The effects of periodontal treatment on pregnancy outcomes

Abstract

Background: Preterm infants are at greater risk than term infants for physical and developmental disorders. Morbidity and mortality increases as gestational age at delivery decreases. Observational studies indicate an association between poor periodontal health and risk for preterm birth or low birthweight, making periodontitis a potentially modifiable risk factor for prematurity. Aim: To identify randomized controlled trials (RCTs) published between January 2011 and July 2012 and discuss all published RCTs testing whether periodontal therapy reduces rates of preterm birth and low birthweight. Methods: Search of databases including PubMed, ISI Web of Science and Cochrane Library. Results: The single RCT identified showed no significant effect of periodontal treatment on birth outcomes. Discussion: All published trials included non‐surgical periodontal therapy; only two included systemic antimicrobials as part of test therapy. The trials varied substantially in terms of sample size, obstetric histories of subjects, study preterm birth rates and the periodontal treatment response. The largest trials – also judged to be high‐quality and at low risk of bias – have yielded consistent results, and indicate that treatment does not alter rates of adverse pregnancy outcomes. Conclusion: Non‐surgical periodontal therapy, scaling and root planing, does not improve birth outcomes in pregnant women with periodontitis.

Periodontal Treatment for Preventing Adverse Pregnancy Outcomes: A Meta- and Trial Sequential Analysis

“…Considering these limitations and our results, the summarized evidence is insufficient to support or refute periodontal treatment for reducing adverse pregnancy outcomes. Our findings add weight to previous studies [ 25 – 29 ], which doubted the association between periodontal treatment and PTB or LBW found by observational studies [ 30 , 31 ]. Possible reasons for the discrepancy between results from observational studies and randomized clinical trials have been discussed elsewhere [ 25 , 31 ].…”

Design features of the Diabetes and Periodontal Therapy Trial (DPTT): A multicenter randomized single-masked clinical trial testing the effect of nonsurgical periodontal therapy on glycosylated hemoglobin (HbA1c) levels in subjects with type 2 diabetes and chronic periodontitis

“…Although some have advocated for the use of such endpoints [38], the minimal response needed to improve glycemic control in patients with T2DM has not been determined. The periodontology community also lacks a consensus regarding the definition of “successful” treatment in terms of PD and BOP reductions [39]. Thus, we standardized treatment by requiring therapists to be trained and certified, by specifying a minimum length of treatment, and by utilizing an independent examiner to verify complete plaque and calculus removal.…”

Potential Common Key Genes Associated with Chronic Periodontitis and Low Birth Weight: A Case Control Study Using Bioinformatics Analysis of Pooled mRNA Expression Datasets

“…However, conversely, some studies have reported nding no association between CP and preterm LBW, and that treatment for periodontitis had no effect on the prevention of LBW [55][56][57][58][59][60][61][62][63][64][65][66]. Furthermore, as LBW is related to numerous risk factors, such as the mother's age, onset of prenatal care, systemic diseases, previous LBW infants, complications during pregnancy, and term of delivery, CP may not be an important risk factor for LBW [23][24][25][26][27]67].…”