March 2014

Preterm Birth is a Global Problem

Preterm Birth is a Global Problem

Approximately 15 million babies are born prematurely around the world, that is one in every 10 live births.  Among the 39 countries with a Very High Human Development Index ranking, the UK is listed as 26th with a rate of 7.8%.  Around 1 million infants will die and those that live have an increased risk of complications throughout their lifetime such as respiratory distress, impaired motor skills, cognitive and intellectual impairment, and visual, hearing and learning difficulties. 

Preterm birth (PTB) occurs for one of three reasons: spontaneous  PTB, preterm premature rupture of membranes (PPROM) and medically indicated PTB. Risks for PTB include diabetes, obesity-related preeclampsia, tobacco, drug and heavy alcohol use, hypertension and intrauterine infections. 

Oral Health During Pregnancy

Oral Health During Pregnancy

Pregnant women are more susceptible to gingival inflammation due to increased amounts of progesterone in their system acting as an immunosuppressant. Statistics reveal that 50% of all pregnant women develop 'pregnancy gingivitis'.  In a small percentage of pregnant women (10% or less) there is an exaggerated inflammatory response leading to the formation of a localised mass of highly vascularised tissue called a pregnancy granuloma and is most common in the maxillary anterior region. 

There have been numerous studies published that looked at the relationship between periodontal disease and PTB, low birth weight and preeclampsia.  The most recent systematic review identified the weaknesses and strengths of the collective studies which prevented a definitive conclusion, but did report that despite the limitations of some of the studies there is a positive association between poor maternal periodontal status and adverse pregnancy outcomes including PTB, low birth weight, and preeclampsia. 

Researchers have looked at the effect of periodontal treatment to help reduce the incidence of adverse pregnancies. To date, high quality studies have not shown a benefit from non- surgical therapy, with or without antimicrobial adjuncts. There are a couple of things to consider regarding these studies; first did the therapy eliminate the infection and second, were the woman provided with effective self-care routines?  If the therapy did not eliminate the infection or the woman could not perform adequate oral hygiene on a daily basis then perhaps there needs to be additional studies that look at a more robust treatment plan.   

What we do know is oral health is just as important during pregnancy as any other time.  It is not okay to have gingivitis and eliminating the infection is a key goal of dental therapy and daily maintenance.


Pregnant Women Need to Practice Good Oral Hygiene

It is important for pregnant women to continue with dental check ups, necessary treatment, and practice good oral hygiene. As a mother, they will pass their oral hygiene routines onto their children and if they take their oral care seriously, especially during pregnancy, then their children will too. 

Recommend a complete oral hygiene routine and consider adding a Water Flosser as it is the easy way to floss and reduce or prevent gingivitis.