Periodontal disease treatment and risk of preterm birth: a systematic review and meta-analysis

Abstract

The events leading to preterm birth are still not completely understood. A quantitative systematic review was performed to estimate the effects of periodontal care during pregnancy on preventing preterm birth and low birth weight. The meta-analysis included randomized trials with pregnant women with a diagnosis of periodontal disease before 20 weeks of gestation. Relative risk (RR) with 95% confidence intervals (95%CI) was calculated. We evaluated the reduction in preterm and low birth weight. Thirteen trials were included, comparing 3,576 women in intervention groups with 3,412 women receiving usual care. The meta-analysis of the effects of periodontal disease treatment during pregnancy indicated a non-significant reduction in preterm births (RR = 0.90; 95%CI: 0.68-1.19) and low birth weights (RR = 0.92; 95%CI: 0.71-1.20). The creation and examination of a funnel plot revealed clear evidence of publication bias. In summary, primary periodontal care during pregnancy cannot be considered an efficient way of reducing the incidence of preterm birth.

Exploring Preterm Birth as a Polymicrobial Disease: An Overview of the Uterine Microbiome

“…There are increasing reports that bacteria, specifically those from the oral cavity, are able to spread hematogenously from the maternal bloodstream to the uterine cavity (5). This is further supported by apparent associations between periodontal disease and PTB (71, 72), although this association is also contentious with numerous studies (73), including a large randomized-controlled trial (74) finding that treatment of periodontal disease during pregnancy does not reduce the rate of PTB.…”

Periodontal Disease and Pregnancy Outcome. Are we Still in the Same Place?

“…But for others, some evidence from observational studies suggests that periodontal intervention may reduce adverse pregnancy outcomes [25]. Although Rosa et al [26] add that treatment of periodontal disease with scaling and root planning cannot be considered to be an efficient way of reducing the incidence of preterm birth. Women may be advised to have periodical dental examinations during pregnancy to test their dental status and may have treatment for periodontal disease [26].…”

“…Although Rosa et al [26] add that treatment of periodontal disease with scaling and root planning cannot be considered to be an efficient way of reducing the incidence of preterm birth. Women may be advised to have periodical dental examinations during pregnancy to test their dental status and may have treatment for periodontal disease [26]. However, they should be told that such treatment during pregnancy is unlikely to reduce the risk of preterm birth or low birthweight infants [27] and primary periodontal care during pregnancy cannot be considered an efficient way of reducing the incidence of preterm birth [26].…”

“…Women may be advised to have periodical dental examinations during pregnancy to test their dental status and may have treatment for periodontal disease [26]. However, they should be told that such treatment during pregnancy is unlikely to reduce the risk of preterm birth or low birthweight infants [27] and primary periodontal care during pregnancy cannot be considered an efficient way of reducing the incidence of preterm birth [26]. On the other hand, George et al [28] said cumulative evidence suggests that periodontal treatment during pregnancy may reduce preterm birth and low birth weight incidence.…”

Periodontitis, cardiovascular disease and pregnancy outcome – focal infection revisited?

“…While it has been established that periodontal treatment in pregnancy can improve oral health 111,112 and be matched by beneficial changes in oral microbiological status, 113 the majority of large well executed studies have failed to show any effect of nonsurgical periodontal treatment on the incidence of adverse pregnancy outcomes, [112][113][114][115][116][117] and this has been supported by systematic reviews. 118,119 It is unclear why treatment has failed to show improvements even though other data suggest that it may be expected to do so. This anomaly may be related to the effects of confounders as outlined above, or to the fact in some studies it was not possible to obtain what the authors called 'complete periodontal health' .…”