Hormonal Changes as the Risk Factor That Modified Periodontal Disease in Pregnant Women: A Systematic Review

Aims:Periodontal disease is a condition characterized by a local infection and immune-inflammatory response involving the supporting tissues of the teeth. The main cause of periodontal disease is dysbiosis bacteria in dental plaque, which can be modified by risk factors, including hormonal changes during pregnancy, which cause various physical changes, including periodontium. This study aimed to review the influence of hormonal changes in pregnancy based on clinical findings and biological changes.Materials and Methods:This study was conducted in PubMed NCBI, Cochrane, ScienceDirect, EBSCOhost database, and web search engine Google Scholar using a systematic review method with Population, Intervention, Comparison, and Outcomes based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The inclusion criteria were articles in English from 2013 to 2023 that discussed the influence of hormone changes on periodontal tissues in pregnant women.Results:Articles that comply with the inclusion criteria of this study were nine articles. The study designs included cross-sectional, randomized control trials, and cohorts. Four articles observed the condition of periodontal tissues based on periodontal pocket depth (PPD) and clinical attachment loss (CAL), one article based on PPD only, and two articles based on plaque index. All of the nine articles observed the periodontal condition based on bleeding on probing. Eight out of nine included articles stated a positive correlation between hormone levels and the condition of periodontal tissues in pregnant women.Conclusions:The increase in hormone levels during pregnancy is the risk factor that can modify periodontal tissue conditions based on clinical findings, such as PPD and CAL, and also affects biological changes in the total number of biofilms and proinflammatory cytokines.