INTRODUCTION
Pregnancy causes many changes in the physiology of the female patient. These alterations are sometimes subtle but can lead to disastrous complications if proper precautions are not taken during dental treatment. Physiologically, changes occur in the cardiovascular, hematologic, respiratory, gastrointestinal, genitourinary, endocrine, and orofacial systems.
The changes that occur are the result of increasing maternal and fetal requirements for the growth of the fetus and the preparation of the mother for delivery. Increased hormonal secretion and fetal growth induce several systemic, as well as local physiologic and physical changes in a pregnant woman. Local physical changes occur in different parts of the body, including the oral cavity. These collective changes may pose various challenges in providing dental care for the pregnant patient.
PHYSIOLOGICAL CHANGES DURING PREGNANCY1
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Increased facial pigmentation is also seen. Elevated circulating estrogen, which causes increased capillary permeability, predisposes pregnant women to gingivitis and gingival hyperplasia. Pregnancy does not cause periodontal disease but does worsen an existing condition. Increased angiogenesis, due to sex hormones coupled with gingival irritation by local factors such as plaque, is believed to cause pyogenic granuloma in 1%-5% of patients, which occurs during the first and the second trimesters and may regress after the child’s birth. The change in composition includes a decrease in sodium and pH, and an increase in potassium, protein, and estrogen levels. Due to increase in salivary estrogen the proliferation and desquamation of the oral mucosal cells provide a suitable environment for bacterial growth which predisposes the pregnant woman to dental caries. Good oral hygiene will help to prevent or reduce the severity of the hormone-mediated inflammatory oral