As most people are aware, pregnancy causes tremendous change in a woman's hormonal activity. Estrogen and progesterone are secreted in progressively greater concentrations throughout most of pregnancy, causing a variety of effects. Perhaps the least known hormonal effect is how hormones can cause pregnancy gingivitis, a condition which makes gum tissue red, swollen and prone to bleeding. The hormones alone are not responsible for the condition. Gingivitis is caused by plaque, which everyone has in varying amounts, and which is removed by brushing, flossing and regular dental cleanings. The marked difference when a woman is pregnant is that the bacterial content of the plaque increases and changes, resulting in more damaging bacteria which in turn causes greater inflammation.

How widespread is this condition among expectant mothers? Gingivitis has been reported to occur in approximately 60 to 75 percent of all pregnant women. The severity of the condition can range from mild inflammation with redness, to inflammation with edema and bleeding, to even more severe cases where periodontal surgery is necessary. If you are experiencing any of these symptoms, call your dentist immediately for an appointment. Your dentist or hygenist should clean your teeth thoroughly, do a periodontal (gum) evaluation and instruct you on home care.

What's important to understand is that even with immediate attention and diligent home care, you may not see visible signs of improvement until several months after pregnancy and childbirth, when hormonal conditions normalize. Don't despair! It's simply a matter of your body not healing quite as quickly due to the high levels of hormones. After your baby is born, your hormone levels will decrease, the number of gingivitis-producing bacteria will drop and the gingival tissues will return to a relatively healthy state.

There is good news on how to best avoid the condition. The incidence of gingivitis is only .03 percent if a woman is plaque free at the beginning of her pregnancy and maintains good oral hygiene habits throughout pregnancy, including regular dental visits during pregnancy. Personally, I recommend at least one -- ideally, two -- visits before the baby is born. I also highly recommend using electric toothbrushes because they are clinically proven to remove plaque better than traditional brushing. Two brands I like are the Sonicare and the Ultra Braun by Oral B.

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