It is often said that most dental problems do not become serious over night, they become serious when ignored.
I can correlate to this statement when I recently encountered a similar case.
A 28 year old pregnant patient, in her eighth month of pregnancy, walked into our clinic with a complain of large reddish growth on gums that bled easily and affected her speech and mastication.
On examination, it was a Pyogenic granuloma — a common condition in pregnant patients due to hormonal changes. The patient revealed that the growth started as a small, painless swelling during the fourth month of pregnancy. But she believed that dental treatment is not safe during pregnancy. Assuming that it will resolve on its own, she ignored it.
Over the months, the swelling gradually increased. It became painful, started bleeding frequently and interfering with her daily activities. By the time she came to us, what could have been a simple procedure had turned into a complicated situation.
Ideally, pyogenic granuloma needs surgical removal and second trimester (4 - 6 months) of pregnancy is considered safest for performing dental procedures. The third trimester is generally avoided until and unless it is an emergency. Unfortunately, in this case, the gynecologist didn’t permit any surgical procedure due to her previous gynecological history.
At the end, we were left with no option but to provide symptomatic treatment — reduce pain, irritation and maintain oral hygiene. The definitive treatment had to be delayed until after delivery. If the patient had turned up early, we could have treated her, safely and more effectively.
What went wrong?
The problem here was not the condition itself. Pyogenic granuloma is a very common condition among pregnant patients. But the lack of awareness and ignorance complicated it.
Many patients still believe that dental treatment should be avoided during pregnancy. In reality, most dental procedures can be safely carried out during the second trimester with proper precautions and coordination with a gynecologist.
Key takeaways from this case
This clinical case highlights that:
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Most dental procedures can be safely performed during second trimester.
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Guidance from a healthcare professional is always better than assumptions.
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Early intervention can prevent complications.
If the patient had visited early, when she first saw the swelling, the outcome would have been different - less discomfort and fewer limitations.
Final thoughts
Maintaining oral hygiene is extremely important during pregnancy. Hormonal changes during pregnancy can affect oral health. Conditions like pyogenic granuloma can occur during pregnancy and are manageable if addressed early.
Moreover, gynecologists can also encourage patients to get dental checkups during pregnancy. As healthcare professionals, awareness is something that we can build together.
Regular checkups during pregnancy can help diagnose problems early and timely intervention can be done before the problems worsen.
MBH/PS