Prevention of Preterm Birth

Jeffrey M. Denney; Jennifer F. Culhane; Robert L. Goldenberg

Disclosures

Women's Health. 2008;4(6):625-638. 

In This Article

Periodontal Care

In a number of studies, the risk of preterm birth rose with increasing severity of periodontal disease and with progression of periodontal disease during pregnancy.[65,66,67,68,69,70,71,72] However, the basis for this association remains uncertain. It may arise from hematogenous transmission of oral microbial pathogens to the genital tract, but is more likely the result of an increase in an overall systemic inflammatory response.[69,72] The best treatment appears to be scaling and root planing accomplished over one to four visits, depending on the severity of the periodontal disease. Several small, randomized trials of scaling and root planing have suggested benefit in reducing preterm birth, but the largest and most recently published study demonstrated no benefit.[70] Several larger trials are ongoing. Therefore, to date, based on existing data, most authorities do not believe that treatment of periodontal disease during pregnancy, solely to reduce preterm birth, should be undertaken.[71] Treating periodontal disease in the interpregnancy interval is also being studied; however, effects on preterm birth rates have yet to be reported. On the other hand, no harm from periodontal treatment during pregnancy has been demonstrated. Therefore, while treatment of periodontal disease is not proven to reduce preterm birth, because of the general adverse effect of periodontal disease on health, there appears to be minimal risk of harm and some benefit to its treatment in the preconception period or during pregnancy.

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