Tag Archives: gum disease

Gum Disease Treatment Recommended During Pregnancy

One of the joys for me in being a family physician is the honor I have had to attend the births of over 1500 of my patients. There’s nothing quite like the experience (indeed, the miracle) of a birth. And, arriving at a safe and healthy birth involves a lot of prenatal prayer and excellent care. As part of my prenatal care, I’ve emphasized to women the critical value of brushing and flossing. Most of my patients did not know:

(1) gum disease can be prevented,

(2) gum disease can be safely treated during pregnancy, and

(3) preventing or treating gum disease in pregnancy significantly reduces the risk of premature birth associated with periodontal disease.

Here’ s the latest article on the the most recent study looking at treating gum disease in pregnancy:

“The present study has potential implications” for the calculations dentists make when deciding whether to treat gum disease during pregnancy, the researhers write in the British Journal of Obstetrics and Gynecology.

Gum disease – typically caused by a bacterial infection that deteriorates gum tissue and leaves it chronically inflamed – is a particular problem during pregnancy. Hormonal changes appear to make a pregnant woman more susceptible to developing it, yet the standard tetracycline-based therapy is not recommended because of its risk to the baby.

Nevertheless, considerable evidence points to gum disease itself raising the risk of premature birth.

Dr. Marjorie Jeffcoat of the University of Pennsylvania’s School of Dental Medicine and her colleagues wanted to know if treating pregnant women with periodontal disease using non-drug methods would reduce their risk of early delivery.

The group recruited 322 pregnant women with gum disease for the study. Participants were randomly assigned to receive active treatment in the form of an aggressive teeth-cleaning method – known as scaling and planning – plus oral hygiene education, or to get oral hygiene education alone. (After delivery of their babies, all study participants were offered treatment for their gum disease.)

At the study’s conclusion, the researchers found no statistically significant difference in the number of premature births among the women who had been treated and the ones who were not. Of the untreated women, 52.4 percent delivered early, while 45.6 percent of women getting treatment had early births.

On closer analysis, however, treatment – when it was successful in curing the gum disease – appeared to reduce the likelihood of an early delivery considerably; “a very exciting finding,” Jeffcoat said.

Among the women in the treatment group, 42 were treated successfully, meaning that on a second dental exam, their gum inflammation had disappeared and the separation of their gums from the teeth had not progressed any further. One hundred and eleven women in the treatment group continued to show signs of gum disease, representing unsuccessful treatment.

Just four of the 42 successfully treated women, or 10.5 percent, delivered prematurely compared to 69 premature deliveries, or 62 percent, among the 111 women who failed treatment.

The researchers conclude that their results confirm the non-drug treatment method is safe and associated with reduced risk of premature birth.

“It is appropriate for obstetricians to refer patients who require dental care to the dentist,” they write.

“It’s not enough to treat periodontal disease, however,” Jeffcoat told Reuters Health. “The treatment must be ‘successful’ and why the scaling and planing treatment was successful in some women and not others isn’t known yet.”

Studies to answer those questions are currently underway.

Regular teeth brushing linked to healthier hearts

Your mom told you to brush your teeth at least twice a day. Now comes another study proving mom right.

Long-time readers know that in at least one past blog, I’ve discussed the cardiovascular benefits of dental and gum health. Now comes a report from Reuters Health claiming “People who don’t brush their teeth twice a day have an increased risk of heart disease.” This new study adds scientific weight to 19th and 20th century theories about oral health and chronic disease.

British researchers studied nearly 12,000 adults in Scotland and found those with poor oral hygiene had a 70 percent extra risk of heart disease compared with those who brushed twice a day and who were less likely to have unhealthy gums.

People with gum disease are more likely to develop heart disease and diabetes because inflammation in the body, including in the mouth and gums, plays a role in the build up of clogged arteries, said Richard Watt from University College London, who led the study.

The 70 percent extra risk compares to a 135 percent extra risk of heart disease in those who smoke, he said.

Although the overall risk was low — with a total of 555 heart attacks or other serious coronary problems among 11,869 people — the effect of regular teeth brushing was significant.

“Compared to things like smoking and poor diet, which are obviously the main risk factors for heart disease, we are not claiming this is in the same league,” Watt said.

“But … even after controlling for all those things there is a still a relationship between this very simple measure of tooth brushing and heart condition,” he told Reuters.

OLD THEORIES

“In a way, it’s really quite an old story, because back in the early 19th century there was a theory called focal sepsis, and people believed that infections in the mouth caused disease in the whole body,” Watt said.

“As a result, they used to take everyone’s teeth out.”

Watt said such a response was “a bit dramatic,” but his findings did suggest that twice-a-day brushing was a good idea.

Gum or periodontal disease is an infection of the tissues surrounding and supporting the teeth and is more likely to occur in people who do not brush their teeth regularly.

Heart disease is the leading killer of men and women in Europe, the United States and many other rich nations and together with diabetes, accounted for almost a third of all deaths around the world in 2005, according to the World Health Organization.

The teeth brushing study published in the British Medical Journal was the first to investigate whether the simple number of times someone brushes their teeth daily has any bearing on the risk of heart disease.

The results showed oral health behaviors were generally good, with 62 percent of participants saying they visited the dentist every six months and 71 percent reporting they brushed their teeth twice a day.

Once the data were adjusted for other known heart risk factors such as social class, obesity, smoking and family history of heart disease, those who reported less frequent teeth brushing had a 70 percent extra risk of heart disease compared to those who brushed twice a day.

Blood tests on those with poor oral hygiene were also positive for two factors called C-reactive protein and fibrinogen — both of which signal inflammation in the body.

Dr. Walt’s Take on the Health Headlines – May 28, 2008

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