Gingivitis is inflammation of the gingiva without destruction of the periodontal ligament or bone, which distinguishes it from periodontitis. Pregnancy-related gingivitis affects 25–75% of pregnant women. It likely occurs because immunosupression and hormonal changes cause an altered response to bacterial plaque. Symptoms Mild gum swelling Tenderness Erythema Bleeding gums when brushing Typically identified in the second month and peaks in the eighth month. Etiology Plaque buildup from poor oral hygiene triggers gingival inflammation Changes in hormone levels as a result of puberty, pregnancy, and diabetes modify the gingival response to plaque, resulting in increased gingivitis. During the second trimester, there is a shift from predominant periodontal pathogens to destructive anaerobes, which frequently triggers gingival inflammation. Decrease in cellular immunity during pregnancy exacerbates this process. Preventative Measures & Treatment Maintaining excellent oral hygiene through frequent brushing and flossing Regular dental visits to monitor oral hygiene and to reinforce appropriate home care Photos show erythema and swelling of the gingiva. References Barak S, Oettinger-Barak O, Oettinger M, Machtei EB, Peled M, Ohel G. Common oral manifestations during pregnancy: A review. Obstetrical and Gynecological Survey 2003;58(9):624-628. Boggess KA. Maternal Oral Health in Pregnancy. Obstet and Gynecol. 2008; 111(4):976-986.