title: Optimal timing of periodontal disease treatment for prevention of adverse pregnancy outcomes: before or during pregnancy?
abstract: Several large randomized controlled clinical trials failed to find that standard periodontal therapy during pregnancy reduces the incidence of adverse pregnancy outcomes (eg, preterm birth and low birthweight). However, treating periodontal disease during pregnancy may be too late to reduce the inflammation that is related to the adverse pregnancy outcomes. Moreover, periodontal treatment during pregnancy can cause bacteremia, which itself may initiate the pathway leading to the adverse pregnancy outcomes. Finally, the periodontal treatments provided during pregnancy are not always effective in preventing the progression of periodontal disease during pregnancy. Pregnancy may not be an appropriate period for periodontal intervention(s). We hypothesize that periodontal treatment before pregnancy may reduce the rates of adverse pregnancy outcomes. Future randomized controlled trials are needed to test if treating periodontal disease in the prepregnancy period reduces the rate of adverse pregnancy outcomes.
authors.affiliation: Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112-2715, USA. xxiong@tulane.edu
authors.forename: Xu
authors.initials: X
authors.lastname: Xiong
authors.forename: Pierre
authors.initials: P
authors.lastname: Buekens
authors.forename: Robert L
authors.initials: RL
authors.lastname: Goldenberg
authors.forename: Steven
authors.initials: S
authors.lastname: Offenbacher
authors.forename: Xu
authors.initials: X
authors.lastname: Qian
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000209:etiology / Q000517:prevention & control*; D020380:Needs Assessment; D010510:Periodontal Diseases / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D010517:Periodontics / Q000379:methods; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology / Q000517:prevention & control*; D047928:Premature Birth / Q000209:etiology / Q000517:prevention & control*; D011295:Prenatal Care / Q000379:methods; D011322:Primary Prevention / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D013997:Time Factors; D014481:United States