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.