Periodontal Disease and Pregnancy: Implications for Maternal and Fetal Health

 

 

                                                                                                     Source: Nannan et al., 2022; Front. Med.

Periodontal disease, a chronic inflammatory condition affecting the supporting structures of the teeth, has been increasingly linked to adverse pregnancy outcomes, including preterm birth, low birth weight, fetal growth restriction, and preeclampsia. Maternal hormonal fluctuations during pregnancy can exacerbate gingival inflammation and alter immune responses, increasing susceptibility to periodontal disease (Marcuschamer et al., 2009; Wen et al., 2023). Poor oral hygiene and pre-existing periodontal disease contribute to systemic inflammation, which may negatively impact the fetal-placental unit (Cetin et al., 2012; Ruma et al., 2008).

Several studies highlight the role of specific periodontal pathogens such as Porphyromonas gingivalis, Fusobacterium nucleatum, and Tannerella forsythia in adverse pregnancy outcomes. These microorganisms can translocate hematogenously or via inflammatory mediators to the placenta, potentially triggering preterm labor or low birth weight (Andonova et al., 2015; Cobb et al., 2017; Yoshida et al., 2022). Evidence also suggests that severe periodontal disease during pregnancy increases the risk of vulvovaginitis, premature rupture of membranes, and fetal growth restriction (Figueiredo et al., 2019).

Early intervention, particularly pre-conception periodontal care, appears to be more effective than treatment initiated during pregnancy. Preconception scaling, non-surgical periodontal therapy, and good oral hygiene reduce systemic inflammatory burden and may prevent adverse outcomes (Jiang et al., 2013; Chen et al., 2022; Bobetsis et al., 2020). Nutritional status and systemic conditions, such as obesity and insulin resistance, can further modulate periodontal inflammation and influence pregnancy outcomes (Seraphim et al., 2016; Caracho et al., 2020; Adimora et al., 2022).

Despite the recognized associations, awareness of the impact of periodontal disease on pregnancy among healthcare providers and pregnant women remains limited, highlighting the need for integrated oral health education and early screening programs as part of prenatal care (Penmetsa et al., 2018; Alotaibi & Khan, 2023; Ganganna & Devishree, 2017).

 

References (For an extensive list of references- click here)

Choudhury, P., et al. Periodontal Disease and Pregnancy Outcome: A Correlative Study. Int. J. Dent. Res. Dev. 7, 45–52 (2017).

Marcuschamer, E., Hawley, C. E., Speckman, I., María, R., Romero, D., Nart, J., et al. A lifetime of normal hormonal events and their impact on periodontal health. Nûmero 23, 12–25 (2009).

Sha, Y. q., Huang, Z., Chen, Z. b., Kang, J., He, L., Yu, X. q. Association between periodontitis and preterm low birth weight. Beijing da xue xue bao. Yi xue ban 41, 1–9 (2009).

Andonova, I., Iliev, V., Živković, N., Sušić, E., Bego, I., Kotevska, V. Can oral anaerobic bacteria cause adverse pregnancy outcomes? Prilozi 36, 1–10 (2015).

Cetin, I., Pileri, P., Villa, A., Calabrese, S., Ottolenghi, L., Abati, S. Pathogenic mechanisms linking periodontal diseases with adverse pregnancy outcomes. Reprod. Sci. 19, 6 (2012).

Ruma, M., Boggess, K., Moss, K., et al. Maternal periodontal disease, systemic inflammation, and risk for preeclampsia. Am. J. Obstet. Gynecol. 198, 4 (2008).

Figueiredo, M. G. O. P., Takita, S. Y., Dourado, B. M. R., et al. Periodontal disease: Repercussions in pregnant woman and newborn health—A cohort study. PLoS ONE 14, e0225036 (2019).

Jiang, H., Xiong, X., Su, Y., Zhang, Y., Wu, H., Jiang, Z., Qian, X. A randomized controlled trial of pre-conception treatment for periodontal disease to improve periodontal status during pregnancy and birth outcomes. BMC Pregnancy Childbirth 13 (2013).

Chen, J. J., Wu, D. R., Lin, W. S., et al. Impact of Scaling and Periodontal Treatment during Pregnancy on the Risk of Adverse Birth Outcomes. J. Pers. Med. 12, 137 (2022).

Bobetsis, Y. A., Graziani, F., Gürsoy, M., Madianos, P. N. Periodontal disease and adverse pregnancy outcomes. Periodontol. 2000 83, 1–18 (2020).

Cobb, C. M., Kelly, P. J., Williams, K. B., et al. The oral microbiome and adverse pregnancy outcomes. Int. J. Womens Health 9, 1–12 (2017).

Wen, X., Fu, X., Zhao, C., Yang, L., Huang, R. The bidirectional relationship between periodontal disease and pregnancy via the interaction of oral microorganisms, hormone and immune response. Front. Microbiol. 14, 1070917 (2023).

Minervini, G., Basili, M., Franco, R., et al. Periodontal Disease and Pregnancy: Correlation with Underweight Birth. Eur. J. Dent. 17, 4 (2023).

Alotaibi, Y., Khan, N. A survey on the Awareness of Interrelationship of Periodontal Disease and Systemic Health Among Qassim Population. Med. Forum Mon. 34, 11 (2023).