Periodontal treatment among mothers with mild to moderate periodontal disease and preterm birth: reanalysis of OPT trial data accounting for selective survival

Merchant, Anwar T.; Sutherland, Melanie W.; Liu, Jihong; Pitiphat, Waranuch; Dasanayake, Ananda P.

doi:10.1093/ije/dyy089

Cited by 26 publications

(39 citation statements)

References 27 publications

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“…Moreover, it is not known whether women who self-reported periodontal disease during pregnancy had sought dental treatment. Recent reanalysis of the Obstetrics and Periodontal Therapy (OPT) trial data concluded that periodontal treatment among mothers with mild to moderate periodontal disease before 21 weeks of gestation may prevent preterm births [25]. Women of childbearing age should be examined by dental practitioners regularly and screened for periodontal disease and if the disease is present, they should be offered treatment options appropriate to the level of disease observed.…”

Section: Discussionmentioning

confidence: 99%

Association of periodontal disease with depression and adverse birth outcomes: Results from the Perinatal database; Finger Lakes region, New York State

Kopycka‐Kedzierawski

Xiao

et al. 2019

PLoS ONE

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Preterm and low birth weight infants are at greater risk for mortality and a variety of health and developmental problems. Data from the Finger Lakes Perinatal Data System database on 316,956 deliveries occurring between 2004–2014 and pregnancy outcomes were analyzed to assess the association of periodontal (gum) disease with depression, other maternal factors and adverse birth outcomes. Adjusted effects of periodontal disease and depression on adverse birth outcomes were estimated using multiple logistic regression models and path analysis. Having preterm delivery was associated significantly with depression (OR = 1.177; 95% CI: [1.146, 1.208]), having adequate health care (OR = 1.638; 95% CI: [1.589, 1.689]), smoking during pregnancy (OR = 1.259; 95% CI: [1.220, 1.300]), and being less educated (OR = 1.214; 95% CI: [1.174, 1.256]). Having low birth weight was significantly associated with depression (OR = 1.206; 95% CI: [1.170, 1.208]), smoking during pregnancy (OR = 1.855; 95% CI: [1.793, 1.919]), and being less educated (OR = 1.322; 95% CI: [1.275, 1.370]). Periodontal disease was significantly associated with alcohol use during pregnancy (OR = 1.314; 95% CI: [1.227, 1.407]) and white race (OR = 1.192; 95% CI: [1.167, 1.217]). Depression was significantly associated with periodontal disease (OR = 1.762; 95% CI: [1.727, 1.797]) and alcohol use during pregnancy (OR = 1.470; 95% CI: [1.377, 1.570]). We concluded that a positive association existed between depression during pregnancy and adverse birth outcomes, and that depression served as a mediator in the association of periodontal disease with adverse birth outcomes.

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Section: Discussionmentioning

confidence: 99%

Association of periodontal disease with depression and adverse birth outcomes: Results from the Perinatal database; Finger Lakes region, New York State

Kopycka‐Kedzierawski

Xiao

et al. 2019

PLoS ONE

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“…Furthermore, these null findings were also supported by the largest RCT (n = 1,806) on periodontitis and preterm birth (Offenbacher et al 2009). However, a reanalysis of the Michalowicz et al (2006) study using a survivor average causal effect analysis to correct potential bias for fetal survival between the treatment and control groups resulted in a positive treatment effect (Merchant et al 2018).…”

