**2. Conclusion**

Pregnancy in woman brings about profound changes in innate and adaptive immunity of the mother and fetus; these changes play a major role altering the clinical course of a number of infectious diseases, including periodontal diseases. The severity of gingival and periodontal diseases increases during the course of normal pregnancy. Gingival inflammation and tissue response toward the microbial plaque is exaggerated during pregnancy due to the hormonal factors and is accepted by the scientific community. Pregnant women with previously existing periodontal disease will have increased destruction of the periodontal structures. The gingival changes observed during pregnancy return to normal limits immediately after delivery of the baby, if the local irritants are removed; this phenomenon is called as "immune reconstitution syndrome." Gestational diabetes which occurs in certain pregnant women can increase the risk for periodontal diseases, and it should be well controlled by treating gynecologist. Preeclampsia if not detected and treated can cause serious condition eclampsia leading to convulsions, coma, and death of the mother.

Large numbers of epidemiological studies suggest that periodontal infection is a modest risk factor for several adverse pregnancy outcomes. The studies conducted to link between periodontal diseases and adverse pregnancy outcomes have had contradictory results, as they were carried out in different sets of populations or with different study designs. It is better to consider periodontal disease as a risk factor for adverse pregnancy outcome, as thorough oral health maintenance helps the pregnant women attain a better oral health which is part of general health.

Controversies in the academic community regarding the treatment of periodontal problems have been eradicated. It is well accepted that oral prophylaxis and nonsurgical periodontal therapy can be rendered to pregnant women in the second trimester.

Periodontal diseases go unnoticed in the initial stages of disease process. The inflammatory load of periodontal disease can enter the systemic circulation and can be a risk factor for several host tissues and physiological activities. There is definite link between periodontal diseases and adverse pregnancy outcomes, through direct or indirect mechanisms. The direct action of perio-pathogenic organisms on amnion and indirect action through systemic circulation by production of inflammatory mediators can be risk for adverse pregnancy outcomes.
