**4.8 Gingival enlargement during pregnancy**

The elimination of all local irritants that may be responsible for precipitating the gingival changes that occur during pregnancy should be done. This elimination is a preventive procedure to avoid any unfavorable situation as well as the treatment of gingival enlargement after it occurs. Marginal and interdental gingival inflammation and enlargement are treated by scaling and root planing. Treatment of tumor-like gingival enlargements consists of surgical excision, as well as the scaling and root planing of the tooth surfaces adjacent to the lesion. The enlargement may recur unless all irritants are removed. Food impaction is frequently an inciting factor. Gingival lesions during pregnancy should be treated as soon as they are detected, although not necessarily by surgical means. Scaling and root planing procedures and adequate oral hygiene measures may reduce the extent of the enlargement. Gingival enlargements do shrink after pregnancy, but they usually do not disappear. After pregnancy, the entire periodontal status of the patient should be reevaluated, and comprehensive treatment should be undertaken. Lesions should be removed surgically during pregnancy if they interfere with mastication or produce an esthetic disfigurement that bothers the patient. During pregnancy, the emphasis should be on (1) preventing gingival disease before it occurs and (2) treating existing gingival disease before it worsens [14].
