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Periodontal disease and preterm birth

Overview: Adult periodontal infection (periodontitis) affects up to 40% of women of reproductive age and is associated with preterm birth. Treatment during pregnancy does not reduce preterm birth but is safe and should be performed to enhance maternal oral health.

Diagnosis/definition: Periodontitis involves infection and progressive loss of the alveolar bone around the teeth.

Epidemiology/Incidence: Periodontitis is commonly encountered in children, young adults, and up to 40% of women of reproductive age.

Risk factors/associations: Dental caries and gingivitis (inflammation of the gum tissue) progress to periodontal infection if untreated. 

Complications: 

  • Left untreated periodontitis can lead to loosening and subsequent loss of teeth. 
  • It has been associated with preterm birth as well as cardiovascular disease, diabetes and  respiratory infection. 
  • Preterm birth: Data from large observational studies associate periodontal infection with a 2.8-fold increase in risk of preterm birth.
  • However, data from randomized treatment trials for periodontitis during pregnancy did not show a reduction in preterm birth (pooled OR 1.15, 95% CI 0.95-1.14).

Prevention: General oral health maintenance: All pregnant women should schedule an oral health evaluation if one has not been done in the last 6 months or a new symptom has occurred. 

Management: Prenatal care: Counsel to schedule oral exam.

Treatment: Scaling (debridement and nonsurgical cleaning below the gumline) and root planing (use of specialized curettes to mechanically remove plaque and calculus from below the gumline) are commonly used. Treatment is safe in pregnancy. 

Last Reaffirmed: Dec 1, 2014



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