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May 9, 2000 -- Most pregnant women know that to keep a growing baby healthy, they must lay off alcohol and cigarettes and eat a balanced diet. Now, researchers say, they should add carefully caring for their teeth and gums to that list. A new study shows that women with serious cases of periodontal disease are far more likely to give birth early.
Although the results are preliminary, researchers are already recommending that pregnant women have their dentists screen for the condition, and that women who suffer from periodontal disease have their dentists carefully clean and disinfect the space between their teeth and gums.
Babies born prematurely face a dramatically increased risk of cerebral palsy, visual problems, and other disorders and account for more than half of all health care costs for newborns. And one in every four women who give birth prematurely has no known risk factors, researcher Marjorie Jeffcoat, DMD, says. She is chair of periodontics at the University of Alabama at Birmingham School of Dentistry.
Past studies have found that pregnant women who suffer from periodontal disease are up to seven times as likely to give birth to premature, low-birth-weight babies.
Now, by keeping tabs on more than 700 otherwise healthy pregnant women who did not drink, smoke, or have genital or urinary tract infections -- all risk factors for preterm births -- Jeffcoat and her colleagues have found that the risk of premature birth is highest in women with the most severe form of the disorder. This type, called generalized periodontal disease, affects more than 30% of the mouth. Women who have this type of disease have a risk of premature birth that is eight times that of women who don't have periodontal disease.
The work was presented Sunday at the American Academy of Periodontology's Specialty Conference on Periodontal Medicine in Washington.
Periodontal disease begins with plaque, which coats the teeth with a bacterial film. About 22% of pregnant women have periodontal disease, which occurs when a bacterial infection between the teeth and gums loosens and separates the gum from its moorings. That creates a pocket for more bacteria to grow.
Left untreated, the infection can spin out of control, causing tooth loss. The infections also require the body to mount a major battle, as the surface area of such infections can be as large as the palm of the hand, Jeffcoat tells WebMD.
It is the body's response to the infection that could cut a pregnancy short, Jeffcoat says. In response to bacterial attack, the body produces molecules called cytokines and prostaglandins that help it battle the invading bugs. But the same molecules can also tell the uterus that it's time to deliver, Jeffcoat says.
"I think it's exciting work that has a lot of merit," Hugh Randall, MD, professor of obstetrics and gynecology at Emory School of Medicine in Atlanta, says of the study. But "what we don't know is whether treating women with periodontal disease during pregnancy is going to make a difference."
Jeffcoat's team has begun a study to find out, testing to see whether specialized periodontal cleaning, or specialized periodontal cleaning plus antibiotic treatment, could prevent premature births.
In the meantime, she recommends that pregnant women brush, floss, and see their dentists regularly. For pregnant women with periodontal disease, Jeffcoat recommends that dentists conduct a procedure called scaling and root planing, which cleans out the pocket between the tooth and gum, during the second trimester. For more information, see www.perio.org or www.ada.org.
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