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Oral Health; Oral Health Education; Pregnancy

In recent decades, many studies have shown the association between maternal oral infections and adverse pregnancy outcomes.

Existing scientific evidence emphasizes the association between the presence and severity of gum infections and premature birth, fetal growth retardation, spontaneous abortion, preeclampsia. The role of these infections as a possible risk factor or co-cause of adverse pregnancy outcomes has not, however, always been confirmed while the possibility of vertical transmission, from mother to child, of bacteria that cause tooth decay has been demonstrated. Gingival bleeding often causes the pregnant woman to decrease the brushing of teeth resulting in greater accumulation of bacterial plaque and further impairment of the general state [1].

Dietary and oral hygiene changes, morning gravidic hyperemesis, esophageal reflux disease can cause tooth tissue demineralization with enamel erosion and increase the risk of tooth decay if appropriate preventive interventions are not planned [2].

A 33-year-old woman, 3-month pregnancy, gravidic gingivitis, no systemic pathologies.

What she referred

Pain in the gums, gums that bleed when brushing, swollen, tense gums, easily traumatizable, high estrogen levels, hyper emesis gravid arum [3-5].

During the objective examination we find what the patient said the alteration of the local immune response with increased susceptibility to gingival inflammation and depression of the chemotactic and phagocytic response of neutrophil granulocytes and other cellularmediated immune functions (Figure 1).

Figure 1: The alteration of the local immune response with increased susceptibility to gingival inflammation and depression of the chemotactic and phagocytic response of neutrophil granulocytes and other cellular- mediated immune functions.

The increased permeability of the gingival blood vessels promotes redness, increased volume of the gums, predisposing them to greater bleeding (Figure 2).

Figure 2: The increased permeability of the gingival blood vessels promotes redness, increased volume of the gums, predisposing them to greater bleeding

Professional treatment

She received perinatale care with a periodontal treatment.

Periodontal therapy consisted of plaque control with a tri-toneplaque- detector, removing with airflow and scaling (Figure 3(a, b)).

Figure 3(a): Periodontal therapy: plaque control with a tri-tone-plaque-detector.

Figure 3(b): Periodontal therapy: plaque control with a tri-tone-plaque-detector.

Maintenance therapy was provided every to 10 days for 1month, and consisted of oral hygiene instruction and supragingival plaque removal by instrumentation, as needed (Figure 4a, 4b).

Figure 4(a): Follow up after 10 days: partial healing of the tissues, the index of plaque and bleeding are reduced.

Figure 4(b): Follow up after 10 days: partial healing of the tissues, the index of plaque and bleeding are reduced.

After the first oral hygiene session we obtained a partial healing of the tissues. The index of plaque and bleeding are reduced.

The teaching and reinforcement of the information of personal oral hygiene techniques have contributed to obtaining excellent results already at the first follow-up after 10 days.

Follow-up 14 days

We have made dietary changes that have led to the disappearance of gravidic hyperemesis (Figure 5(a-c)). Reduction of: plaque and bleeding index, gum edema, gums pain [6].

Figure 5(a): Follow up before 14 days: Professional perinatal treatment significantly reduced glum bleeding and inflammation.

Figure 5(b): Follow up before 14 days: Professional perinatal treatment significantly reduced glum bleeding and inflammation.

Figure 5(c): Follow up before 14 days: Professional perinatal treatment significantly reduced glum bleeding and inflammation.

Professional perinatal treatment significantly reduced glum bleeding and inflammation.

Dental procedures during pregnancy are safe and necessary: every pregnant woman should be assessed for dental hygiene habits and oral problems. The maintenance of optimal conditions of the oral cavity of the woman is crucial for the best outcome of pregnancy. Good oral hygiene, brush twice a day and floss once a day, good nutrition, regular visits to the dental hygienist can prevent gingivitis in early stages.

Conflict of Interest

We declare that we have no conflict of interest.

1. Bobetsis YA, Barros SP, Offenbacher S (2006) J Am Dent Assoc 137: S7-S13.

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2. Gajendra S, Kumar JV (2004) N Y State Dent J 70(1): 40-44.

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3. Dye BA, Vargas CM, Lee JJ, Magder L, Tinanoff N (2011) J Am Dent Assoc 142(2): 173-183.

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4. Albert DA, Begg MD, Andrews H F, Williams SZ, Ward A, et al. (2011) Am J Public Health 101(1): 151-156.

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5. Shrout MK, Comer RW, Powell BJ, McCoy BP (1992) J Am Dent Assoc 123(5): 75-80.

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6. Calabrese N, Calabrese A, Nibali L, Rosati A, Fiengo S, et al. (2010) J Matern-Fetal Neonatal Med 23(11): 1288-1293.

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