Effect of nonsurgical periodontal therapy and strict plaque control on preterm/low birth weight: a randomized controlled clinical trial

• Published in: Clinical oral investigations Vol. 17; no. 1; pp. 37 - 44
• Main Authors: Weidlich, Patricia, Moreira, Carlos Heitor C., Fiorini, Tiago, Musskopf, Marta L., da Rocha, José M., Oppermann, Maria Lucia R., Aass, Anne M., Gjermo, Per, Susin, Cristiano, Rösing, Cassiano K., Oppermann, Rui V.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 2013; Springer Nature B.V
• Subjects: Adult; Comprehensive Dental Care; Dental Calculus - prevention & control; Dental Plaque - prevention & control; Dental Scaling - methods; Dentistry; Educational Status; Female; Gingival Hemorrhage - prevention & control; Humans; Infant, Low Birth Weight; Infant, Newborn; Medicine; Oral Hygiene - education; Original Article; Patient Education as Topic; Periodontal Attachment Loss - prevention & control; Periodontal Debridement - methods; Periodontal Diseases - prevention & control; Periodontal Index; Periodontal Pocket - prevention & control; Periodontitis - prevention & control; Pregnancy; Pregnancy Complications - prevention & control; Pregnancy Outcome; Premature Birth - prevention & control; Root Planing - methods; Social Class; Young Adult; Periodontal diseases; Periodontal treatment; Risk factors; Pregnancy complications
• ISSN: 1432-6981; 1436-3771
• DOI: 10.1007/s00784-012-0679-3

Objective
This randomized controlled clinical trial was carried out to assess the effect of comprehensive nonsurgical periodontal treatment and strict plaque control performed during pregnancy on the reduction of preterm and/or low birth weight rates (PTLBW).
Material and methods
Three hundred and three women were randomly allocated to receive periodontal treatment either during pregnancy (
n
 = 147, test group) or after delivery (
n
 = 156, control group). During pregnancy, the control group received only one session of supragingival scaling and oral hygiene instruction. In contrast, the test group received comprehensive periodontal treatment including multiple sessions of scaling and root planing, oral hygiene instructions, and frequent maintenance visits.
Results
At baseline, periodontal inflammation was observed in approximately 50% of sites and attachment loss affected <15% of sites. Compared to controls, women in the test group had significant reductions in the percentage of sites with plaque (48.5% vs. 10.3%,
p
 < 0.001), gingival bleeding (23.3% vs. 2.5%,
p
 < 0.001), calculus (21.3% vs. 4.1%,
p
 < 0.001), bleeding on probing (38.1% vs. 2.6%,
p
 < 0.001) and probing depth ≥3 mm (19.97% vs. −2.45%,
p
 < 0.001). No significant differences were observed between the groups in the occurrence of PT (11.7% vs. 9.1%,
p
 = 0.57), LBW (5.6 % vs. 4.1%,
p
 = 0.59), and PTLBW (4.15% vs. 2.60%,
p
 = 0.53).
Conclusions
Comprehensive periodontal treatment and strict plaque control significantly improved periodontal health; however, no reduction of PTLBW rates was observed. Thus, remaining periodontal inflammation posttreatment cannot explain the lack of effect of periodontal treatment on PTLBW.
Clinical relevance
This study demonstrated that periodontal diseases may be successfully treated during pregnancy. Our results do not support a potential beneficial effect of periodontal treatment on PTLBW.