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Successful Periodontal Therapy May Reduce the Risk of Preterm Birth, 0

Successful Periodontal Therapy May Reduce the Risk of Preterm Birth,

According to Dental Study


ScienceDaily (Sep. 15, 2010) – A collaboration led by a periodontal

researcher from the University of Pennsylvania School of Dental Medicine has

found a possible link between the success of gum-disease treatment and the

likelihood of giving birth prematurely, according to a study published in

the journal BJOG: An International Journal of Obstetrics and Gynaecology.

While a number of factors are associated with an increased rate of preterm

birth, such as low body-mass index, alcohol consumption and smoking, the

study adds to the body of research that suggests oral infection may also be

associated with such an increase.

The study looked at 322 pregnant women, all with gum disease. Half the group

was given oral-hygiene instruction and treated with scaling and root

planning, which consists of cleaning above and below the gum line. The

second half received only oral-hygiene instruction.

The incidence of preterm birth was high in both the treatment group and the

untreated group: 52.4 percent of the women in the untreated control group

had a preterm baby compared with 45.6 percent in the treatment group. These

differences were not statistically significant.

However, researchers then looked at whether the success of periodontal

treatment was associated with the rate of preterm birth. Participants were

examined 20 weeks after the initial treatment, and success was characterized

by reduced inflammation, no increase in probing depth and loosening of the


Within the treatment group of 160 women, 49 were classified as having

successful gum treatment and only four, or 8 percent, had a preterm baby. In

comparison, 111 women had unsuccessful treatment and 69, or 62 percent, had

preterm babies.

The results show that pregnant women who were resistant to the effects of

scaling and root planning were significantly more likely to deliver preterm

babies than those for whom it was successful.

The mean age of the women in the study was 23.7 years; 87.5 percent were

African-American, and 90 percent had not seen a dentist for tooth cleaning.

“First and foremost, this study shows that pregnant women can receive

periodontal treatment safely in order to improve their oral health,” said

Marjorie Jeffcoat, professor of periodontics at Penn Dental Medicine and

lead author of the paper. “Second, in a high risk group of pregnant women,

such as those patients who participated in this study, successful

periodontal treatment when rendered as an adjunct to conventional obstetric

care may reduce the incidence of preterm birth.”

Future papers will address the role of antimicrobial mouth rinses in

reducing the incidence of preterm birth.

“Researchers have previously suggested that severe gum infections cause an

increase in the production of prostaglandin and tumour necrosis factor,

chemicals which are associated with preterm labor,” Philip Steer,

editor-in-chief of BJOG, said. “This new study shows a strong link between

unsuccessful gum-disease treatment and preterm birth; however, we need to

bear in mind that 69 percent of women failed to respond to the dental

treatment given. Therefore, more effective treatment will need to be devised

before we can be sure that successful treatment improves outcome, rather

than simply being a marker of pregnancies with a lower background level of

inflammation that will go to term anyway.”

The study was conducted by Jeffcoat, Mary Sammel, Bonnie Clothier and

Annette Catlin of Penn Dental Medicine; Samuel Parry of the Department of

Maternal and Fetal Medicine at Penn’s School of Medicine; and George Macones

of Washington University in St. Louis.

The study was funded by the Commonwealth of Pennsylvania and an educational

grant from the Procter and Gamble Company

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