Periodontal changes in pregnancy causes and possible methods of control .

Category:

Research type: Research Paper

Authors: Gasmalla, Bakri Gobara .

Abstract: It was observed that during pregnancy there is frequently an increase in the intensity of periodontal disease. In this study which is considered the first in Sudan, the main objectives includes investigating the relationship between the prevalence and severity of periodontal disease among pregnant ladies at different stages of gestation and possible local etiologic factors. A group of 60 pregnant ladies at different stages of pregancy attending obstetric and gynecology were randomly selected from women attending clinics at Fath Elrahman Elbasheer medical multiclinic compound in Khartoum, to constitue the study group. On the other hand 60 post partum ladies attending the same center for other reasons including vaccination, check up, etc. were considered as a control group. Both study and control groups were divided into two subgroups I and II. Subgroup II received oral hygiene instructions and 0,02 percent chlorhexidine mouthwash once daily for eight weeks. 20 percent of both study and control group had sex hormone (Follicular stimulating hormone, estradiol) analysis using ELISA method. For all subjects the gingival index (loe 1963), plaque index (Silness 1964), probleable pocket depth, and attachment loss were recorded at days 0,14,28 and 56. The results of comparing plaque index study and control group was statistically significant at day 0. Comparing the mean, plaque index for the subgroup of the pregnant not treated and not pregnant not treated no statistically significant difference was found. On the other hand no statistically significant difference was found when the mean plaque index for pregnant treated and not pregnant treated were compared. Concerning the gingival index statistically significant difference was found between the study and control group at all days. The mean gingival index for pregant not treated was higher than that of not pregnant not treated subgroup at all days. On the other hand mean gingival index for pregnant not treated was statistically significant when compared with not pregnant not treated at days 14 and 56. Comparing the mean attachment loss, of pregnant not treated and not pregnant not treated the difference was statistically significant. As for probeable pocket depth of pregnant not treated and not pregnant not treated subgroup indicated that the former show a higher mean of probeable pocket depth. The results of comparison between mean gingival index and toothbrushing frequency for the pregnant treated subgroup show no statistically significant difference even with increased tootbrushing frequency. The not pregnant treated subgroup show reduction of gingival index with increased frequency of toothbrushing. The mean gingival index for the pregnant not treated show higher reading when comparing with that of pregnant treated subgroup. Comparing the mean plaque index and follicular stimulating hormone, estradiol levels for all subgroups statistically significant difference was found. The result of this study supports the earlier findings that mechanical plaque control is the best method of controlling plaque. Also it shows that pregnant ladies were having more gingival inflammation when compared with non pregnant ladies even at comparable levels of oral hygiene standard. On the other hand the results support the need for further investigations and studies of changes in the immune system during preqnancy.