Periodontal disease
as a risk factor for adverse pregnancy outcomes.
Dental care during pregnancy is important, especially
for preventive (periodontal) care. Some dental treatment,
especially most elective procedures, can and should be postponed.
Most medical advice lumps all dental treatment together and that
is misguided as this and other studies support. All pregnant
women should have regular and perhaps increased visits to the
dentist and hygienist during pregnancy. -DFB
Ann Periodontol. 2003 Dec; 8(1): 70-8
Scannapieco FA, Bush RB, Paju S
BACKGROUND: Recent studies have implicated a variety of infections,
including periodontal diseases, as risk factors for adverse pregnancy
outcomes such as prematurity and low birth weight. RATIONALE:
A number of studies have shown that bacterial vaginosis is related
to preterm and/or low birth weight (PT/LBW), which continues to
be a significant cause of infant morbidity and mortality. It is
also possible that other infectious processes, including periodontal
diseases, contribute to PT/LBW. This systematic review examines
the literature to determine the possible relationship between
PT/LBW and periodontal diseases
.
FOCUSED QUESTION: Does prevention/control of periodontal
disease as compared to controls have an impact on the initiation/progression
of adverse pregnancy outcomes?SEARCH PROTOCOL: MEDLINE, pre-MEDLINE,
MEDLINE Daily Update, and the Cochrane Oral Controlled Trials
Register were searched to identify published studies that related
variables associated with PT/LBW and periodontal disease. Searches
were performed for articles published through October 2002.
INCLUSION CRITERIA: Randomized controlled clinical trials (RCTs),
case-control, and cohort studies were included. Study populations
included mothers, with or without periodontal disease, who gave
birth to preterm and/or mature infants. The interventions considered
included all forms of periodontal therapy.
EXCLUSION CRITERIA:
Only studies on humans were included.
DATA COLLECTION AND ANALYSIS: Due to study heterogeneity, meta-analysis
was not possible. MAIN RESULTS: 1. Of the over 660 studies identified,
12 (6 case-control, 3 cross-sectional and longitudinal, and 3
intervention) met inclusion and exclusion criteria and were included
in the analysis. 2. While several studies implicated periodontal
disease as a risk factor for PT/LBW, few assessed the impact of
the prevention and treatment of periodontal disease on outcomes.
3. Several epidemiologic studies did not support periodontal disease
as a risk factor for PT/LBW.
REVIEWERS' CONCLUSIONS: 1. Periodontal disease may be a
risk factor for PT/LBW. 2. Additional longitudinal, epidemiologic,
and interventional studies are needed to validate this association
and to determine whether it is causal. 3. It is not yet clear
whether periodontal diseases play a causal role in adverse pregnancy
outcomes. 4. Preliminary evidence to date suggests that periodontal
intervention may reduce adverse pregnancy outcomes.
