History of Periodontal Treatment and Risk for Intrauterine Growth Restriction (IUGR)

Cande V. Ananth; Howard F. Andrews; Panos N. Papapanou; Angela M. Ward; Emilie Bruzelius; Mary Lee Conicella; David A. Albert


BMC Oral Health. 2018;18(161) 

In This Article


Periodontal disease manifests itself as destruction of the supporting structures of the teeth and is associated with systemic dissemination of bacteria and bacterial products as well as the release of inflammatory mediators that can adversely impact the placenta resulting in fetal growth restriction. In our analysis, IUGR was present in 6.3% of the sample. In 2012, 46% of the United States adult population was estimated to have experienced periodontal disease.[21] The high prevalence of periodontal disease in adults, and the cost associated with the morbidity and mortality of adverse birth outcomes, justifies further investigation of the systemic impact of periodontal infection/inflammation on the feto-placental unit.

As demonstrated in this study, research that involves the integration of medical and dental records can be informative in elucidating the role of potential exposures on adverse outcomes, and may ultimately lead to improved patient outcomes and more cost-effective care.[22] In particular, the use of combined medical and dental national insurance claims data provides an opportunity to explore the association of birth outcomes with dental health and dental treatment in women of childbearing age. 56% of American adults aged 19–64 had private dental insurance in 2009, and 10% of all procedure types in the dental office were related to periodontics.[23,24] Data were obtained from a national insurance carrier that provides medical insurance to 23.5 million persons, and dental coverage to about 14.6 million persons across the United States.[25]

In this retrospective study we show an association between periodontal treatment as a proxy for the presence of periodontal disease and IUGR, however randomized controlled trials are needed to establish the efficacy of periodontal therapy on pregnancy outcomes such as fetal growth restriction. Periodontal care should be emphasized for women of childbearing age to improve general oral health. Policies encouraging evaluation and early intervention to control/eliminate periodontal pathology prior to pregnancy may be able to reduce the risk of IUGR and related complications in the newborn.