Periodontal treatment doesn't reduce preterm birth

Treating women for periodontal disease during pregnancy is safe and effective, but does not reduce the risk of preterm delivery, low birth weight or growth restriction of the fetus, a new study shows.

Periodontitis is an infection that destroys the tissue and bone supporting the teeth, Dr. Bryan S. Michalowicz of the University of Minnesota in Minneapolis and colleagues report.

Although studies have shown a statistical link between the condition and adverse pregnancy outcomes, Michalowicz told Reuters Health, but just one other investigation has looked at periodontitis treatment in pregnant women. That study, performed in Chile, found that treatment did reduce the risk of poor outcomes.

In the current study, Michalowicz and his team randomly assigned 823 women with periodontitis who were between 13 and 17 weeks pregnant to undergo scaling and root planing to treat the condition, or to a control group that received no treatment. Women in the treatment group also had monthly tooth polishing and oral hygiene instruction.

There were no differences between the two groups in rate of preterm deliveries. Twelve percent of women in the treatment group delivered infants with low birth weights or who were small for their gestational age, compared with 12.8% of those in the control group, which was not significantly different. There was also no difference between the groups in average birth weight or percentage of small-for-gestational age infants.

In an editorial accompanying the study, Drs. Robert L. Goldenberg and Jennifer F. Culhane of Drexel University in Philadelphia suggest that periodontal treatment might need to be provided before a woman becomes pregnant to reduce the risk of adverse pregnancy outcomes. They note that three other, larger studies of periodontal treatment in pregnancy are underway.

While the study didn't show an effect on pregnancy outcomes, Michalowicz noted, it did show that periodontal treatment is safe for pregnant women. Periodontitis can lead to tooth loss, he added, and should be treated whenever it is diagnosed. There are many other reasons why a pregnant woman "should seek care if she needs it," he said.

SOURCE: The New England Journal of Medicine, November 2, 2006.