Periodontal Disease In Pregnancy Research Articles

An overview of periodontal disease in pregnancy

Periodontal disease (PD), an inflammatory and infectious condition affecting the tissues supporting teeth, is prevalent among pregnant women due to hormonal changes. Studies indicate a link between PD and adverse pregnancy outcomes, including preterm labor and low birthweight newborns, likely due to increased inflammatory mediators. Oral pathogens like Tannerella forsythia and Porphyromonas gingivalis have been associated with these complications. The most prevalent oral conditions affecting pregnant women that may influence the course of their pregnancy are periodontitis, gingivitis, and dental caries. From supragingival plaques to subgingival infections and PD, these conditions are linked to one another. Elevated maternal serum antibodies to these pathogens and inflammatory markers correlate with poor pregnancy outcomes. Animal models further support the connection between PD and fetal health issues. While research suggests that periodontal treatment may reduce the risk, the exact mechanisms remain complex and multifactorial. Integrating dental care into prenatal care is vital for prevention and management.  

Bibliometric Analysis of the Knowledge Landscape of Periodontal Disease in Pregnancy: A Noteworthy Multidisciplinary Issue

Bibliometric Analysis of the Knowledge Landscape of Periodontal Disease in Pregnancy: A Noteworthy Multidisciplinary Issue

Periodontal disease in pregnancy: A comparative prospective study.

Periodontal disease affects many pregnant women and may be associated with adverse pregnancy outcomes. The object of this study was to evaluate women's level of knowledge about this condition in pregnancy. We compared level of knowledge, participation in medical screening, and periodontal health status in pregnant women and nonpregnant controls. This study included 141 pregnant and 141 nonpregnant women, examined by one examiner at the Department of Gynecology and Obstetrics of the University Hospital Muenster, Germany. With reference to periodontal health status, the Periodontal Screening Index was used and a questionnaire was designed to represent the level of knowledge and predisposing factors. Pregnant women showed a strong tendency towards higher Periodontal Screening Indices than the nonpregnant controls (P=0.058). A strong positive correlation between participation in screenings and a lower Periodontal Screening Index was measured, but no direct relation between knowledge and periodontal health was detected. However, a better level of knowledge correlated noticeably with participation in screening programs. Educational attainment was found to be a main factor correlated with periodontal health and further factors such as medical screening and smoking habits. A great number of women felt they were not sufficiently informed about oral health aspects in pregnancy. As participation in screenings was a main item that positively correlated with healthier periodontal status, it had to be a focused element. The possible positive influence of knowledge regarding the participation in screening programs showed not only the need to spread awareness but also the need for proper education.

Periodontal disease in pregnancy and adverse pregnancy outcomes: Progress in related mechanisms and management strategies.

Periodontal disease is an inflammatory and destructive disease of tissues supporting the tooth. A large number of studies have confirmed that periodontal pathogens and their metabolites can lead to adverse pregnancy outcomes in direct or indirect ways. Adverse pregnancy outcomes, such as preterm birth, low birth weight, and pre-eclampsia, have a serious impact on human reproductive health. In recent years, although the level of global medical technology has gradually improved, the incidence of adverse pregnancy outcomes has not declined and is still a global public health problem. The purpose of this review is to summarize the current data on periodontal disease in pregnancy and adverse pregnancy outcomes, including the association between periodontal disease and adverse pregnancy outcomes, the pathogenic mechanism related to this association, the efficacy of different nutrition supplements for both periodontal disease and adverse pregnancy outcomes and the effect of providing periodontal treatment on the occurrence of adverse pregnancy outcomes, to provide guidance for the prevention and treatment of adverse pregnancy outcomes in clinical practice.

Gestational periodontitis impact on the fetus and neonate

Maternal oral pathologies during pregnancy represent a controversial subject. The incidence of periodontal disease is approximatively 40% among pregnant women. Periodontal disease has been associated with several unfortunate outcomes; among them, the most important are cardiovascular disorders, respiratory infections, diabetes and Alzheimer's disease. Regarding mechanisms, bacteria enter the blood stream and cross the placenta or the inflammatory mediators can affect the fetoplacental unit or generate an increased inflammatory response with subsequent consequences on the fetus. The most disputed subjects concerning periodontal disease in pregnancy are related to the effects on the pregnancy outcome and the offspring, respectively the associations between maternal periodontal disease and small for gestational age, preeclampsia, arteriosclerosis, gestational diabetes and perinatal mortality. In order to improve neonatal outcome and ensure maternal oral health, we should assure that the necessary dental treatment is provided during the entire pregnancy, preferably between 14 and 20 gestational weeks. Moreover, women should be encouraged to received dental treatment preconceptionally.