Section: The Periodontitis and Adverse Pregnancy Outcomes Timelinementioning

confidence: 99%

Periodontal Medicine: 100 Years of Progress

et al. 2019

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Periodontal medicine is a term used to describe how periodontal infection/inflammation may impact extraoral health. Periodontitis has been linked to over 50 systemic diseases and conditions. As part of the Journal of Dental Research’s Centennial Celebration, this narrative review discusses periodontal medicine research done over the past 100 y, with particular focus on the effects of periodontal disease on 3 pathological conditions: cardiovascular disease, diabetes mellitus, and adverse pregnancy outcomes. We selected 29 total studies that were the “first” of their kind, as they provided novel observations or contributed to shifting paradigms as well as important studies that made strong contributions to progress in understanding relationships to the systemic conditions. These studies were organized in an overview timeline and broken down into timelines by topic: cardiovascular disease ( n = 10), diabetes ( n = 12), and adverse pregnancy outcomes ( n = 7). Overall, the majority of cross-sectional, case-control, and longitudinal studies have revealed positive associations between poor periodontal status and cardiovascular disease, diabetes metabolic control, and a number of adverse pregnancy outcomes, and these associations are upheld in systematic reviews. Findings from randomized controlled trials testing the effects of periodontal therapy on systemic health outcomes were conflicting and inconsistent. While there has been a great deal of progress, we highlight lessons learned and make comments and suggestions on a number of key aspects, including the heterogeneity of case definitions of periodontal disease across studies, accounting for features of the periodontal phenotype that are most relevant to the biological link between periodontitis and systemic outcomes, the role of other comorbid inflammatory conditions, selection of study participants, and timing and intensity of the periodontal intervention.

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“…Cohort studies have shown a relationship between periodontal disease, premature delivery, and low birth weight [16,17,18], as it has been confirmed in some systematic reviews [19,20,21,22]. On the other hand, clinical trials have studied the effect of periodontal treatment on adverse pregnancy outcomes and showed controversial results [8,21,22,23,24,25,26,27,28,29,30,31]. This is probably because there is a marked heterogeneity between studies in terms of the population´s characteristics (race, age, etc.)…”

Section: Introductionmentioning

confidence: 99%

Non-Surgical Treatment of Periodontal Disease in a Pregnant Caucasian Women Population: Adverse Pregnancy Outcomes of a Randomized Clinical Trial

Caneiro-Queija

López-Carral

Martín-Lancharro

et al. 2019

IJERPH

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Aim: To analyze if non-surgical treatment of periodontitis in a pregnant Caucasian women population can reduce adverse pregnancy outcomes. Methods and results: A parallel randomized clinical trial was designed and approved by the Ethical Committee of Sanitary Area Santiago-Lugo, Spain (registration number: 2016/451). Forty patients with periodontitis stage II grade B were randomly allocated to receive either comprehensive non-surgical periodontal therapy (test group; n = 20) or professional tooth cleaning (control group; n = 20) before 24 gestational weeks. Randomization was computer-generated by the statistic program Epidat v.4.1 and allocation was performed using sealed opaque envelopes. Clinical measurements and peripheral blood samples for biochemical variables were collected at baseline, in the middle of second trimester before non-surgical treatment, and in the third trimester. Microbiological samples were collected in the second and third trimester. A statistically significant reduction was verified in all clinical and microbiological parameters after periodontal treatment in the test group. No significant differences were observed for the rest of the variables, including preterm birth and/or low birth weight. No adverse events related to periodontal treatment were reported. Conclusions: Non-surgical periodontal treatment in Caucasian patients with periodontitis stage II grade B did not significantly reduce the risk of adverse pregnancy outcomes.

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Periodontal treatment among mothers with mild to moderate periodontal disease and preterm birth: reanalysis of OPT trial data accounting for selective survival

Abstract: Periodontal treatment provided to mothers with mild to moderate periodontal disease before 21 weeks of gestation may prevent preterm births.

Cited by 26 publications

References 27 publications

Association of periodontal disease with depression and adverse birth outcomes: Results from the Perinatal database; Finger Lakes region, New York State

Association of periodontal disease with depression and adverse birth outcomes: Results from the Perinatal database; Finger Lakes region, New York State

Periodontal Medicine: 100 Years of Progress

Non-Surgical Treatment of Periodontal Disease in a Pregnant Caucasian Women Population: Adverse Pregnancy Outcomes of a Randomized Clinical Trial

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