Gingivitis In Pregnant Women Research Articles

Effectiveness of cocoa bean extract mouthwash against gingivitis in pregnant women in Aceh Besar

Background: Gingivitis and periodontitis are the most common dental support tissue problems in dentistry. Gingivitis is an inflammation of the gingiva due to the body's response to the accumulation of dental plaque bacteria in the form of Streptococcus mutans, Streptococcus sanguis, Actinomyces, and Spirochaeta on the surface of the teeth. Gingivitis and nutritional status in pregnant women are related to the risk of 8.75 times the birth of low-birth-weight babies (BBLR) and premature babies. Prevention of gingivitis can be done chemically through gargling with antibacterial mouthwash. Therefore, herbal ingredients are needed that can prevent plaque and control gingivitis. This study aims to determine the effectiveness of mouthwash of cocoa bean extract against gingivitis. Methods: This study used the post-test only control group design method. The study was conducted on pregnant women in Bayu Aceh Besar village with a total of 30 samples. The sample was divided into 3 groups that received different treatments. Group 1 was instructed to do a mouthwash with cocoa extract mouthwash while Group 2 with chlorhexidine, group 3 with mineral water. Each pregnant woman gargles for 30 seconds (20 ml) for 3 days. Results: Analysis of the gingival index before and after using cocoa seed extract mouthwash showed that this mouthwash was more effective in reducing the gingival index with a value of p=0.012 (p<0.05). Conclusions: Gargling with cocoa bean extract is more effective in reducing gingivitis. We recommend further studies to investigate the potential of cocoa bean extract for use in mouthwashes.

Oral hygiene and salivary IgA in relation to gingival condition in pregnant women

Pregnancy is a physiological state that causes changes in many parts of the body, including the oral cavity. Gingivitis has been reported to be the most common oral manifestation during pregnancy, most likely due to an exaggerated inflammatory response to the dental plaque. This study aims to investigate oral hygiene and salivary IgA concerning gingival conditions in pregnant women. In this study, the total sample included was 80 women. The study group consisted of 40 pregnant women: 20 females in the first and 20 in the third trimester, while the control group included 40 non-pregnant women. Between 9 and 11 a.m., unstimulated saliva was collected. The rate of salivary flow and concentration of salivary immunoglobulin A were measured. Dental plaque, calculus and gingivitis were assessed. Results demonstrated that plaque, calculus and gingival indices were higher in a pregnant group, with significant differences in plaque index only. In contrast, salivary flow rate was lower in pregnant women with no significant difference. Salivary IgA was the highest level in the pregnant group during the third trimester, with no statistical difference. In conclusion, the pregnant women revealed a poor oral hygiene status and alteration in salivary parameters, leading to an increased prevalence of gingivitis in pregnant women. Keywords: Gingivitis, salivary flow rate, Pregnant women, Salivary IgA.

Efficacy of Sonic-Powered and Manual Toothbrushes on Plaque-Induced Gingivitis in Pregnant Women: A Randomized Controlled Trial.

Hormonal changes and physiological alterations in pregnancy increase the susceptibility of the woman to oral diseases such as plaque-induced gingivitis. In individual oral prophylaxis, effective tooth brushing can reduce gingival inflammation. Therefore, it is necessary to update the scientific evidence to identify which type of toothbrush, manual or sonic-powered, is most effective in reducing the incidence of gingivitis in pregnant women. The aim of this clinical trial is to compare the biofilm control effectiveness of two manual and two sonic toothbrushes in pregnant women. This study is designed as a four-arm, parallel, randomized controlled trial with an allocation ratio of 1:1:1:1. The pregnant woman will be included at 15-18 weeks of amenorrhea and followed for 3 months. The primary outcome will be the change in the incidence of gingival bleeding from a baseline and various follow-up periods of the study. Secondary outcomes measures will be to compare clinical effects of the toothbrushes tested on (i) gingival inflammation, (ii) dental plaque, (iii) gingival attachment and (iv) periodontal pocket; and to assess toothbrush acceptability. Thus, identifying the best device for effective tooth brushing in pregnancy could be helpful in reducing and improving the incidence of gingival inflammation.

Obesity is related to maternal periodontitis severity in pregnancy: a cross-sectional study.

