Third Molars and Progression of Periodontal Pathology During Pregnancy

Abstract

This study was conducted to evaluate the association between third molar periodontal pathology at enrollment and periodontal disease progression during pregnancy. The data were derived from patients in an institutional review board-approved prospective study known as the Oral Conditions and Pregnancy (OCAP) study. Demographic, health behavior, and medical history data were obtained from medical records. Full-mouth periodontal examinations of 6 periodontal probing sites for each visible tooth, including third molars, were conducted at less than 26 weeks of pregnancy and within 72 hours postpartum. The primary outcome variable was periodontal progression (4 or more probing sites with at least a 2 mm increase in probing depth (PD), all at least 4 mm deep), between the enrollment and postpartum examinations. The primary predictor variables at enrollment were at least 1 PD >or=4 mm around the third molars, and the upper tertile of the number of third molar probing sites recorded as bleeding on probing (BOP). Bivariate analyses were performed for baseline characteristics. The chi2 test was used to determine statistical significance (P = .05). Significant variables were included in unconditional logistic multivariable models to derive relative risk ratios (RRs) and 95% confidence intervals (CIs). Data from enrollment and term were available for 360 subjects with visible third molars (mean age, 27.3 years; standard deviation, 5.5 years). At the postpartum examination, 122 subjects (34%) demonstrated periodontal progression. These subjects included 74 of the 176 subjects (42%) in whom a third molar PD >or=4 mm was detected at baseline and 48 of the 184 (26%) without third molar PD >or=4 mm (P = .001). Periodontal progression was found in 40 of the 77 subjects (52%) who were in the upper tertile of the number of third molar probing sites exhibiting BOP at enrollment versus 82 of the 203 (29%) in the lower tertiles (P = .0002). In multivariable models, either third molar PD >or=4 mm at enrollment (RR = 1.4; 95% CI = 1.1 to 2.0) or third molar bleeding on probing (RR = 1.7; 95% CI = 1.3 to 2.3) was associated with periodontal disease progression. Third molar periodontal pathology appears to be a significant risk indicator for periodontal disease progression during pregnancy.