Periodontal diseases and pregnancy

Pregnancy induces significant hormonal, immunological, and physiological changes that affect the periodontium. These modifications increase vascular permeability, alter subgingival microbiota, and modulate immune defenses, making women more susceptible to gingivitis, epulis, and the progression of pre-existing periodontitis. Gingivitis affects up to 75% of pregnant women, while epulis gravidarum, although less frequent, also reflects the impact of hormonal and inflammatory responses. Periodontitis, a chronic destructive disease, has been studied as a possible risk factor for adverse pregnancy outcomes such as preterm birth, low birth weight, preeclampsia, and gestational diabetes. Proposed mechanisms include systemic dissemination of periodontal pathogens and inflammatory mediators affecting the feto-placental environment. Despite numerous epidemiological studies, results remain heterogeneous and inconclusive, and the benefits of periodontal treatment during pregnancy on obstetric outcomes are uncertain. Prevention and early management, ideally before conception, appear to be the most effective strategies for preserving maternal oral health and potentially reducing risks. During pregnancy, treatment should focus on inflammation control, comfort, and reduction of local irritants, with safe use of mechanical debridement and selected antiseptics or antibiotics when needed. Clinically, these findings underline the importance of multidisciplinary collaboration between dentists and other healthcare providers. Promoting oral health in women of reproductive age is essential to optimize both maternal well-being and pregnancy outcomes.