To evaluate the relationship between obesity and periodontitis staging compared with periodontal healthy or gingivitis in pregnant women. An analytical cross-sectional study was conducted on pregnant women between 11 and 14weeks of pregnancy. Sociodemographic, clinical, obstetric, and periodontal variables were studied. The exposure variable was obesity (body mass index [BMI] ≥ 30), and the primary outcome was periodontitis staging versus periodontal healthy/gingivitis. Data were analysed and estimated by multinomial logistic regression models. The present study screened 1086 pregnancies and analysed 972 women with a median age of 29years; 36.8% were diagnosed as obese. 26.9% of patients were diagnosed as periodontal healthy or gingivitis, 5.5% with stage I periodontitis, 38.6% with stage II periodontitis, 24% with stage III periodontitis, and 5.1% with stage IV periodontitis. After identifying and adjusting for confounding variables (educational level and plaque index), obesity had a relative risk ratio (RRR) of 1.66 (95% CI: 1.05-2.64; p = 0.03) and 1.57 (95% CI: 1.09-2.27; p = 0.015) for stage III periodontitis compared to periodontal healthy/gingivitis and stage II periodontitis, respectively. Besides the already known risk indicators for periodontitis (age, smoking, and educational level), our study suggests a relationship between obesity and periodontitis staging in pregnancy. Obesity can alter host immune responses, leading to increased susceptibility to infections and overactive host immunity, which could influence the prevalence and severity of maternal periodontitis in pregnancy.

Analisis Faktor Yang Mempengaruhi Kualitas Gingivitis Pada Ibu Hamil Di Puskesmas Pujon Malang

Objective: to analyze the influence of gestational age, the level of knowledge of pregnant women about gingivitis and oral hygiene status on gingivitis in pregnant women at the Pujon health center, Malang Regency.Methods: The design of this study is quantitative observational with dependent variables of gingivitis. The independent variabels in this study were gestational age, level of knowledge as well as oral hygiene status. The subjects of the study were pregnant women who met the inclusion and exclusion criteria of 102 people. The study was conducted in the Pujon health center area, Malang regency, for the time period of July-September 2022. The data were analyzed using SPSS software version 25 with ordinal regression tests.Results: The results showed that gestational age did not affect gingivitis with p value=0.061. The level of knowledge affects gingivitis with p value=0.016. Oral hygiene status affects gingivitis with p value=0.000. Gestational age, level of knowledge, oral hygiene status simultaneously influenced gingivitis p value=0.001, with a large influence of 32.9%.Conclusion: Simultaneously the gestational age, level of knowledge, oral hygiene status affect gingivitis in pregnant women at the Pujon health center, Malang regency

PREGNANCY PERIOD WITH THE OCCURRENCE OF GINGIVITIS IN PREGNANT WOMEN

Background: Health is the most important part in human life, pregnant women health are no exception. Pregnant women often experience problems with their teeth and mouth during pregnancy. Diseases of dental and oral health above tend to be ignored by pregnant women. Mothers-to-be tend to be more concerned about the health of their fetuses and the pregnancy itself, thus neglecting the health of their teeth and mouth. During pregnancy, hormonal changes cause changes in the dental and oral health of pregnant women starting from the first trimester to the third trimester. Objective: To determine the relationship between gestational age and the occurrence of gingivitis in pregnant women at the posyandu, Darawati village, Cipatujah district, Tasikmalaya district. Method: Design The type of research used is descriptive analytic with a cross sectional aim is to determine whether there is a relationship between the independent and the dependent variable in the form of gestational age and the occurrence of gingivitis in pregnant women at the Posyandu. Results: the results of the SPSS test with the Spearman correlation for pregnant women at the Posyandu, Darawati Village, obtained a p-value of 0.004 (p>0.05), namely HO is rejected and HA is accepted and the criterion for the level of correlation strength that is calculated is 0.588, which is a relationship criterion. strong. The hypothesis, which means that there is a relationship between the period of pregnancy and the occurrence of gingivitis at the Posyandu, Drawati Village. Conclusion: There is a relationship between gestational age and the occurrence of gingivitis in pregnant women in Darawati Village, Cipatujah District, Tasikmalaya Regency with the level 3 of gingivitis.