Periodontal disease and preterm birth: Findings from the 2015 Pelotas birth cohort study.

To verify the association between periodontal conditions and preterm birth. This study used data from the 2015 Pelotas Birth Cohort Study, Brazil. Pregnant women expected to give birth in 2015 were interviewed and dentally examined by a trained dentist, with periodontal measures collected in all teeth, six sites per tooth. Exposure was periodontal disease. Outcomes were preterm birth (all births <37weeks of gestational age) and early preterm birth (<34weeks). Analysis was carried out using Poisson regression according to a directed acyclic graph. A total of 2,474 women participated in the study. Incidence of preterm births was 10.2% and of early preterm births was 3.5%. Frequency of gingivitis was 21.7%, and periodontitis was 14.9%. Periodontitis was associated with a risk almost two times higher of having early preterm delivery compared with healthy pregnant women (RR 1.93; 95% CI 1.09-3.43). Presence of 5+ mm periodontal pocket with bleeding on probing was also associated with higher risk for early preterm delivery. The association between periodontal disease in pregnancy and the occurrence of preterm delivery is sensitive to the case definitions. Periodontal disease increased the risk of early preterm delivery.

The Association between Hyperemesis Gravidarum and Periodontal Disease in Pregnancy

Abstract Purpose: Periodontal diseases (PDs) are considered a risk factor for some systemic conditions such as cardiovascular diseases, diabetes, and adverse pregnancy outcomes. Hyperemesis gravidarum (HG) is a common health problem, and inflammation is claimed to play a vital role in its etiopathogenesis. Here, we aimed for the first time to demonstrate the relationship between PD and HG. Materials and Methods: A total of 30 pregnant with HG and 30 healthy pregnant between the age group of 18 and 40 years were enrolled in the study. HG was diagnosed if the followings were present: at least one-positive ketonuria, &gt;5% weight loss, and severe vomiting, which is &gt;2 times a day. Periodontal status was evaluated by the plaque index (PI), gingival index (GI), probing pocket depth (PPD), and bleeding on probing index (BOPI), and these parameters were recorded. All measurements were performed at 6 points of each tooth (mesiobuccal, midbuccal, distobuccal, mesiolingual, midlingual, and distolingual) and compared between the groups. Results: Mean age was 29 ± 3 in HG and 28 ± 4 in the control group. There was no difference between two groups according to the age (P = 0.421), gravida (0.524), and parity, (P = 0.54). PI, GI, PPD, and BOPI were significantly higher in HG group as compared to controls. Conclusions: Gingival inflammation is more common in patients with HG, and it is possibly associated with insufficient tooth brushing because it may stimulate the gagging reflex and vomiting. Since there could be a vicious cycle between PD and HG, periodontal preventive programs are crucial for pregnant women with HG.

Microbiological and Clinical evaluation of Neem gel and Chlorhexidine gel on Dental Plaque and Gingivitis in 20-30 Years Old Adults: A Randomized Parallel-Armed, Double-Blinded Controlled Trial.

ABSTRACTBackground:The etiological relationship between the plaque and the gingival inflammation has been long established. The long-term use of chemical antiplaque agents may lead to side effects such as teeth staining and alteration of taste. Therefore, natural plant extracts with potential antibacterial and anti-inflammatory activity have been explored, which are equally effective and safe for long-term use.Objective:The aim of this study was to compare and evaluate effect of neem gel and chlorhexidine (CHX) gel on dental plaque, gingivitis, and bacterial count of Streptococcus mutans and Lactobacilli among 20–30-year-old school teachers in a city of western Maharashtra, over 90 days’ usage.Materials and Methods:A double-blind, parallel armed, controlled, randomized clinical study was conducted among 60 school teachers of 20–30 years’ age group for 90 days. The two study groups were as follows: Group A––2.5% neem gel (n = 30) and Group B––0.2% CHX gel (n = 30). The plaque scores were recorded by Plaque Index (Löe H. The gingival index, the plaque index and the retention index systems. J Periodontol 1967;38:610-6) and gingival scores by Gingival Index (Löe H, Silness J. Periodontal disease in pregnancy. Acta Odontol Scand 1963;21:533-51). Streptococcus mutans and Lactobacilli species count by conventional culture method was carried out at baseline, 30th day and 90thday. Considering P value <0.05 as statistically significant, intergroup comparison was performed using unpaired t test. One-way analysis of variance (ANOVA) test was used followed by Tukey’s post hoc test for intragroup comparison.Results:The mean plaque, gingival scores, and microbial count of S. mutans and Lactobacilli showed significant reduction at 30th and 90th day in neem gel group as well as CHX gel group (P < 0.05). None of the parameter showed any significant change at 30th and 90th day (P > 0.05) on intergroup comparison.Conclusion:The neem gel showed significant decrease in dental plaque, gingival inflammation, and microbial counts, which was comparable to CHX gel proving to be a good herbal alternative. No side effects were reported for use of neem gel over considered period of time.

