Periodontal Disease and Pregnancy: The promotion of good oral health during pregnancy is an important aspect for the well-being and health of mothers. The need for good health of mothers during pregnancy has provided an opportunity for dentists to educate mothers on preventing dental caries in their babies in order to lessen the occurrences of undesirable pregnancy outcomes. Moreover, mothers need this education in order to prevent the occurrence of periodontal disease since oral health is not widely addressed during prenatal care. Several obstetrician-gynecologists have recognized the significance of obtaining routine dental care during pregnancy and the positive impact of treating the disease to enhance pregnancy outcome.

Periodontal Disease:

Periodontal diseases basically consist of a group of diseases that have a huge negative impact on the supporting structures of the teeth (Avula & Avula, 2011). While the disease was previously known as pyorrhea in earlier literature, it's prevalent across the globe since no continent or country is unaffected by it. It's important to note that these diseases have an adverse effect on both the gums and alveolar bone though the involved teeth remain normal. Periodontal disease is normally characterized by gum bleeding, discharge of pus, and increased mobility of teeth. In certain instances, the increased mobility of teeth results in their ultimate loss as the disease is chronic and painless. The other characteristic of the disease is that it produces no gripping urge for seeking treatment in the absence of severe pain.

Causes of Periodontal Disease:

Throughout the years, periodontal disease is characterized by the overgrowth of bacteria though gum destruction is caused by constant immune response to chronic infections in the mouth. Porphyromonas gingivalis is one of the bacterium that is likely to cause aggressive periodontal disease. The bacterium is a gram-negative organism with black spots and normally resides in the mouth below the gingival surface. In the early inflammation of the gingival or periodontitis is usually characterized by the bacterium as one of the common pathogens. According to the findings of research, porphyromonas gingivalis is a microorganism involved in the disease as it has been discovered in the amniotic fluid of some pregnant women.

The other bacterium that is likely to contribute to the disease is Fusobacterium nucleatum that has emerged as the leading cause for preterm births and stillborn infants. The bacterium is associated with gum or periodontal infections instead of uterine or genital infections. The development of Pyogenic granumola in the oral cavity of pregnant women can also be regarded as a cause of periodontal disease. A pyogenic granumola is likely to develop during pregnancy when there gingivitis that is caused porphyromonas gingivalis is very prevalent. Due to their link between gingival and vaginal infections, Prevotella bivia and Prevotella disiens are additional organisms or bacteria that cause periodontal disease.

Effect of the Bacteria on the Fetus:

If periodontal disease remains untreated, it can pose a safety risk to the pregnant woman and her fetus (Guilbeau & Hurst, 2009). Based on the findings conducted on pregnant mice infected with porphyromonas gingivalis, the bacteria had increased levels of TNF-?, concealed levels of maternal IL-10, and restriction on increased fetal-growth. Therefore, the main effect of porphyromonas gingivalis on the fetus is that in suppressed maternal levels and restricts enhanced growth of fetus. The bacterium is linked with the resistance to ordinary treatments for gum disease and increases the risk of severe gum disease.

The bacteria that cause periodontal disease have significant impacts on the unborn child or fetus because they enter the womb. In order to understand the impact of the bacteria on the unborn child, its critical to examine the way these bacteria enters the womb, especially for bacterium that are not linked with vaginal infections. The major contributing factors to how these bacteria enter the womb are relaxed immune systems, bleeding gums, and the possibility of increased number of bacteria. A pregnant woman has more bacteria in their mouth when she is suffering from periodontal disease to approximately 10,000 times more than the initial population. This is characterized by the relaxation of the immune system to prevent any harm to the unborn child. As the immune system is relaxed, there is likelihood for the growth and development of more bacteria. As the mother's gums are likely to bleed due to the disease, the bacteria enter the blood stream and travels through her body to enter the placenta (Han, 2011).

Even though the placenta is designed to specifically protect the unborn child, the bacteria that enter the womb can affect the fetus. For instance, the Fusobacterium nucleatum bacterium targets the amniotic fluid and placenta specifically when the immune system...

