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Pregnancy is recognised by various physiological changes in the body of pregnant women, including changes related to oral health. Studies say that fluctuations of oestrogen and progesterone hormones during the gestational period can cause weakening of microvasculature (small vessels), especially oral blood vessels, thus making pregnant women vulnerable to oral infections like pregnancy gingivitis. 
High levels of estrogen are primarily known to cause pregnancy gingivitis, along with other dental problems like cavities, pyogenic granulomas and alterations in salivary flow. Women with existing oral problems are at increased risk of the condition; however, there were reports of women getting pregnancy gingivitis without any previously existing periodontal inflammation and dental plaque
Though pregnancy gingivitis is not a life-threatening condition, it may sometimes progress without treatment and result in pregnancy complications such as low birth weight and preterm birth, including adverse oral health outcomes on infants.
In this article, we will discuss causes, symptoms, treatments and other details on pregnancy gingivitis. Take a look.
Prevalence Of Pregnancy Gingivitis
Gingivitis is the inflammation of the gums due to the accumulation of plaque or bacteria in the teeth. It occurs mainly due to poor oral hygiene.
Pregnancy gingivitis without plaque has been reported since the early 1960s, while pre-existing gingivitis during gestation is known to worsen the condition.
A study has shown that gingival inflammation is prevalent by 30-100 per cent during pregnancy. The data from the study have also shown that the percentage of pregnant women with gingivitis is 86.2% in Thailand, 89% in Ghana and 47% in Brazil.
The study also reported that in comparison to non-pregnant women, the gingival index in pregnant women often spikes during the third trimester while drops three months after the delivery.
Causes Of Pregnancy Gingivitis
Some of the common causes of pregnancy gingivitis include:
- Socioeconomic status and dietary habits: It includes factors like age, level of education, previous pregnancies and times of vomiting. A study says that the risk of pregnancy gingivitis is more in women with increased age and less education, who are unemployed and have been pregnant multiple times and vomits more times.
- Alterations in the levels of estrogen and progesterone: Alteration in these steroid hormones can increase the blood flow in the oral tissues, thus making them sensitive, swollen and weak. This results in bleeding gums and gingivitis during brush or floss.
- Use of oral contraceptives for prolonged periods: The use of contraceptive pills before pregnancy may have resulted in dental plaque due to increased hormonal levels. The condition may have exaggerated during the pregnancy causing pregnancy gingivitis. 
Symptoms Of Pregnancy Gingivitis
Common symptoms of pregnancy gingivitis include:
- Swollen gums
- Sensitive gums
- Tender gums
- Bleeding from the gums, especially after brushing or flossing
- Bad breath
- Redness in the gums
- Pain in the gums
Note: In most cases, pregnancy gingivitis symptoms often disappear after the delivery. That is why, pregnancy gingivitis only has a reversible effect on the gums without any permanent effects on periodontal sites. 
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Difference Between Pregnancy-associated Gingivitis And Chronic Dental Plaque-Induced Gingivitis
The primary reason between pregnancy-associated gingivitis and chronic dental plaque-induced gingivitis is the severity of the condition due to inflammation of the gums caused by bacteria.
In pregnancy-related gingivitis, elevated levels of female sex hormones (oestrogen and progesterone) along with bacterial load, or the high levels of hormones alone, could lead to the condition, however, in gingivitis related to plaque, the bacterial burden alone could be the main cause.
This is because, instead of the gingival inflammation during pregnancy, no high levels of inflammatory biomarkers due to bacteria were found. 
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Complications Of Pregnancy Gingivitis
If left untreated, pregnancy gingivitis can progress to cause:
- Preterm birth
- Low birth weight of the baby
- Tooth loss
- Oral defects in newborns.
Treatments Of Pregnancy Gingivitis
Some of the treatment methods of pregnancy gingivitis include:
- Use of anti-gingivitis mouthwash and toothpaste
- Daily brushing and flossing.
- Managing the levels of estrogen.
- Use of antibiotics.
How To Prevent Pregnancy Gingivitis?
- Brush twice a day with a fluoride-based toothpaste.
- Eat healthy foods like fruits, vegetables and whole grains.
- Avoid sodas and sweet juices
- Avoid starchy foods.
- Avoid candies, cookies or other market-based products that contain high amounts of sugar.
- Avoid sweet dried fruits like raisins and figs.
- If you notice swelling in gums, gargle with salt water daily.
- Include dental checkup in your routine.
Pregnancy gingivitis is a common condition prevalent during pregnancy. It can be treated well at an early stage, but can exaggerate if left untreated for long. Therefore, visit a doctor if you notice symptoms like inflamed gums and bleeding from the gums to avoid the condition.
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