Determinants of Periodontal Disease in Pregnancy in an Urban Setting in Zimbabwe

Periodontal disease is one of the most common infectious diseases in pregnancy. The disease is caused by bacteria that produce inflammation of gingiva through production of inflammatory mediators that may have direct insult on amnion. Untreated and chronic dental infections have a possibility of causing harm to both the mother and the baby. This was an analytical cross-sectional study the purpose of which was to determine the prevalence and risk factors for periodontal disease in pregnancy. The study was conducted on a random sample of 350 postnatal mothers at Harare city Primary Care clinics. Study approval was granted by the Joint Research Ethics Committee of the University of Zimbabwe, College of Health Sciences and Parirenyatwa Group of Hospitals (JREC), the Medical Research Council of Zimbabwe (MRCZ) and Harare City Directorate. All participants gave informed consent. Code numbers were used to identify participants and interviews and oral assessments were conducted in private rooms. Data was collected through face to face interviews following a structured questionnaire, clinical intraoral examination and from clinical records. Data was captured using research electronic data capturing (RedCap) and was analyzed using the Statistical Package for Social Sciences (SPSS). Mean maternal age was 25.9 years, SD 5.7. prevalence of periodontal disease was 48.7%. No significant factors were associated with periodontal disease in the current study. However, other studies have reported significant risk factors for periodontal disease such as gestation age of the pregnancy and place of residence periodontal disease was significantly associated with the following birth outcomes. Periodontal health is the relatively neglected area in perinatal care. Health care professionals should be trained in screening for periodontal disease and giving health education in order to reduce adverse perinatal outcomes.

Periodontal Disease in Pregnancy: The Influence of General Factors and Inflammatory Mediators.

To determine the influence of plaque and progesterone on periodontitis in pregnant women and their relationship with inflammatory mediators. A longitudinal observational study of 60 pregnant women was undertaken in two observation periods. During the third trimester, plaque Index (PI), bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment level (CAL) were assessed, and the basal levels of progesterone, CRP, IL-6 and TNF-α in plasma were measured. The second observation phase was carried out 6 weeks after childbirth, when periodontal indices, progesterone and serum levels of CRP were again evaluated. Periodontal disease was moderate in 18.3%. PI and toothbrushing proved to have a correlation with the severity of periodontitis. High levels of CRP were significantly correlated (p < 0.05), with a greater BOP (r = 0.360) and PPD (r = 0.321). There was no correlation between IL-6 or TNF-α with periodontal parameters. After childbirth, progesterone was drastically reduced, BOP and PPD improved and CRP showed a significant reduction of 2.63 mg/l (p < 0.05). Periodontal disease is prevalent during pregnancy. PI and frequency of toothbrushing are correlated with the severity of periodontitis in pregnant women. Pregnancy showed an increased in the level of CRP, which was positively correlated with BOP and PPD. All periodontal indices and CRP level statistically significantly decreased after childbirth, together with a marked reduction of progesterone and without changes in PI.

Enfermedad periodontal como factor de riesgo adicional asociado con nacimiento pretérmino en México: un estudio de casos y controles.