Factors Associated with Gingivitis in Pregnant Women in a Disadvantaged Population

Objective: The objective was to determine the factors associated with gingivitis in pregnant women who come to the health center in the district of San José de Sisa. Methodology: The research was of a basic type and the research design was non-experimental, descriptive, cross-sectional and correlational. The population and sample was the same as the population, that is, 110 pregnant women from the District of San José de Sisa with a non-probabilistic sampling for convenience to which a questionnaire of 5 questions on oral hygiene habits and sociodemographic factors and a clinical evaluation to observe the gingival state were provided. Results: The study revealed that the associated factors were socioeconomic status where it was found that 43.5% at the mean level had gingivitis with a p value = 0.002, with reference to the age group 48.2% with gingival disease were between 20 and 29 years old with a p value = 0.280; 43.6% of pregnant women with gingivitis reported brushing at least 2 times a day when obtaining a p =0.098, el 41.7% in the second trimester presented gingivitis with a p value = 0.004. When comparing the information of the degree of instruction it was found that pregnant women with gingivitis were found that 40% had only primary and 39.1% secondary, when obtaining a p value = 0.000. Conclusions: It concluded that there is a significant relationship between gingivitis and socioeconomic status (p=0.002), with the trimester of pregnancy (p=0.004), and with the degree of education of the pregnant woman (p=0.000); but found no statistical relationship with the age group (p=0.280) or with oral hygiene habits (p=0.098).

Does Treatment of Gingivitis During Pregnancy Improve Pregnancy Outcomes? A Systematic Review and Meta-Analysis.

This study aimed to investigate whether treatment of gingivitis in pregnant women affects pregnancy outcomes. This was a systematic review and meta-analysis of clinical trials using PRISMA guidelines to appraise the treatment of gingivitis on pregnancy outcomes, including preterm birth (less than 37 weeks), low birth weight (less than 2,500 g), gestational age and birth weight. Pooled odds ratios (OR), mean difference, and 95% confidence intervals (CI) were calculated using the random effect model. A search was conducted in databases including Medline, Pubmed, Web of Science, Google Scholar and Embase without restrictions regarding language or date of publication. Three clinical trials comprising 1,031 participants were included in this review. Treatment of gingivitis during pregnancy was associated with a decreased risk of preterm birth (OR = 0.44, 95% CI [0.20-0.98], P = 0.045) and higher birth weight (weighted mean difference (WMD) =105.36 g, 95% CI [36.72-174.01], P = 0.003). Gestational age at birth in the treatment group (WMD = 0.31 weeks, 95% CI [-0.02-0.64], P = 0.64) as well as likelihood of low birth weight (OR = 0.92, 95% CI [0.38-2.21], P = 0.851) did not reach statistical significance. The results of this meta-analysis indicate that treatment of gingivitis in pregnancy may improve pregnancy outcomes including increased infants birth weight and reduced preterm births. Future trials are warranted to validate the true effect size of gingivitis treatment on pregnancy outcomes.

ИЗМЕНЕНИЯ ФИЗИКО-ХИМИЧЕСКИХ И БИОХИМИЧЕСКИХ ПОКАЗАТЕЛЕЙ РОТОВОЙ ЖИДКОСТИ ПРИ МЕСТНОМ ЛЕЧЕНИИ ГИНГИВИТА У БЕРЕМЕННЫХ ЖЕНЩИН С ГЕСТОЗОМ

Introduction. Gestosis (late toxicosis of pregnant women) — pathological conditions of the second half of pregnancy, characterized by a triad of main symptoms: edema (hidden and visible), proteinuria, hypertension. In the third trimester, during physiological pregnancy of women and, especially when it is complicated by gestosis, there is a decrease in salivation, an increase in the viscosity and acidity of the oral fluid, which significantly increases the severity of the course of inflammatory periodontal diseases. We have developed a method for local treatment and prevention of gingivitis in women with pregnancy complicated by preeclampsia using a chewing phyto-substrate.
 Purpose: to assess changes in the physicochemical and biochemical parameters of the oral fluid during the local treatment of gingivitis using a chewing phyto-substrate in pregnant women with gestosis.
 Materials and methods: the examination of pregnant women was carried out in cooperation with obstetricians-gynecologists at the clinical base of the Department of Obstetrics and Gynecology No. 2 at the City Clinical Hospital No. 8, Ufa. Physicochemical (salivation rate, kinematic viscosity, pH) and biochemical parameters (calcium, magnesium, phosphorus, protein) of the oral fluid were determined before and after complex treatment of gingivitis with the inclusion of a chewing phyto-substrate in pregnant women with gestosis.
 Conclusion: in the third trimester during physiological pregnancy and, especially when it is complicated by gestosis, there is a decrease in salivation, an increase in the viscosity and acidity of the oral fluid. The use of chewing phytosubstrate plates in complex treatment, containing 0.1 g of dry extract of the collection (oak bark, licorice alder, birch buds, chamomile flowers, thyme herb) and 1.0 g of beeswax, increases the rate of salivation by 1.5 times, reduces the viscosity of the oral fluid by 1.3 times and its acidity, which indicates the effectiveness of the proposed method of local treatment of gingivitis in pregnant women with preeclampsia.

