Pregnancy, Gingivitis and Tumors

By Frank Rugani, DDS and Tim Kosinski, DDS, MAGD

Many pregnant women show signs of gingivitis during pregnancy. This inflammation is normally the result of poor oral hygiene. Pregnancy often exaggerates the body's normal response to dental plaque. This is because the four basic hormones vital to the continuation of pregnancy are produced in large quantities during the gestation period. This hormonal increase exaggerates the way the gingival tissue react to the bacteria in plaque, resulting in an increased likelihood that a pregnant woman will develop gum disease if her daily plaque control is not adequate. It is important to note, that it is the plaque, and not the increased hormonal levels that is the major cause of pregnancy gingivitis. (www.umanitoba.ca/prgnanc.htm).

Sometimes a large lump with deep red pinpoint marking on it forms on inflamed gum tissue, usually near the upper gum line. (Figures 1 and 2) The red lump glistens, may bleed and crust over, and can make eating and speaking difficult and cause discomfort. These growths are called pregnancy tumors, and can occur any time during pregnancy, though they usually occur during the second trimester. These growths are not cancerous and cannot be spread to other people. The pregnancy tumors are also known as pyogenic granuloma, granuloma of pregnancy, lobular capillary hemangioma and pregnancy epulides. The pregnancy tumor often disappears on its own after the baby's birth (http://my.webmd.com/content/article) However, if the tumor interferes with eating, the dentist may choose to remove it. Local anesthesia is used and it is simply excised with a scalpel or laser.

The case presentation is of a 20 year old woman in her 6^th month of pregnancy. The lesion was excised. Figure 3 illustrates healing after only 24 hours. Figure 4 shows the health of the tissue after 2 weeks and proper oral hygiene.

Good oral care is essential during pregnancy. Brushing with a soft bristled brush and flossing are important. If nausea is present, brushing and rinsing after vomiting should be done immediately. Pregnancy gingivitis or tumors can be minimized by careful periodontal examination and meticulous oral hygiene.

About Dr. Timothy Kosinski: He has practiced general and implant dentistry for 20 years. A graduate of University of Detroit Dental School, he completed comprehensive implant training at Harvard. He is a Diplomate of the American Board of Oral Implantology/Implant Dentistry, The International Congress of Oral Implantologists and the American Society of Osseointegration. He is a Fellow of the American Academy of Implant Dentistry and most recently received his Mastership in the AGD in Anaheim this year. Dr. Kosinski has been inducted into the American and International Colleges of Dentists and the Academy of Dentistry International. Dr. Kosinski was selected the Best Dentist in America by his peers in 2004-2005.

For more information about Dr. Kosinski or SmileCreator go to www.smilecreator.net, call 248-646-8651 or send an email query to allquestions@smilecreator.net. SmileCreator is located at 31000 Telegraph Rd., Suite 170, Bingham Farms, MI 48025.

Frank Rugani graduated in 1964 with a Doctor of Dental Science degree from the University of Michigan and began his practice in Saginaw, Michigan. He studied implant dentistry at the University of Toronto which led to a Fellowship in the International Congress of Oral Implantology. He was secretary of the Saginaw Valley Dental Association and was a Consultant to the Insurance Committee of the Michigan Dental Association. He currently resides in Traverse City, Michigan and enjoys mentoring younger practitioners and the camaraderie of other dental professionals.

To arrange an interview with Dr. Timothy Kosinski, contact Scott Lorenz of Westwind Communications at scottlorenztk@westwindcos.com or by phone at 734-667-2090.