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The hormonal changes that occur during pregnancy are responsible for modifying the mother’s body and the oral cavity.Therefore, knowledge of these changes and their implications for oral health is essential.
Dental care for pregnant women requires special attention, focused on pre- and postnatal care. For its part, gonadotropin is related to nausea and vomiting, which can lead to enamel erosion.
Pregnancy gingivitis: Increased hormonal levels, including estrogens and progesterones essential for the development of the fetus, are associated with oral diseases such as pregnancy gingivitis; the increase in these hormones produces capillary vasodilation favoring exudate and gingival permeability.
An exaggerated inflammatory response may appear. Bacterial plaque is the fundamental etiological factor for the appearance of gingivitis, associated with increased microvascularization. This occurs most often in the second trimester of pregnancy.
Granuloma of pregnancy: Also called a “pregnancy tumor.” It is a benign tumor (1-5%) located in an area with gingivitis in the vestibule of the upper jaw, which usually remits after delivery. It is common in the first pregnancies, during the first and second trimesters.
Periodontal disease: During pregnancy the hormone relaxin is produced, whose function is to relax the joints to facilitate childbirth, and can also act on the periodontal ligament causing slight dental mobility that tends to disappear after delivery. It is unusual to find a severe picture of bone resorption and tooth loss due to mobility.
If there is a previous periodontal disease, it will be aggravated by the same factors mentioned above.
Tooth decay: Pregnancy should not be considered per se as a cause of tooth decay. There is a belief that demineralization occurs due to the loss of calcium for “the new being”, but enamel has a very slow mineral exchange, conserving its mineral content throughout life. However, pregnant women are subjected to situations that make them sensitive to this disease.
The salivary composition and oral flora are altered, producing physiological xerostomia that facilitates the appearance of caries. Increased gonadotropin in the first trimester is associated with nausea and vomiting; which causes a discomfort that brings with it an inappropriate behavior in relation to oral hygiene, which has a negative influence on the oral cavity, there is accumulation of dentobacterial plaque; factor that determines the increase in gingival inflammation and dental caries, which is aggravated when associated with disorganized eating habits, vascular modifications and a weak immune response.
The increase in progesterone slows gastric emptying and the resulting acidity during vomiting causes erosion of the tooth enamel, mainly on the lingual aspect of the lower molars and incisors.