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Gum Disease Doesn't Affect Birth Outcomes

Study refutes prior findings linking poor gum health to preemie delivery

WEDNESDAY, Nov. 1, 2006 (HealthDay News) -- The health of an expectant mom's gums does not affect her odds for premature delivery or delivering a low-birth-weight baby, a new study suggests.

The finding runs counter to previous studies that have suggested that the inflammation associated with periodontal (gum) disease may be a factor in "preemie" deliveries.

"Periodontal therapy delivered between 13 and 21 weeks [of pregnancy] is safe and effective, but there's no evidence that it affects birth outcomes," said the study's lead author, Dr. Bryan Michalowicz, an associated professor in the department of developmental and surgical sciences at the University of Minnesota in Minneapolis.

His team published its findings in the Nov. 2 issue of the New England Journal of Medicine.

More than one in 10 infants in the United States is born prematurely, according to background information in the study. Babies born prematurely or at low birth weight are at increased risk of death, neurological problems, cognitive difficulties and behavioral disorders.

Since previous studies have linked prematurity to periodontal disease, Michalowicz and his colleagues wanted to learn if treating the diseased gums of pregnant women could affect the outcome of their pregnancies.

To answer that question, they recruited 823 pregnant women diagnosed with periodontal disease.

Between 13 and 21 weeks gestation, 413 of the study volunteers underwent treatment for gum disease. This treatment is known as scaling and root planing. For this procedure, periodontists remove plaque from underneath the gum line down to the roots of the teeth.

The remaining 410 women received no treatment.

Treating periodontal disease in these pregnant women caused no serious adverse reactions. However, the treatment did not appear to help with either prematurity or low birth weight.

Twelve percent of the women in the treatment group delivered prematurely vs. 12.8 percent of the women in the control group -- not a statistically significant difference, according to the researchers. The number of babies born small for their gestational age didn't differ greatly either -- 12.7 percent for the treatment group vs. 12.3 percent for the control group.

Dr. Robert Goldenberg, a professor of obstetrics and gynecology at Drexel University in Philadelphia, said he still believes periodontal disease plays some role in prematurity because it starts an inflammatory process. However, he added that prematurity is a complex problem that likely has many causes.

"All the current study says is that a single-bullet approach [treating gum disease] doesn't seem to work," said Goldenberg, who also co-authored an accompanying editorial in the same issue of the journal.

"You have to look at all of the risk factors, not just one, and reduce as many as possible," Goldenberg said. He advised women who were pregnant or thinking about becoming pregnant to treat periodontal disease, stop smoking, treat any existing vaginal infections and to reduce stress as much as possible, to help increase the odds of having a full-term baby.

He also noted that the timing of the treatment in this study may have affected the outcome and that treatment of gum disease prior to pregnancy might have more of an effect on birth outcomes.

"Women should have routine dental care all the time. One of the things this study did show is that even scaling and root planing don't seem to have any safety issues associated with it. There's no reason not to get appropriate dental care during pregnancy; it's just not likely to reduce prematurity," concluded Goldenberg.

More information

To learn more about periodontal disease, visit the American Academy of Periodontology.

SOURCES: Bryan Michalowicz, D.D.S., associated professor, department of developmental and surgical sciences, University of Minnesota, Minneapolis; Robert L. Goldenberg, M.D., professor, obstetrics and gynecology, Drexel University, Philadelphia; Nov. 1, 2006, New England Journal of Medicine
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