HUBUNGAN SEXTAN YANG MENGALAMI GINGIVITIS DENGAN USIA KEHAMILAN PADA IBU HAMIL DI PUSKESMAS MANGGIS II KABUPATEN KARANGASEM TAHUN 2019

It is very important for pregnant women to maintain healthy teeth and mouth during pregnancy. It is even expected for expectant mothers before planning a pregnancy, paying attention to the state of their oral health. During pregnancy, acid levels in the mouth increase due to nausea and vomiting which are usually experienced by pregnant women. In addition, pregnant women are also prone to gum inflammation that is compounded by the hormones progesterone and estrogen. Gingivitis in pregnant women increases with gestational age. Handayani's research concluded that all pregnant women in the Manggis II Health Center had gingivitis. The purpose of this study was to determine the relationship between sextans who had gingivitis and gestational age among pregnant women at the Manggis II Health Center in Karangasem Regency in 2019. Cross sectional research method. Using secondary data, with 45 respondents. Spearmen correlation test results sig 0.013. Conclusion: there is a relationship between sextans who have gingivitis and gestational age in pregnant women at Manggis II Health Center in Karangasem Regency in 2019.

Relationship Between Gestational Age and Severity of Gingivitis

Increased levels of the hormones estrogen and progesterone in the blood during pregnancy can cause gingivitis due to vascular changes that cause the gingiva to become more sensitive especially to toxins and other irritants, such as plaques and calculus, which causes the gingiva to become easily inflamed. Pregnancy can also aggravate gingivitis due to the excessive inflammatory response of the gingiva to dental plaque and hormonal changes that occur during pregnancy. This study aims to determine the differences in the degree of gingivitis in pregnant women in each trimester of gestational age. This study was a cross-sectional study conducted in April 2019 on 80 pregnant women with gingivitis who examined their pregnancies at the Puskesmas Merdeka Palembang during the fourth week of March 2019. The relationship between the degree of gingivitis in each trimester of pregnancy was analyzed using Fisher's exact test with 95% confidence interval. The results showed that gingivitis was found most frequently in third trimester pregnancy (47.5%) and mild gingivitis, mostly experienced by pregnant women in trimester II pregnancy (52.6%), while moderate and severe gingivitis was more experienced by trimester pregnant women III (50% and 81.8%). The statistical test results showed a significant relationship between the gestational age and severity of gingivitis (p 0.05). It can be concluded that increasing gestational age is related to the increasing severity of gingivitis.

Features of etiology, pathogenesis, treatment and prophylaxis of periodontal diseases in pregnant women in the context of iron deficiency anemia (review of the literature)

An important task of modern dentistry is the study of dental morbidity in pregnant women with somatic pathology. This is due to many factors, including a significant prevalence of periodontal diseases among the population, infection impact on the body of the pregnant woman and the fetus, an increase in the frequency of somatic diseases in pregnant women.The aim of the retrospective literary research was to study modern scientific trends regarding the peculiarities of etiology, pathogenesis, treatment and prophylaxis of periodontal diseases in pregnant women with iron deficiency anemia.The collection of scientific publications (30 sources), including 19 domestic and 11 foreign professional sources, has been analyzed on the current issue of modern dentistry: periodontal diseases in pregnant women with iron deficiency anemia. The aspects of high prevalence of periodontal diseases among this contingent of patients, their polyethiologic origin, complex mechanism of development, peculiarities of treatment and prevention have been considered. According to the authors' researches, it was found that catarrhal gingivitis is the most common clinical form of the inflammatory process in the 1st trimester, gingivitis of pregnant women develops as a catarrhal or hypertrophic inflammation, rarely - ulcerous-necrotic gingival lesion in the 2nd trimester. The clinical picture of hypertrophic gingivitis in pregnant women is to be seen in its most clinical manifestation in the 3rd trimester and in the immediate prenatal period. Taking into account the fact that to date, in the majority of women, the actual consumption of macro- and micronutrients and vitamins with food is much lower than the level that provides a favorable course of pregnancy and lactation, the use of vitamin-mineral complexes are obligatory in pregnant women with periodontal disease and concomitant iron deficiency anemia. At the initial stages of generalized periodontitis, vitamin therapy is most effective. Today, foreign authors refer to the concept of micronutrient programming of the future baby's development during pregnancy, which is the applicability of multivitamin complexes. The main task of dentists and obstetrician-gynecologists is to create a conscious awareness of the importance of timely dental care in pregnant women by forming a positive motivation among expecting mothers to seek dental care. From these data, the optimal periods of dental examinations and differential approach to medical preventive measures can be determined.

