1. Inflammation of the gums, increases in pregnant women in the presence of small quantities of bacterial plaque biofilm. Inflammation of the gums, initiated plaque biofilm and exacerbated by hormonal changes in the second and third trimesters of pregnancy, called pregnancy gingivitis
2. Probing the depths, bleeding on probing, and crevicular fluid flow is increased in pregnancy gingivitis.
3. The probability of gingivitis increases in the second month, when circulating hormones associated with pregnancy increases in the blood, increasing the susceptibility to bacterial plaque biofilm and other local irritants. Pregnant women, next to or in the future, the creation of a large number of estradiol, estriol and progesterone. The incidence of gum disease is highest in eight months, when the level of circulating hormones are at their peak.
4. Impact on Subgingival plaque composition Biofilms
a. Increasing the selective growth of periodontal pathogens in subgingival plaque biofilm in the period of pregnancy gingivitis on the third and fourth month of pregnancy.
Gestational hormones act as growth factors bacteria .
B. 55-fold increase in the share P. intermedia was demonstrated in pregnant women compared with non-pregnant management .
5. Effects on tissues and immune response
a. The increase in the severity of inflammation of the gums during pregnancy may be associated with increased blood levels of progesterone and its impact on the walls of blood vessels and capillaries .
B. The increased levels of progesterone during pregnancy increases the permeability of capillaries and expansion, resulting in increased gums exudate.
c. High levels of progesterone and estrogen related to pregnancy has been shown to suppress the immune response to dental plaque biofilm .
d. Chemotaxis and phagocytosis of neutrophils were reportedly to be depressed in response to the high level of gestational hormones .
6. Oral manifestations of inflammation of parodont
a. Gum tissue can be swollen and dark red, with a strong interdental papillae (Fig. 10-5).
B. In some cases, gingival papilla may react so strongly bacterial plaque biofilm that great, localized growth of gum tissue, called associated with pregnancy pyogenic granuloma (pregnancy, tumors) may form on the interdental gums or on the gingival margin (Fig. 10-6).
1) these tumors, benign and usually not painful.
2) If growth continues after birth, it can be removed by surgery,
c. Of dental hygienists should educate pregnant women about the consequences
pregnancy on gingival tissues and emphasize the importance of careful
self-help for a plaque biofilm control and professional care.
D. menopause and Postmenopause
1. Menopause gum problems affect only a small percentage of women. If menopause affects the gums, this is called menopause gingivostomatitis.
2. During menopause, the decrease of hormonal background. Decreasing levels of circulating hormones in women in menopause or menopause can result in oral changes, such as thinning the mucous membrane of the mouth, dry mouth, burning, altered taste, gingival recession, and alveolar bone loss.
3. Menopausal and postmenopausal women taking hormone replacement therapy (HRT) may experience pregnancy symptoms similar to symptoms of gingivitis.
4. Postmenopausal women may experience osteopenia or osteoporosis. A possible link between skeletal osteoporosis and alveolar bone loss in the jaw discussed in the section " subject "osteoporosis" in this Chapter.