retention and increased blood flow, the gums become swollen and very tender. Brushing and flossing may become painful.

If the woman neglects her daily oral hygiene, she allows the accumulation of dental plaque on teeth and gums. Toxins produced by bacteria irritate more the already irritated gums, causing inflammations and a form of gum disease that is called pregnancy gingivitis. Gingivitis is one of the earliest stages of a more severe type of gum disease, called periodontitis. Untreated periodontal disease can cause irreversible damage to the gums and result in tooth loss.

Morning sickness may also play a role in pregnancy gingivitis. Increased vomiting during pregnancy can cause prolonged irritation of the gums, due to stomach acids. Pregnant women sometimes become sensitive to the smell or taste of toothpaste and they start to avoid tooth brushing. In this case, it is important to continue to brush regularly even without using toothpaste.

Gingivitis is a reversible condition, as long it is treated before it progresses to periodontitis, causing permanent damage to gums and jaw bone. Proper daily oral hygiene is everything that is needed for preventing and treating the symptoms of pregnancy gingivitis.

The following tips can help you maintain good oral health throughout pregnancy:

• Visit the dentist after you get pregnant for consultation and dental cleaning if needed. If you already had a gum disease problem it is important to treat it as early as possible.
• Do not miss your regular 6 month examination and dental cleaning.
• Brush gently your teeth at least twice a day, after each meal (and always after vomiting from morning sickness). If the gums are painful change your toothbrush with a softer one.
• Floss your teeth at least once a day to remove plaque from the gum line and between teeth.
• Watch your diet. Control sugar consumption. Proper nutrition is essential not only for avoiding pregnancy gingivitis but also for the proper development of the fetus.
• Good oral hygiene during pregnancy helps to reduce the chances of developing pregnancy gingivitis or periodontal disease.

A very characteristic symptom of pregnancy gingivitis are the so called pregnancy 'tumors'. Sometimes during pregnancy, a large red lump may form on inflamed gum tissue near the gum line. These growths are called ‘pregnancy tumors’ and they usually occur during the second trimester. Despite their name, pregnancy tumors are not cancerous. Pregnancy tumors are also known by several other names including pyogenic granuloma, granuloma of pregnancy, lobular capillary hemangioma, and pregnancy epulides.

A pregnancy tumor is an extreme inflammatory reaction, occurring in up to 10% of pregnant women and more often in women who also have pregnancy gingivitis. Pregnancy tumors can grow up to three-quarters of an inch in size and may cause discomfort or even pain. If ruptured, they can become infected.

Pregnancy tumors can be easily removed by a dentist under local anesthesia, before they cause any complications. However it should be noted that after removal, there is a high rate ~50% of the pregnancy tumor to grow again before delivering the baby. After the birth of the baby, pregnancy tumors disappear on their own, if the mother follows proper oral hygiene.

It is important to take symptoms of pregnancy gingivitis seriously because, if untreated, it will lead to periodontal disease. Periodontal gum disease is an advanced form of gingivitis that attacks the bones and tissues supporting the teeth. The disease can cause permanent damage to your mouth, and can cause you to lose both your gums and teeth.

Periodontal disease has also been linked to a higher risk of premature birth – in fact, some studies indicate that women with gum disease are four to seven times more likely to give birth prematurely. Pregnant women with severe periodontal disease are in even higher risk of preterm labor than women with healthy gums.

With proper treatment pregnancy gingivitis is not a serious condition. However, if pregnancy gingivitis is left untreated it could cause potential health problems for both you and your baby. If you notice swollen or bleeding gums during pregnancy (which are the first signs of pregnancy gingivitis), visit your dentist for consultation and treatment.