Oral Health in Women During Preconception and Pregnancy: Implications for Birth Outcomes and Infant Oral Health

Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill School of Medicine, CB 7516, Chapel Hill, North Carolina 27599-7516, USA.
Maternal and Child Health Journal (Impact Factor: 2.24). 10/2006; 10(5 Suppl):S169-74. DOI: 10.1007/s10995-006-0095-x
Source: PubMed


The mouth is an obvious portal of entry to the body, and oral health reflects and influences general health and well being. Maternal oral health has significant implications for birth outcomes and infant oral health. Maternal periodontal disease, that is, a chronic infection of the gingiva and supporting tooth structures, has been associated with preterm birth, development of preeclampsia, and delivery of a small-for-gestational age infant. Maternal oral flora is transmitted to the newborn infant, and increased cariogenic flora in the mother predisposes the infant to the development of caries. It is intriguing to consider preconception, pregnancy, or intrapartum treatment of oral health conditions as a mechanism to improve women's oral and general health, pregnancy outcomes, and their children's dental health. However, given the relationship between oral health and general health, oral health care should be a goal in its own right for all individuals. Regardless of the potential for improved oral health to improve pregnancy outcomes, public policies that support comprehensive dental services for vulnerable women of childbearing age should be expanded so that their own oral and general health is safeguarded and their children's risk of caries is reduced. Oral health promotion should include education of women and their health care providers ways to prevent oral disease from occurring, and referral for dental services when disease is present.

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    • "Periodontal disease occurs in up to 15% of the fertile women and a large proportion of pregnant women.[1] Thus, researches were carried out on grounds of finding the link between periodontal disease and the complications of pregnancy such as pre-eclampsia. "
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    ABSTRACT: Aims:Periodontal disease has been considered a systemic exposure implicated in a higher risk of adverse pregnancy outcomes. The aim of the present study was to determine whether maternal oral health is associated with an increased risk of pre-eclampsia.Subjects and Methods:A case-control study was conducted which included 40 pregnant women patients admitted to the Department of Obstetrics and Gynecology, J.N. Medical College, A.M.U, Aligarh. Pre-eclampsia was defined as classic triad of hypertension, proteinuria and symptoms such as swelling/edema esp. in hands and face, headache, visual changes etc., A periodontal examination was done during 48 h after child delivery. Maternal oral status was evaluated using gingival index by Loe and Silness, oral hygiene index (simplified) by greene and vermillion and periodontal pockets and clinical attachment level (CAL).Statistical Analysis:Null hypothesis that no difference exist between the two groups (pre-eclamptic and non-pre-eclamptic Group) was calculated using paired t-test, Chi-square and Mann-Whitney U statistical tests using SPSS 11.5 (Statistical Package for Social sciences, Chicago). P < 0.05 was considered to be statistically significant.Results:The amount of gingival inflammation, oral hygiene levels, pocket depth and CALs as measured by their respective indices were higher in the pre-eclamptic group when compared to non-pre-eclamptic group. Furthermore CAL was significantly increased in the test group. This study showed that pre-eclamptic cases were more likely to develop periodontal disease (P < 0.05). 30% of the test group and 65% of the case group had periodontal disease (P < 0.05) which had shown that pre-eclamptic cases were 4.33 times more likely to have periodontal disease (odds ratio = 4.33).Conclusions:Maternal oral status was determined to be associated with an increased risk of pre-eclampsia.
    Journal of Indian Society of Periodontology 05/2014; 18(3):321-5. DOI:10.4103/0972-124X.134569
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    • "The mechanism of this process includes direct tissue damage as a result of bacterial plaque and indirect damage due to the bacterial effects on the immune system and the initiation of the host’s inflammatory response. Periodontal disease occurs in up to 15% of the fertile women and a large proportion of pregnant women (1). The severity of periodontitis is measured by clinical attachment loss (CAL); higher CAL is representative of severe disease. "
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    ABSTRACT: A lot of studies have shown periodontal diseases as a risk factor for adverse pregnancy outcomes. The association between periodontitis and preeclampsia has been studied recently with controversy. Considering the importance of preventing preeclampsia as a dangerous and life-threatening disease in pregnant women, the present study was carried out. Two hundred and ten pregnant women participated in this case-control study (105 controls & 105 cases) during years 2007 and 2008. Preeclamptic cases were defined as blood pressure ≥140/90mmHg and proteinuria +1. Control group were pregnant women with normal blood pressure without proteinuria. Both groups were examined during 48 hours after child delivery. Plaque Index (PLI), Pocket Depth (PD), Clinical Attachment Level (CAL), Bleeding On Probing (BOP), Gingival Recession (GR) were measured on all teeth except for third molars and recorded as periodontal examination. Data was analyzed using t-test, chi-square, and Mann-Whitney U statistical tests. There was no significant difference between the two study groups for PD. CAL, GR, BOP significantly increased in the case group (P< 0.02). This study showed that preeclamptic cases were more likely to develop periodontal disease (P< 0.0001). Eighty three percent of the control group and 95% of the case group had periodontal disease (P< 0.005) which had shown that preeclamptic cases were 4.1 times more likely to have periodontal disease (OR= 4.1). Preeclamptic cases significantly had higher attachment loss and gingival recession than the control group.
    Iranian Journal of Public Health 09/2011; 40(3):122-7. · 0.55 Impact Factor
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    • "Various underlying factors deter women from seeking dental care during pregnancy such as socioeconomic factors (US Department of Health and Human Services 2000), socio-cultural factors (Machuca et al. 1999), lack of resources to pay for treatment, barriers to access care (Boggess et al. 2006), lack of public awareness of the importance of oral health, persistent myths about the effects of pregnancy on dental health, and, concerns for foetal safety during dental treatment (Wasylko et al. 1998). The situation is compounded by the lack of comprehensive clinical guidelines for the management of common oral conditions in pregnancy (Silk et al. 2008). "
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    ABSTRACT: The aim of this paper is to examine current evidence supporting the promotion of oral health during pregnancy and proffer aspects of a potential role for Australian midwives. Research continues to show that poor oral health during pregnancy can have an impact on the health outcomes of the mother and baby. Poor maternal oral health increases the chances of infants developing early caries and is strongly associated with adverse pregnancy outcomes such as preterm and low birth-weight babies. Unfortunately in Australia, no preventive strategies exist to maintain the oral health of pregnant women. Systematic review. This review examines all literature on oral health during pregnancy published to date in the English language and focuses on whether preventive oral health strategies during the prenatal period are warranted in Australia and if so, how they could be provided. Maintaining oral health is important during pregnancy and many developed countries have implemented preventive strategies to address this issue using non-dental professionals such as prenatal care providers. However, despite the positive international evidence, limited importance is being given to the oral health of pregnant women in Australia. It is also evident that the unique potential of prenatal care providers such as midwives to assess and improve maternal oral heath is not being thoroughly utilised. Compounding the issue in Australia, especially for pregnant women from socioeconomically disadvantaged backgrounds, is the limited access to public dental services and the high cost of private dental treatment. Promoting and maintaining oral health during pregnancy is crucial, and preventive prenatal oral health services are needed in Australia to achieve this. Midwives have an excellent opportunity to offer preventive oral health services by providing oral health assessments, education and referrals for pregnant women attending antenatal clinics.
    Journal of Clinical Nursing 10/2010; 19(23-24):3324-33. DOI:10.1111/j.1365-2702.2010.03426.x · 1.26 Impact Factor
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