Pregnancy & Periodontal Inflammation: Pathogens or Hormones?

The Challenge:

Pregnant, periodontal maintenance patient appointed with increasing periodontal measurements over the last two periodontal maintenance appointments. The goal of testing is to establish the cause for the increase of inflammation.

The Background:

• Age: 44
• Sex: F
• Medical History: Patient is 4 months pregnant with a history of smoking.
• Last Dental Exam: Initial therapy was completed in 2013. The most previous periodontal therapy was completed in 2018. Both therapies consisted of LANAP.
• Home Care: 2-3x day with electric toothbrushing, flossing 1x pm and Waterpik^™ 2x/day
• Chief Complaint: Patient has noticed pus around crowns in morning.
• Periodontal Assessment: 4mm-9mm pocketing present with bleeding upon probing, tissue appears to be inflamed, red and bulbous.

The Solution:

• Date of Pre MyPerioPath^® test: 8/13/2021
• Periodontal Therapy: Adjusted periodontal maintenance appointments to every month until delivery. This allowed for closer monitoring and placement of Arestin when needed.
• Systemic Antibiotic Used: This wasn’t considered however, the localized antimicrobial, Arestin^® will be placed as needed.
• Home Care: Stressed continued home care, no modifications are needed.
• Retesting will occur following the delivery.

The Result:

Periodontal health during pregnancy can be extremely difficult to achieve. There are many systemic conditions such as immunosuppressive hormones and stress, in addition to potential localized triggers such as periodontal pathogens. To know exactly how to approach care, testing was a must and revealed significant pathogens, some of which could complicate a pregnancy.

About the Author:

Gabby graduated from Madison College in 2018. What she enjoys most about dental hygiene is connecting with patients and educating as well as motivating them to have perfect home care instructions to allow for not only a healthy mouth, but overall health as well. Working at Barotz Dental has allowed her to be a part of life changing cases from start to finish. She is empowered as the hygienist to be a leader in the hygiene department. Gabby is a proud mother of a bunny named Foo and a kitten named Indy. In her free time, she loves doing anything outside, going to parks in the city, hiking in the mountains, and camping with friends.