Factors Affecting Oral Health

Review of literature

Pregnancy is an important milestone in the life-course of a female with the dual factors of pregnancy affecting oral health and oral health affecting the pregnancy outcome. Pregnant women are vulnerable to common oral diseases such as periodontal disease and dental caries; if oral health is not well maintained during this period there are implications for oral health in the woman’s subsequent life (Evans, &Briggs. 1994; Acharya, Parvati, & Bhat. 2009). So, every gestational woman requires various levels of support throughout this time, such as medical and dental care, preventive care, physical and emotional assistance (Hemalatha, Manigandan, Sarumathi, Aarthi Nisha, & Amudhan, 2013).

Pregnancy affects nearly every aspect

The tissue of the free gingiva fits closely around the tooth but is not directly attached to it. This tissue, because it is unattached, may be stretched away from the tooth surface with a periodontal probe. The shallow space between the free gingiva and the tooth which (is called the gingival sulcus) has a depth of 1.5-2 mm in healthy conditions . Structurally, the free gingiva comprises three different subtypes of epithelium (oral, sulcular, junctional) and the underlying connective tissue, (lamina propria) which contains various collagen fibre bundle groups, nerves, blood and lymphatic components (Hassel, 1993; Schroeder & Listgarten, 1997).

The Gingival Sulcus

The gingival sulcus is a V-shaped, shallow space between the free gingiva and the tooth surface. The base of the sulcus is formed by the junctional epithelium—a specialized type of epithelium that attaches to the tooth surface (Bosshardt, &Lang, 2005).

The Attached Gingiva

The attached gingiva continues from the cemento-enamel junction (CEJ) to the mucogingival junction and lies between the free gingiva and the alveolar mucosa. In health, the attached gingiva is pale or coral pink. In dark-skinned individuals, it may be pigmented. The pigmented areas of the attached gingiva may range from light brown to black. The alveolar

Hormonal changes in pregnancy have been found to be a modifying factor, and bacterial plaque is a necessary primary etiology for gingivitis. In the absence of bacterial challenge, gingival tissues can remain in a healthy state during pregnancy. (Arafat, 1974; Mariotti, 1999 in Kaur, et al., 2014).also, the dose-dependent influence of female sex hormone secretion on inflammation increases to high levels from 16- 40 weeks and then decreases after parturition (Loe, 1965; Mealey, &Moritz 2003).

Additionally, pregnancy gingivitis (Fig. 2) usually appears in the first trimester of pregnancy. This form of gingivitis results from increased levels of progesterone and estrogen causing an exaggerated gingival inflammatory reaction to local irritants. The interproximal papillae become red, edematous and tender to palpation, and they bleed easily if subjected to trauma. In some patients, the condition will progress locally to become a pyogenic granuloma or “pregnancy tumour,” which is most commonly seen on the labial surface of the papilla (Giglio, Lanni, Laskin, & Giglio.