Substances related to microorganisms involved in periodontal disease can reach the maternal-fetal interface via the hematogenous route and stimulate uterine contractility. To determine the association between periodontal disease and preterm birth. Case-control study in 343 preterm and 686 full-term pregnant women. Gestational age was calculated based on the date of the last menstrual period and confirmed with Capurro and Ballard methods. Periodontal disease was diagnosed according to the depth of the space between the tooth root and the gum. The association was measured with logistic regression. Maternal age of the cases was 23.8 ± 6.7 years, and 23.2 ± 6.7 in the controls. Periodontal disease was present in 66.8% of cases and 40.5% of controls. The factors associated with preterm birth were periodontal disease (Odds ratio [OR] = 2.26), history of preterm birth (OR = 4.96), unplanned pregnancy (OR = 2.15) poor prenatal control (OR = 2.53), urinary tract infection (OR = 2.22), preeclampsia (OR = 4.49), premature rupture of membranes (OR = 2.59) and caesarean section delivery (OR = 9.15). Periodontal disease in pregnancy was an independent risk factor for preterm birth.

Septicaemia with Fusobacterium necrophorum from Periodontal Disease in Pregnancy Resulting in Immature Birth: Case Report and Review of Literature

Septicaemia with Fusobacterium necrophorum from Periodontal Disease in Pregnancy Resulting in Immature Birth: Case Report and Review of Literature

Is Periodontal Disease in Pregnancy Associated with Adverse Pregnancy Outcomes?

Is Periodontal Disease in Pregnancy Associated with Adverse Pregnancy Outcomes?

Effect of Periodontal Diseases on Pregnancy

ABSTRACT Pregnancy is a unique physiological state that affects almost all the organs, because of changes in the hormonal milieu meant to support the pregnancy. These changes, generally reversible after delivery, are sometimes not without adverse effects. Recent upsurge in the interest in periodontal disease in pregnancy is attributed to association between periodontitis and adverse pregnancy outcome. Periodontal diseases are a group of infections and conditions that cause inflammation of the gingiva and the surrounding structures, which leads to destruction of the supporting tooth structures. Periodontal infections are predominantly caused by Gram-negative bacteriae that induce local and systemic elevations of proinflammatory cytokines. Transient bacteremia that occurs due to high vascularity of the periodontal tissue may lead to direct bacterial invasion of the fetoplacental unit. The release of toxic products incites host's response and triggers an inflammatory response. As a source of subclinical and persistent infection along with the cascade of systemic inflammatory responses and immune-mediated injury, periodontitis puts the pregnancy at high risk. Evidence for and against association between oral diseases and adverse pregnancy outcome comes from cross-sectional studies and a few trials. Like any other association of obstetric outcome with systemic diseases, this one is also a subject of debate. We reviewed the studies providing evidence for and against effect of periodontal diseases on pregnancy. We found that different investigators have used different parameters to define periodontal disease, hence different results. Larger randomized controlled trials with uniform definitions of disease and outcome are needed to arrive at a definite conclusion. How to cite this article Suri V, Singla R. Effect of Periodontal Diseases on Pregnancy. J Postgrad Med Edu Res 2015;49(3): 132-138.

Changes in inflammatory mediators in gingival crevicular fluid following periodontal disease treatment in pregnancy: relationship to adverse pregnancy outcome

Periodontal disease (PD) in pregnancy is associated with an increased risk of adverse pregnancy outcomes including miscarriage and preterm birth. Evidence exists that periodontal disease treatment may reduce inflammatory mediators in gingival crevicular fluid (GCF) and the risk of inflammation-associated pregnancy complications. The aim was to determine if periodontal disease treatment during mid-pregnancy alters local inflammation in GCF and has beneficial effects on clinical dental parameters. Eighty pregnant women with clinically diagnosed PD were recruited from a randomised controlled trial on the treatment of periodontal disease in pregnancy conducted in Perth, Australia. The treatment group underwent intensive PD treatment (20–28 weeks’ GA), while the control group underwent the same treatment postnatally. GCF was collected at 20 and 28 weeks’ gestation and concentrations of cytokines determined by multiplex assay: IL-1β, IL-6, IL-8, IL-10, IL-12p70, IL-17, TNF-α and MCP-1. Periodontal treatment significantly reduced the GCF levels of IL-1β, IL-10, IL-12p70 and IL-6 at 28 weeks’ GA compared with controls, while levels of MCP-1, IL-8 and TNF-α exhibited a significant gestational age-dependent increase, but no treatment response. Post-treatment clinical parameters improved with significant reductions in bleeding on probing, clinical attachment loss, and probing depth. No changes in pregnancy-related outcomes were observed, although the severity of periodontal disease was significantly associated with an increased risk of infants born small for gestational age. PD treatment in pregnancy reduces the levels of some inflammatory mediators in the GCF and improves dental parameters, with no overt effects on pregnancy outcome.

