1. Preterm birth is the number one cause of neonatal mortality in the U.S. and with substantial cost burdens. If treatment of periodontal disease in pregnant women improved pregnancy outcomes it would clearly be of major public health benefit.
The table summarizes the current medical literature on this subject. At present, studies do not demonstrate that treatment of periodontal disease during pregnancy improves pregnancy outcomes. However, the studies do demonstrate that periodontitis improved with treatment and treatment is safe during pregnancy. Studies are needed to determine if pre-pregnancy treatment would lower risk as treatment during pregnancy may be too late to avoid effects of inflammation.
Meta-analysis
Offers a very thorough review of the latest evidence.
Inclusion criteria were rigorous with only good RCTs included.
Women in the treatment groups received deep root scaling and planing (vigorous cleaning below and at the gum line; the standard of care for periodontitis management) before 24 weeks gestation.
Women in the control groups received routine prenatal care but no specific dental care until after delivery when they were offered deep root scaling and planing.
Other studies listed are more recent studies not included in the meta-analysis.
Definitions
PTB = Preterm Birth
LBW= Low Birth Weight
OR = Odds Ratio
CI = Confidence Intervals
References
Polyzos NP, Polyzos IP, Mauri D, Tzioras S, Tsappi M, Cortinovis I, Casazza G. Effect of periodontal disease treatment during pregnancy on preterm birth incidence: a metaanalysis of randomized trials. Am J Obstet Gynecol ; 200(3):
Offenbacher S, Beck J, Jared H, et al. Maternal oral therapy to reduce obstetric risk(MOTOR): A report of a mulitcentered periodontal therapy randomized-controlled trial on rate of preterm delivery. Am J Obstet Gynecol. 2008; 199(6):S2.
Srinivas SK, Sammel MD, Stamilio DM, Clothier B, Jeffcoat MK, Parry S, Macones GA, Elovitz MA, Metlay J. Links Periodontal disease and adverse pregnancy outcomes: is there an association? Am J Obstet Gynecol. 2009; 200(5):497.e1-8.
Newnham JP, Newnham IA, Ball CM, et al. Treatment of periodontal disease during pregnancy: a randomized controlled trial. Obstet Gynecol. 2009; 114:
Xiong X, Buekens P, Goldenberg RL et al. Optimal timing of periodontal disease treatment for prevention of adverse pregnancy outcomes: before or during pregnancy? Am J Obstet Gynecol ; 205(111):e1-6.