Abstract
During pregnancy, there are several metabolic changes and an alteration in the composition of microorganisms that inhabit the oral cavity, with an increase in pathogenic bacteria that promote the onset of gingival diseases. This review is based on research in reference to the PICO model (Problem/Intervention/Comparison/Outcome), related to changes in the oral microbiome of pregnant women and possible oral consequences in patients with COVID-19. The results showed a growth of some pathogenic bacteria in pregnant women, including Aggregatibacter actinomycetemcomitans and Fusobacterium nucleatum, and the selective growth of the Prevotella intermedia, Porphyromonas gingivalis and Tannerella species, probably due to the fact that these bacteria use progesterone as a source of nutrition. These same bacteria are implicated in the development of periodontal disease. Periodontal pockets have bidirectional interactions between the oral cavity and the systemic circulatory system through the peripheral gingival blood vessels. The affinity of the SARS-CoV-2 virus to specific membrane receptors is now clear, and could involve the internal and external epithelial lining or the fibroblasts of the periodontal ligament. According to the results of the present review, the control of oral microbiome changes during pregnancy would be welcomed. The use of probiotics could help clinicians manage pregnant patients, reducing inflammatory indexes. Future studies should focus not only on changes in the level of the oral microbiome in pregnancy or the correlation between periodontal disease and COVID-19, but also on oral changes induced by both clinical situations.
Highlights
Patients with COVID-19 and whose course increases in complexity are those with different systemic diseases, such as cardiovascular problems and diabetes, often associated with an increase in some pathogenic bacteria, such as Fusobacterium nucleatum, Prevotella intermedia and Porphyromonas gingivalis, that favor the progression of periodontal disease [14]
In light of the scientific literature, several oral changes have been noted in pregnant women, especially regarding the quality of subgingival bacterial plaque, which returns to favorable health conditions immediately after delivery
Increasing several bacterial species implicated in the development of gingival problems, such as Fusobacterium nucleatum, Prevotella intermedia, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans, it is advisable to conduct professional oral hygiene sessions more frequently to lower the pathogenic bacterial load
Summary
Microorganisms 2021, 9, 2385 including high levels of Poprhyromonas gingivalis and Aggregatibacter actinomycetemcomitans These bacteria can promote the onset of gingival disease and the development of periodontal disease [3]. The response occurs with an increase in volume, bleeding and edema until the appearance, in some cases, of periodontal disease, which tends to regress after the end of pregnancy These are well-documented changes that occur at the level of the oral microbiome, with an increase of anaerobic and aerobic bacteria, such as Bacteroides melaninogenicus, Prevotella intermedia and Porphyromonas gingivalis [4,8,9,10]. Patients with COVID-19 and whose course increases in complexity are those with different systemic diseases, such as cardiovascular problems and diabetes, often associated with an increase in some pathogenic bacteria, such as Fusobacterium nucleatum, Prevotella intermedia and Porphyromonas gingivalis, that favor the progression of periodontal disease [14]
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