Pregnancy and Women’s Oral Health

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Does Treatment of Periodontal Disease Improve Birth Outcomes? The Bottom Line

Pregnancy and Women’s Oral Health Effects of Periodontal Disease on Pregnancy Does Treatment of Periodontal Disease Improve Birth Outcomes? The Bottom Line

The following 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 that 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 or placental colonization.

Meta-analysis

  • 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 removal of bacterial plaques, calculus deposits, and necrotic tissue 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 scaling and root planing.
  • Other studies listed are more recent studies not included in the meta-analysis.
Study Study Type Participants Outcomes
Polyzos et al, 2009 Metaanalysis of 7 RCTs Case 1491 Control 1172 Tx produced: Lower PTB OR 0.55 (p=0.008) Lower LBW OR 0.48 (p=0.049)
Offenbacher et al, 2008 RTC Case 903 Control 903 No difference in PTB, LBW
Srinivas et al, 2009 RTC Case 311 Control 425 No difference in PTB, IUGR, Preeclampsia
Newnham et al, 2009 RTC Case 542 Control 540 No difference in PTB
Cochrane 2017 Meta-analysis of 15 RCTs 7161 participants No difference in PTB, Preeclampsia, or Perinatal Mortality; Lower LBW <2500g in subset of 7 studies, RR 0.67, 95% CI 0.48-0.95

Definitions: PTB = Preterm Birth, LBW= Low Birth Weight, OR = Odds Ratio, CI=Confidence Intervals, RR = Relative Risk

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