Effects of topical and systemic folic acid supplementation on gingivitis in pregnancy

A double-blind study evaluated the effects of systemic and topical folate on gingival inflammation during the fourth and eighth months of pregnancy. Thirty women were randomly divided into three groups. Group A received placebo mouthwash and tablets; Group B; placebo mouthwash and 5 mg folate tablets; Group C: folate mouthwash and placebo tablets. Supplementation lasted for 14 days during months 4 and 8. Subjects took one tablet daily and rinsed twice daily for 1 min with the mouthwash. At the start and finish of each 14-day period, fasting serum and red cell folate levels were estimated and oral status assessed by a plaque index (P1I), a gingival index (GI), and gingival exudate flow meter (GEF). Subjects completed 1-week diet sheets which were analysed for dietary folate. All groups were similar in each parameter at the start. Correlation was demonstrated between GI and P1I, and between GI and GEF. GI tended to increase throughout pregnancy in all groups except Group C, when in the eighth month there was a highly significant improvement (0.001 less than P 0.01) despite no significant change in P1I. Although dietary intake of folate was significantly higher during the eighth month in Group C as compared with Groups A and B, (0.001 less than P less than 0.01), the folate mouthwash produced highly significantly improvement in gingival health in pregnancy.