OVERVIEW

What is pregnancy gingivitis?

Pregnancy gingivitis refers to the worsening of pre-existing chronic gum inflammation in women during pregnancy due to elevated female hormone levels. Existing gum bleeding may intensify, causing gum swelling or the formation of tumor-like growths. The swelling may subside or disappear on its own after childbirth.

What is the relationship between pregnancy gingivitis and pregnancy?

Patients typically begin to show noticeable symptoms around 2-3 months into pregnancy, peaking at 8 months. About 2 months after delivery, gingivitis may reduce to pre-pregnancy levels.

SYMPTOMS

What are the symptoms of pregnancy gingivitis?

Pregnancy gingivitis can occur in individual gums or the entire gum line, with the front teeth area being the most affected. The gums appear bright red or dark red, inflamed, and swollen, and may bleed easily during brushing, sucking, or eating.

Another manifestation of pregnancy gingivitis is called pregnancy epulis (pregnancy tumor), where the gum swells to resemble a tumor-like growth. It usually occurs on the gum papilla of a single tooth, typically starting in the third month of pregnancy, with a diameter generally not exceeding 2 cm.

However, in severe cases, the epulis may grow too large, interfering with eating, or may be bitten and bleed, leading to infection.

Gingival inflammation may worsen during pregnancy and improve after childbirth.

What diseases can pregnancy gingivitis potentially cause?

Long-term occurrence, progression, or improper management of pregnancy gingivitis may lead to oral diseases such as dental caries and gingival abscesses in pregnant women, with poor clinical prognosis.

Additionally, pregnancy gingivitis can contribute to perinatal respiratory infections, bacterial pneumonia, and other conditions.

CAUSES

What are the causes of pregnancy gingivitis?

Pregnancy itself is not the direct cause of pregnancy gingivitis; the root cause is dental plaque. Without the presence of plaque, pregnancy would not lead to gum inflammation.

During pregnancy, women experience changes in their daily routines, increased frequency of eating, cravings for snacks, and a preference for sweet and sour foods. As a result, women who previously had no dental caries may develop them during pregnancy.

Changes in estrogen and progesterone levels during pregnancy can affect the balance of oral microbiota, leading to dysbiosis. Additionally, the synthesis of gum matrix components, such as collagen, decreases during pregnancy, making the gums thinner and more vulnerable to bacterial byproducts, thereby increasing the risk of gingivitis.

DIAGNOSIS

How is pregnancy gingivitis diagnosed?

The diagnosis of pregnancy gingivitis generally requires meeting two conditions: occurrence during pregnancy + symptoms of gingivitis.

TREATMENT

How to treat gingivitis during pregnancy?

The treatment of gingivitis during pregnancy should include plaque removal supplemented with antibiotics. The treatment principle is similar to chronic gingivitis, and scaling is also used. The optimal treatment period is between the 4th to 6th months of pregnancy, and unnecessary systemic medication should be avoided to prevent affecting fetal development.

However, for gingivitis during pregnancy, necessary oral hygiene and prevention are more important than treatment.

Gingivitis during pregnancy can be treated by scaling. What is scaling?

The professional term for scaling is supragingival scaling, which refers to the process of removing dental calculus and plaque above the gumline using specific equipment. Currently, ultrasonic scaling is commonly used, where an ultrasonic scaler is employed to break down and remove calculus.

Gingivitis during pregnancy can be treated by scaling. Does scaling hurt?

Scaling generally does not cause severe pain, but mild soreness may occur after removing calculus from the tooth surface. Consuming lukewarm or cool foods after scaling can help alleviate the discomfort within a few days.

Gingivitis during pregnancy can be treated by scaling. How often should scaling be done?

Scaling is performed to remove calculus from the tooth surface. If no calculus is present, scaling is unnecessary. It is recommended to undergo regular dental check-ups (1-2 times a year) and schedule scaling only when calculus is detected.

DIET & LIFESTYLE

What should patients with pregnancy gingivitis pay attention to in daily life?

Mainly focus on oral hygiene and avoid arbitrary medication. For specific measures, please refer to the oral healthcare section under "Prevention" below, which also applies to those who have already developed pregnancy gingivitis.

PREVENTION

How to Prevent Pregnancy Gingivitis?

Preventing pregnancy gingivitis primarily involves effective oral care, which can be divided into two stages for expectant mothers:

• Pre-pregnancy Oral Examination:

• Address potential issues. Since the safe period for dental treatment during pregnancy is limited, women planning to conceive should undergo a comprehensive examination at a periodontal department of a dental hospital.
  This includes systematic treatment of periodontal diseases, thorough supragingival scaling (commonly known as teeth cleaning), removal of defective prostheses (dentures), and necessary replacements.

• In the first three months of pregnancy, if symptoms like significant gum swelling, bleeding, or ulcers occur, physical interventions such as hydrogen peroxide gum rinses, chlorhexidine mouthwash, or guidance on proper brushing techniques can help alleviate gingivitis symptoms.

• Regular Oral Checkups During Pregnancy:

• Maintain oral hygiene by adhering to "brushing morning and night, rinsing after meals" to thoroughly remove plaque. Fluoride toothpaste and dental floss can be used. Due to frequent nausea and vomiting during pregnancy, regurgitated food may accumulate in the mouth.
  Thus, keeping the mouth clean is crucial. Teeth cleaning can also be performed if necessary, typically recommended between the 4th and 6th months of pregnancy.

• Seek prompt dental checkups for any oral issues and avoid self-medication.

• Follow a balanced diet with adequate vitamins and calcium supplementation.