Treatment of periodontal disease during pregnancy: a randomized controlled trial.
OBJECTIVE
To investigate whether treating periodontal disease prevents preterm birth and other major complications of pregnancy.


METHODS
This single-center trial was conducted across six obstetric sites in metropolitan Perth, Western Australia. Pregnant women identified by history to be at risk (n=3,737) were examined for periodontal disease. Approximately 1,000 women with periodontal disease were allocated at random to receive periodontal treatment commencing around 20 weeks of gestation (n=542) or 6 weeks after the pregnancy was completed (controls; n=540). The treatment included mechanical removal of oral biofilms together with oral hygiene instruction and motivation at a minimum of three weekly visits, with further visits if required.


RESULTS
There were no differences between the control and treatment groups in preterm birth (9.3% compared with 9.7%, odds ratio [OR] 1.05, 95% confidence interval [CI 0.7-1.58], P=.81), birth weight (3,450 compared with 3,410 g, P=.12), preeclampsia (4.1% compared with 3.4%, OR 0.82, 95% CI 0.44-1.56, P=.55), or other obstetric endpoints. There were four unexplained stillbirths in the control group and no pregnancy losses in the treated group (P=.12). Measures of fetal and neonatal well-being were similar in the two groups, including abnormalities in fetal heart rate recordings (P=.26), umbilical artery flow studies (P=.96), and umbilical artery blood gas values (P=.37). The periodontal treatment was highly successful in improving health of the gums (P<.01).


CONCLUSIONS
The evidence provided by the present study does not support the hypothesis that treatment of periodontal disease during pregnancy in this population prevents preterm birth, fetal growth restriction, or preeclampsia. Periodontal treatment was not hazardous to the women or their pregnancies.


BACKGROUND
ClinicalTrials.gov, www.clinicaltrials.gov, NCT00133926.


METHODS
I.
Newnham
John P
JP
From the Schools of Women's and Infants' Health and Dentistry of The University of Western Australia; the Women and Infants Research Foundation of Western Australia; and the Oral Health Centre of Western Australia, Perth, Western Australia.
Newnham
Ian A
IA
Ball
Colleen M
CM
Wright
Michelle
M
Pennell
Craig E
CE
Swain
Jonathan
J
Doherty
Dorota A
DA
D000328:Adult; D005260:Female; D005317:Fetal Growth Retardation / Q000517:prevention & control*; D006801:Humans; D010510:Periodontal Diseases / Q000628:therapy*; D011225:Pre-Eclampsia / Q000517:prevention & control*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D047928:Premature Birth / Q000517:prevention & control*; D014904:Western Australia