Periodontal health and oral hygiene status during the second trimester and its effects on pregnancy outcomes - preterm and low birth weight

Periodontal disease is one of the most prevalent chronic diseases known to mankind. Recently there have been studies that suggest a possible inter-relationship between periodontal disease and systemic diseases including, cardiovascular disease, diabetes, and adverse pregnancy outcomes including pre-term and low birth weight deliveries. However, most of these studies are carried out in the western part of the world and the results may not be directly applicable to the population in Pakistan. This research is an exploratory study that aims to find the relationship between periodontal disease and adverse pregnancy outcomes including preterm and low-birth weight in Pakistani population. The periodontal status in forty-five medically healthy pregnant females aged less than 35 years during the second trimester of pregnancy were assessed. A detailed periodontal examination, including plaque score, bleeding score, probing pocket depth and clinical attachment loss were recorded. Postpartum data was collected and the outcomes were recorded as pre-term [<32 weeks of gestation], term [on or >37 weeks], post term [>40 weeks] and low birth weight [< 2.5 kg]. Pregnant females in the second trimester had an average plaque score of 84% [95% C.I. 51.1-87], average bleeding on probing score of 66.3% [95% C.I= 60.4-72.2], and average clinical attachment loss of 2.5 mm [95% C.I= 2.35-2.6]. Thirty-four participants delivered on or term [>37 weeks] and 8 participants delivered pre-term [<32 weeks of gestation]. Only one patient delivered post term [>40 weeks]. This exploratory study highlights that the oral hygiene and periodontal status of these female patients in the second trimester of pregnancy is poor. These patients had high plaque scores, marked gingival inflammation as evidenced by high gingival bleeding score, and were diagnosed with mild generalized periodontitis. None of the periodontal variables had a significant correlation with pre-term or post-term pregnancy outcomes [p>0.05]

Hereditary gingival fibromatosis diagnosis and treatment

Hereditary Gingival Fibromatosis [HGF] also referred to as idiopathic gingival hyperplasia is a rare type of slow growing gingival enlargement with great clinical and genetic heterogeneity inherited usually as Mendelian autosomal dominant fashion. Occurring as an isolated trait [HGF] and/or as a component of a syndrome, the affected gingival is characterized by firms, asymptomatic, non-hemorrhagic enlarged [hyperplastic] tissue with characteristic pale pink colour, covering most of the anatomic crown, involving usually all the quadrants. There is no definitive treatment present but post pubertal surgical intervention and good oral hygiene maintenance can improve the compromised esthetics and function of the patient. This paper presents a case report of a 15 year old male suffering from hereditary gingival fibromatosis with a positive family history. Periodontal management including gingivectomy [external bevel] was being undertaken after biopsy