The association between hyperemesis gravidarum and periodontal disease in pregnancy

Abstract

Purpose: Periodontal diseases (PDs) are considered a risk factor for some systemic conditions such as cardiovascular diseases, diabetes, and adverse pregnancy outcomes. Hyperemesis gravidarum (HG) is a common health problem, and inflammation is claimed to play a vital role in its etiopathogenesis. Here, we aimed for the first time to demonstrate the relationship between PD and HG. Materials and Methods: A total of 30 pregnant with HG and 30 healthy pregnant between the age group of 18 and 40 years were enrolled in the study. HG was diagnosed if the followings were present: at least one-positive ketonuria, >5% weight loss, and severe vomiting, which is >2 times a day. Periodontal status was evaluated by the plaque index (PI), gingival index (GI), probing pocket depth (PPD), and bleeding on probing index (BOPI), and these parameters were recorded. All measurements were performed at 6 points of each tooth (mesiobuccal, midbuccal, distobuccal, mesiolingual, midlingual, and distolingual) and compared between the groups. Results: Mean age was 29 ± 3 in HG and 28 ± 4 in the control group. There was no difference between two groups according to the age (P = 0.421), gravida (0.524), and parity, (P = 0.54). PI, GI, PPD, and BOPI were significantly higher in HG group as compared to controls. Conclusions: Gingival inflammation is more common in patients with HG, and it is possibly associated with insufficient tooth brushing because it may stimulate the gagging reflex and vomiting. Since there could be a vicious cycle between PD and HG, periodontal preventive programs are crucial for pregnant women with HG.