In some cases, the bacterium wins the fight with numerous defense systems of the womb.
Adverse Pregnancy Outcomes:

Periodontal disease is prevalent in pregnant women because approximately 50% of these women usually experience pregnancy gingivitis. Pregnancy gingivitis is not only uncomfortable but also characterized by bleeding, swelling, and tenderness or redness in the gum tissue. The other reason for the prevalence of the disease among pregnant women is the hormonal changes as tissues have a tendency to react more seriously to present irritations. These hormonal changes not only cause sensitivity but they also contribute to more incidences of gum disease. Due to its prevalence in pregnant women, periodontal disease has adverse pregnancy outcomes on these women.

. Unlike pregnant women without periodontitis, pregnant women without the disease have greater risks of adverse pregnancy outcomes. The main reason for the adverse pregnancy outcomes are the complications associated with the disease. Some of these adverse pregnancy outcomes due to periodontal disease include pre-term birth, low birth weight infants, preeclampsia, fetal loss, SGA infants, and gestational diabetes. The two major adverse pregnancy outcomes are pre-term or premature births and low birth-weight babies.

As the bacteria travels through the mother body because of bleeding gums, its main impact on the unborn child is either premature birth or the birth of the baby with a small weight. This is because the disease restricts the growth of the unborn child and suppressed maternal levels. Preterm birth and low-birth weight can be caused by prostaglandin that is triggered by the release of proinflammatory mediators. Its plays a role in preterm birth because it increases the inflammatory nature of the gingival that predisposes pathogenic bacteria. Actually, periodontal disease enhances the risk of premature labor and birth by speeding up prostaglandin production. Once the level of prostaglandin attains a particular threshold, labor is triggered (Babalola & Omole, 2010).

Prevention and Control of Gingivitis and Periodontitis:

Pregnant women are likely to experience periodontitis and gingivitis when they suffer from spongy and bleeding gums. Most of the gingival changes during pregnancy are normally associated with changing hormonal levels and lack of oral hygiene. Therefore, some of the most appropriate ways for preventing and controlling gingivitis and periodontitis include:

Good Oral Health:

The promotion of good oral health during pregnancy is considered as a vital measure for the well-being of the mother (Morgan et. al., 2009). While good oral health is not usually examined during prenatal care, many professionals in the field recognize that routine dental care has a positive impact on pregnancy outcome and lessening the impact of gingivitis and periodontitis. Based on accumulating evidence, oral care during pregnancy is considered as both important and safe. The possibility for pregnant women to have compromised oral health is enhanced by changes in hormonal levels and eating habits. Oral hygiene and dental care is an important part of the pre-conception period and prenatal care because of its ability to prevent the occurrence and lessen the impact of gingivitis and periodontitis.

As part of promoting good oral health care, the dental conditions of a pregnant woman are identified and subsequently treated. This has the ability to lessen severe pregnancy outcomes and should be provided to every pregnant woman as a means of promoting safe and healthy pregnancy. The most suitable time for discussing and carrying out dental health screening is during pre-conception planning. Furthermore, an overall dental examination should not only be encouraged but also conducted during early pregnancy. Good oral health at home and through seeing a hygienist by the pregnant woman is important in order for the woman to avoid the development of gum diseases that could contribute to gingivitis or periodontitis.

Management of Pyogenic Granuloma:

Pyogenic granumola is a relatively common skin growth that is usually a small red bleeding and oozing bump appearing like a raw hamburger meat. The reddish bump bleeds easily because of the unusually high number of blood vessels. The main complications that are associated with pyogenic granumola are lesion bleeding and reappearance of treated lesions. The management of the unusual large pyogenic granuloma of the gingiva during and after pregnancy is an appropriate way for controlling gingivitis. Pregnant women may sometimes have a distorted susceptibility to plaque accumulation that could be motivated by hanging restorations or calculus margins (Lindenmuller et. al., 2010). This may result in gingivitis that can develop and even extend further to pyogenic granumola if left untreated. The effective management of the large pyogenic granumola…