Pregnancy and Periodontal Disease: Does Exist a Two-Way Relationship?

Abstract

Periodontal disease (PD) is an inflammatory disease of the tissues supporting the teeth. PD affects 65 million adults over the age of 30 years in the USA, and worldwide 5 to 70% of adults. Women who develop PD during pregnancy, it's estimated 1 woman in 5, may have a higher risk of adverse pregnancy outcomes. PD during pregnancy starts by dental plaque and is increased by the action of pregnancy hormones. In order to study the effect of PD on adverse pregnancy outcomes, we have performed this narrative review summarising the current studies about the influence of PD on pregnancy. Periodontal pockets are a reservoir of oral microbiota. Modifications in oral microbiota may be considered as a potential mechanism for developing PD during pregnancy. PD is surely caused by bacteria, but the progression and worsening are due to a host immune response. The inflammation caused by PD is not limited to the oral cavity. It is hypothesized that episodes of bacteraemia and dissemination of endotoxins from periodontal pockets can induce the activation of the systemic immune response. In conclusion our narrative review shows that there's no relationship between PD and adverse pregnancy outcomes, and PD treatment during pregnancy does not confer a general protection against adverse pregnancy outcomes.

Prevalence of and risk factors for periodontal disease among pregnant women in an antenatal care clinic in Khartoum, Sudan

“…During pregnancy, due to hormonal factors (high oestrogen and progesterone), women are more vulnerable to periodontal disease than their non-pregnant peers [5]. Pregnant women with periodontal disease are more susceptible to poor maternal and perinatal outcomes such as preeclampsia [6], gestational diabetes [7], vulvovaginitis, preterm labour, foetal growth restriction [8], low birth weight [9] and perinatal mortality [10].…”

A 28-year-old pregnant woman with severe toothache

“…But, once one gets an acute problem that is severe and makes life very restless must be treated but with every caution. 21,22 This patient has a severe toothache in the six weeks of her pregnancy. It could be better if it could be neglected and done in the next trimester but it could give severe suffering and distress to the mother and at the same time to the fetus.…”

Mitos y evidencias en odontología sobre la gestación

“…Cambios en el sistema renal. Cuando el flujo sanguíneo renal y la tasa de filtración glomerular aumenta esto puede conducir a una mayor eliminación de los fármacos que normalmente se excretan sin cambios ( 8 ) (tabla 1 que ocasiona las bolsas periodontales; estas bacterias pueden traspasar la placenta y causar infecciones agudas o efectos adversos en el bebé ( 10,11 ).…”