Smoking and periodontal disease in pregnancy: Another chance for permanent smoking abstinence

A number of publications confirm the association between periodontitis and general health. It is widely accepted that maternal periodontitis is a risk factor for adverse pregnancy outcomes, such as preterm birth and preterm low birth weight (<2500 g). These risks increase further in women who smoke. The aim of this study is to clarify the correlations between periodontitis, smoking and adverse pregnancy outcomes and to emphasize the need for an interdisciplinary approach among health professionals (e.g. gynecologists/obstetricians, family physicians, dentists, periodontists and nurses) in order to reduce such risks. Pregnancy is an ideal time for permanent smoking cessation. This condition provides an important 'teachable moment' to motivate smokers to change behavior that increases health risks for both fetus/infant and mother.

Treatment of Periodontal Disease in Pregnancy

Does not improve pregnancy outcomes, but should still be part of routine preventive care Epidemiological studies have shown that clinical and subclinical periodontal infections during pregnancy are associated with preterm birth. Infection is thought to result in the release of proinflammatory cytokines, which have downstream effects on other biological pathways and tissues. The association was first noted for bacterial vaginosis in the 1980s and 1990s, and randomised controlled trials were then performed to assess whether screening and treating the infection during pregnancy would improve pregnancy outcomes. Most of these trials found no benefit, and such screening is not currently recommended.1 More recently, observational data have suggested that periodontal disease may also be linked to preterm birth and other adverse pregnancy outcomes.2 Several large clinical trials have since been performed to assess whether pregnancy outcomes can be improved with treatment⇓. BSIP, LA/SPL In the linked systematic review (doi:10.1136/bmj.c7017), Polyzos and …

Periodontal Disease and Pregnancy Outcomes: Time to Move On?

Maternal periodontal disease is a highly prevalent condition that has been studied extensively in relation to adverse pregnancy outcomes, including preterm delivery, preeclampsia, and low birth weight. Investigators speculate that hematogenous transport of bacteria and/or pro-inflammatory mediators from sites of periodontal infection into the placenta, fetal membranes, and amniotic cavity induces pathological processes that lead to these adverse outcomes. Preliminary observational studies supported this hypothesis, but more recent work by our group and others do not demonstrate an increased risk of adverse pregnancy outcomes among women with periodontal disease, and most randomized trials fail to demonstrate improved perinatal outcomes following treatment of periodontal disease in pregnancy.

Periodontal Disease in Pregnancy is a Risk Factor for Preeclampsia

The prevalence of gingivitis and periodontitis is high among women in rural areas of India. Recent studies indicate that there may be an association between periodontitis and pregnancy complications such as preeclampsia. This observational study investigated the possible association between periodontitis during pregnancy and preeclampsia among women attending a tertiary care hospital in South India. The study population included 130 pregnant women aged >18 years who were enrolled between 26 and 32 weeks of gestation. Participants were given oral health examinations at recruitment, and again within 48 hours of delivery, to determine the presence of periodontal disease and its progression. The presence of periodontitis was defined as clinical attachment loss of ≥3 mm and pocket depth of ≥5 mm. Periodontitis was found more frequently among women with preeclampsia than among normotensive women, both at enrollment (100% vs. 78%) and after delivery (100% vs. 86%) (for both the comparisons, P < 0.001). Multiple logistic regression analysis showed an association between the occurrence of periodontitis and an increased risk of preeclampsia, both at enrollment (odds ratio, 5.78, 95% confidence interval, 2.41-13.89) and within 48 hours of delivery (odds ratio, 20.15; 95% confidence interval, 4.55-89.29). These findings show that the occurrence of periodontitis in pregnancy may be a risk factor for development of preeclampsia.

Periodontal disease in polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) and periodontal disease (inflammatory diseases of the tissues around teeth) are common disorders associated with diabetes and cardiometabolic risk. Comprehensively examining the periodontal status in PCOS, this study suggests that the susceptibility for periodontal disease may significantly increase in patients with PCOS compared with healthy young women, and that local/periodontal oxidant status appears to be affected in PCOS.