RELATIONSHIP BETWEEN PREGNANCY AND PERIODONTAL DISEASE

Abstract

Summary. The gingivitis associated with pregnancy has been attributed to increased concentrations of circulating estrogen and/or progesterone. However, the mechanism by which these steroids increase gingival inflammation is not known. Female steroid hormones may have dual effects on the pathogenesis of pyogenic granuloma in pregnancy. The hormones not only enhance the expression of angiogenic factors in inflamed tissue, but also decrease apoptosis of granuloma cells to extend angiogenic effect. The bacteria known as Fusobacterium nucleatum, has been linked with adverse pregnancy outcomes. Since F. nucleatum is associated with periodontal infections rather than genital or uterine infections, it is supposed that the infection doesn't enter the womb by an ascendant route coming up through the genital tract; rather it enters the mother's bloodstream making its way down from the oral cavity. Systemic inflammation and its chemical mediators play a major role in the pathogenesis of preterm delivery, including preeclampsia, intrauterine growth restriction, and preterm delivery. Chronic infections like intrauterine infection and chorioamnionitis are linked to both preterm birth and elevated CRP levels. Furthermore, periodontal disease has been associated with increased risk of preterm low birth weight, low birth weight, and preterm birth. Therefore, chemical mediators, principally CRP, might be a plausible mediator of the association between periodontitis and adverse pregnancy outcomes. Periodontal intervention results in a significantly decreased incidence for preterm delivery. Pregnancy without periodontal treatment is associated with significant increases in probing depths, plaque scores, GCF IL-1β, and GCF IL-6 levels.