(RxWiki News) Women experience a host of physical changes during pregnancy, and the mouth is one of the areas where these changes happen. For some, these changes may include swollen gums.
Many women had gingivitis (inflammation of the gums) in the second and third trimesters of their pregnancy, according to recent research that reviewed studies on the topic. The peak of swelling was found to be in the third trimester.
Gingivitis in the middle of pregnancy was more notable than in early pregnancy or when the woman was no longer pregnant, the researchers reported.
"Visit your dentist while pregnant to keep your teeth and gums healthy."
Researchers led by Elena Figuero, DDS, PhD, of University Complutense in Madrid, Spain, did a search of PubMed and Embase databases for articles related to pregnancy and swollen gums (gingivitis). They included articles in the database through August of 2011. These researchers also manually searched through the Journal of Periodontology, the Journal of Periodontal Research and the Journal of Clinical Periodontology. Altogether, they found 44 articles representing 33 studies assessing the effect of pregnancy on gingivitis.
Gingivitis was identified using the gingival index and/or bleeding of the gums on probing (a common sign of gingivitis).
In people who are not pregnant, inflammation of the gums usually results from plaque build-up on the teeth. These researchers found, however, that while pregnant women experienced small changes in their plaque levels, there was no substantial increase in plaque. An increase in plaque in a non-pregnant person can lead to cavities, but whether inflammation of the gums in pregnant women leads to more cavities is not known.
Gingivitis in pregnancy is a commonly recognized issue, the researchers noted. They did not attempt to find out what causes the inflammation but wrote that data shows there are changes in hormones, cytokines (proteins that interact with cells of the immune system) and inflammatory mediators during pregnancy, which can all play a part in causing inflammation of the gums.
A pregnant woman typically has more circulating blood when pregnant, so there is more blood flow to the gums, they also wrote.
Gingivitis tends to go away after pregnancy due to a drop in hormones, the authors noted.
Dr. Figuero and team cautioned that they included a small number of studies, there were differences in study design and quality of the studies and there was no periodontal diagnosis at the start of the study or data on performance of periodontal treatment. Different studies also had researchers assess different numbers of teeth in pregnant women.
In an accompanying commentary, Dr. Richard Niederman of the New York University College of Dentistry in New York wrote that he believes that pregnancy may cause inflammation of the gums, but how much pregnancy impacts gingivitis is still unknown.
The authors of this study acknowledged that problems caused by the gingivitis are also not addressed. "No conclusions could be drawn regarding secondary outcomes. Further studies with higher quality should be designed to answer these questions," they wrote.
This study appeared in the Journal of Clinical Periodontology.
No conflicts of interest were mentioned.