Epulis of Pregnancy

During week 28 of her pregnancy, a 28-year-old woman presented with a gingival hemangioma between the right upper central incisor and canine tooth. The asymptomatic lesion arose during the thirteenth week of her pregnancy; it gradually enlarged and bled occasionally with minor trauma. The patient had no similar lesions in her 2 previous pregnancies.

Hemangiomas of gingival capillaries (epulis of pregnancy) are treated with proper dental hygiene and avoidance of trauma. Surgical excision, cryotherapy, and electrodesiccation can cause unnecessary blood loss or permanent disfigurement and should be avoided. The lesion usually resolves spontaneously after delivery.

The differential diagnosis includes pyogenic granulomas of pregnancy (granuloma gravidarum), which are associated with extensive gingivitis and may arise anywhere in the oral cavity, often from the gingival papillae.