PREVALENSI GINGIVITIS PADA IBU HAMIL BERDASARKAN USIA KEHAMILAN, PEKERJAAN, DAN PENDIDIKAN DI RSUD KLUNGKUNG TAHUN 2017

Background: Pregnant women usually suffer from gingivitis due to an increase in progesterone and estrogen hormones followed by hypervascularization. As the result, gingiva becomes more sensitive to plaque and calculus. Pregnant women in Trimester II began to experience gingivitis and would get worse in the trimester III. As known, gingivitis in pregnant women may be affected by age of pregnancy, occupation and education level. The aim of the study was to describe the prevalence of gingivitis in pregnant women at RSUD Klungkung, related to age of pregnancy, occupation and education. Methods: This research was a descriptive study using cross sectional study approach. Sample in this study was 85 people using consecutive sampling technique. Data collection was done by giving questionnaire and screening to pregnant women to know their gingival score. Result: The results of this study showed that most of pregnant women in trimester I experienced gingivitis score 1 (57,9%), trimester II gingivitis score 2 (65,5%), and trimester III gingivitis score 3 (83,8%). Pregnant women who did not work had more gingivitis (42%) than pregnant women who worked (37.1%). Pregnant women with lower education level experienced more gingivitis (92.8%) than pregnant women with higher education level (75%). Conclusion: The number of gingivitis in pregnant women is increasing as their age of pregnancy, where the ginggivitis score in trimester I is better than trimester III. This result also correlated with age of pregnancy, occupation and educationlevel.

Exploring Self-Care Needs of Pregnant Women with Gingivitis: A Qualitative Study in Iran.

Background:Oral self-care behaviors are not satisfactory among pregnant women; incidence of gingivitis is high in them and training programs have slightly improved their gingivitis. This study was aimed to explore self-care needs of pregnant women suffering from gingival inflammation.Materials and Methods:This study was carried out in Sanandaj, west of Iran, in 2017. Twenty pregnant women with gingivitis were included in the study. Data were collected via semi-structured individual and group interviews and note-taking, and were analyzed by conventional content analysis. To confirm the accuracy and strength of the data, credibility, confirmability, and transferability components were taken into account.Results:The results of data analysis yielded six major categories, including “organizational support,” “dentist's professional competence,” “increasing perceived threat,” “increasing self-efficacy,” “increasing perceived benefits,” and “culture-making.” Increased self-efficacy was the most important concern of pregnant women.Conclusions:The findings showed that self-care behaviors to prevent gingivitis in pregnant women are influenced by various factors. It is essential to consider the cooperation of the media and organizations, support of society, and attention of families and authorities to oral health education and disease prevention among women.

Periodontal Status and Some Variables among Pregnant Women in a Nigeria Tertiary Institution.

Background:Gingival changes during pregnancy have been well-documented. The prevalence of gingivitis in pregnant women has reportedly ranged from 30% to 100%. Increase in both the rate of estrogen metabolism and synthesis of prostaglandins by the gingiva contributed to the gingival changes observed during pregnancy. In effect increased prevalence of dental caries, gingivitis, periodontitis and tooth mobility may be encountered in pregnancy.Aim:The purpose of the study was to determine the association of some variables and the periodontal status in a sample of pregnant women attending the Ante Natal Clinic (ANC) of Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos.Subjects and Methods:Women at various stages of pregnancy, attending the ANC of LASUTH, constituted the target population. The questionnaire was administered on each patient followed by dental examinations. Periodontal status was assessed using the community periodontal index (CPI) of treatment needs. Oral hygiene status was evaluated according to Green and Vermilion simplified oral hygiene index (OHI-S).Results:The association between the CPI scores; OHI-S scores and variables such as trimester and dental visits were statistically significant.Conclusion:This study indicated that the gestational age of pregnancy and dental visits have a definite impact on the periodontal status. Oral health education should be included as an integral part of antenatal care to increase the women awareness. This would improve the mothers’ dental care-seeking behavior.

