Research presented in a recent paper by Michalowicz et al published in the New England Journal of Medicine suggests that treatment of periodontitis in pregnant women improves periodontal health and is safe but does not significantly alter rates of preterm birth, low birth weight, or fetal growth restriction.
This outcome is at variance with findings of other studies, which have suggested that periodontal treatment positively affects birth outcomes.
There may be several explanations for the differences in research findings to date including timing of the treatment intervention, as well as the pregnancy outcomes studied.
For example, the Michalowicz research did not study the effect of periodontal treatment on early adverse outcomes, such as late miscarriage, stillbirth, and early spontaneous preterm birth, which previous observational studies have linked with periodontal disease.
According to the March of Dimes, the rate of infants born preterm increased nearly 14% from 1994 to 2004. And while the specific causes of spontaneous preterm labor and delivery are largely unknown, the March of Dimes believes they are likely due to a complex interplay of multiple risk factors, as opposed to any single isolated risk factors.
The intriguing findings of the study by Michalowicz study support the need for additional research to clarify the potential effect of periodontal disease on adverse pregnancy outcomes, given the potential impact of the increasing problem of prematurity.
Other trials are underway that should provide additional insight on this important topic. In the meantime, the recent NEJM study confirms that treatment of periodontitis in pregnant women improves oral health and is safe, which is an important message for the dental and medical communities and all patients.
