ORAL MANIFESTATIONS OF HORMONAL CHANGES DURING PREGNANCY: A CLINICALGYNAECOLOGIC PERSPECTIVE

Background: Pregnancy induces significant hormonal shifts—particularly elevated estrogen and
progesterone—that influence vascular permeability, immune modulation, and microbial activity in the oral
cavity. These changes predispose pregnant women to gingival inflammation, xerostomia, plaque accumulation,
and enamel erosion, yet these manifestations often remain undiagnosed due to limited awareness and
insufficient integration of dental screening into antenatal care.
Objective: To assess the prevalence and trimester-specific distribution of oral manifestations in pregnant
women, evaluate maternal awareness regarding oral health, and investigate the association between hormonal
symptoms and gingival/plaque severity.
Materials and Methods: A cross-sectional clinical study was conducted with 180 pregnant women aged 18–
40 years, grouped by trimester. Gingival and Plaque Indices were recorded clinically. Self-reported hormonal
symptoms, fatigue, and oral hygiene behaviors were obtained via structured questionnaires. Statistical analysis
included ANOVA for trimester-wise comparisons and Pearson’s correlation to evaluate associations between
hormonal symptoms and oral indices.
Results: Gingival inflammation was the most common finding (79.4%), peaking in the second trimester
(Gingival Index: 2.01 ± 0.38; Plaque Index: 1.94 ± 0.46; p < 0.05). Xerostomia (41.1%) and pyogenic
granuloma (9.4%) also showed second-trimester predominance. Significant correlations were noted between
gingival inflammation and hormonal symptoms (r = 0.39, p < 0.01), and between xerostomia and
fatigue/dehydration (r = 0.31, p = 0.02). Only 15.6% were aware of oral health changes; just 3.3% had dental
referrals.
Conclusion: Hormonal changes during pregnancy significantly impact oral health, particularly in the second
trimester. Low awareness and limited dental referrals highlight the need to incorporate dental screening into
routine antenatal care.