Oral health education and therapy reduces gingivitis during pregnancy

Pregnant women demonstrate increases in gingivitis despite similar plaque levels to non-pregnant counterparts. To evaluate an intensive protocol aimed at reducing gingivitis in pregnant women and provide pilot data for large-scale randomized controlled trials investigating oral hygiene measures to reduce pregnancy gingivitis and alter maternity outcomes. One hundred and twenty participants between 16 and 24weeks gestation with Gingival Index (GI) scores ≥2 at ≥50% of tooth sites were enrolled. Plaque index (PI), gingival inflammation (GI), probing depth (PD), and clinical attachment levels (CAL) were recorded at baseline and 8weeks. Dental prophylaxis was performed at baseline and oral hygiene instructions at baseline, 4 and 8weeks. Pregnancy outcomes were recorded at parturition. Mixed-model analysis of variance was used to compare clinical measurements at baseline and 8weeks. Statistically significant reductions in PI, GI, PD, and CAL occurred over the study period. Mean whole mouth PI and GI scores decreased approximately 50% and the percentage of sites with PI and GI ≥2 decreased from 40% to 17% and 53% to 21.8%, respectively. Mean decreases in whole mouth PD and CAL of 0.45 and 0.24mm, respectively, were seen. Intensive oral hygiene regimen decreased gingivitis in pregnant patients.

A clinical evaluation of the effect of 0.2% chlorhexidine gluconate as a mouthrinse on gingival inflammation in pregnant and non-pregnant women with and without undergoing scaling and root planing procedures

There is a high incidence of gingivitis in pregnant women due to combined effect of local and systemic factors. Chlorhexidine is an effective chemical plaque control agent by virtue of its property substantivity. Aim and Objective: In the present work we propose to study the effect of 0.2% chlorhexidine gluconate solution as a mouth rinse on gingival inflammation in pregnant women in comparison with non-pregnant women, before and after scaling and polishing procedures. Materials and Methods: A total number of seventy six healthy pregnant and non pregnant females in the age group of 20 to 30 years were included for the study. All the subjects used 0.2% chlorhexidine gluconate mouthrinse twice a day for 3 weeks. Weekly observations were made in both subgroups. Results: There was no significant reduction in plaque index, papilla,marginal gingiva and attached gingiva index and gingival bleeding index when 0.2% chlorhexidine gluconate mouth rinse was used alone without scaling and polishing procedures. When 0.2% chlorhexidine gluconate mouthrinse was used after scaling and polishing procedures at the end of 3 weeks, there was highly significant reduction in PMA index and gingival bleeding index in nonpregnant women group, whereas in pregnant women group there was only a significant reduction in the gingival bleeding index. Conclusion: 0.2% chlorhexidine gluconate used as mouth rinse twice a day for three weeks reduces gingival inflammation and gingival bleeding in both pregnant and non pregnant women, but significantly more in non pregnant women.

Pengaruh Status Sosial Budaya pada Kondisi Jaringan Periodontal Selama Masa Kehamilan

The effect of socio-cultural status on periodontal condition in pregnant women has been reported by a number of researches. This study aimed to investigate the effect of socio-cultural status on periodontal condition in pregnancy. The periodontal condition was evaluated for 84 pregnant women at their first, second, and third trimesters. The clinic indices include gingival index, plaque index, and the amount of subgingival plaque bacterial colonies. Statistical testing used one way Anova at 95% confidence level (α = 0.05), and t-test for the differences in the gingivitis severity of each group. The results of the study showed that gingival index, plaque index, and the amount of subgingival plaque bacterial colonies increased gradually in the first, second, and third trimesters, and that most severe gingivitis in pregnant women was associated with low level of education and unemployment. The conclusion of this study showed (1) increasing severity of gingivitis in pregnancy, (2) higher level of education is related to lower severity of gingivitis, and (3) employed women have lower rate of severe gingivitis than unemployed women.