Document Detail

A critical assessment of adverse pregnancy outcome and periodontal disease.
MedLine Citation:
PMID:  18724864     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Pre-term birth is a major cause of infant mortality and morbidity that has considerable societal, medical, and economic costs. The rate of pre-term birth appears to be increasing world-wide and efforts to prevent or reduce its prevalence have been largely unsuccessful.
AIM: To review the literature for studies investigating periodontal disease as a possible risk factor for pre-term birth and adverse pregnancy outcomes.
MAIN FINDINGS AND CONCLUSION: Variability among studies in definitions of periodontal disease and adverse pregnancy outcomes as well as widespread inadequate control for confounding factors and possible effect modification make it difficult to base meaningful conclusions on published data. However, while there are indications of an association between periodontal disease and increased risk of adverse pregnancy outcome in some populations, there is no conclusive evidence that treating periodontal disease improves birth outcome. Based on a critical qualitative review, available evidence from clinical trials indicates that, although non-surgical mechanical periodontal treatment in the second trimester of pregnancy is safe and effective in reducing signs of maternal periodontal disease, it does not reduce the rate of pre-term birth. Clinical trials currently underway will further clarify the potential role of periodontal therapy in preventing adverse birth outcomes. Regardless of the outcomes of these trials, it is recommended that large, prospective cohort studies be conducted to assess risk for adverse pregnancy outcome in populations with periodontal disease. It is critical that periodontal exposure and adverse birth outcomes be clearly defined and the many potential confounding factors and possible effect modifiers for adverse pregnancy outcome be controlled in these studies. If periodontal disease is associated with higher risk of adverse pregnancy outcome in these specific populations, large multicenter randomized-controlled trials will be needed to determine if prevention or treatment of periodontal disease, perhaps combined with other interventions, has an effect on adverse pregnancy outcome in these women.
Gernot Wimmer; Bruce L Pihlstrom
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Journal of clinical periodontology     Volume:  35     ISSN:  1600-051X     ISO Abbreviation:  J. Clin. Periodontol.     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-26     Completed Date:  2009-01-13     Revised Date:  2013-07-15    
Medline Journal Info:
Nlm Unique ID:  0425123     Medline TA:  J Clin Periodontol     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  380-97     Citation Subset:  D; IM    
Department of Dentistry and Maxillofacial Surgery, Division of Prosthodontics, Restorative Dentistry, Periodontology and Implantology, Medical University of Graz, Graz, Austria.
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MeSH Terms
Birth Weight
Confounding Factors (Epidemiology)
Fetus / immunology
Multicenter Studies as Topic
Periodontal Diseases / complications*,  microbiology,  therapy
Pregnancy Complications* / prevention & control
Pregnancy Outcome*
Pregnancy Trimester, Second
Premature Birth / etiology,  prevention & control
Randomized Controlled Trials as Topic
Risk Assessment
Risk Factors

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