Background: Pre-eclampsia, the second most frequent direct source of maternal mortality, is a multisystem gestational disorder characterized by proteinuria and maternal hypertension after the 20th gestational week. Although the causes of pre-eclampsia are still discussed, research has suggested that the placenta has a central place in the pathogenesis of this disease. Moreover, current surveys indicated that periodontal disorders observed during the pregnancy and more particularly, periodontal pathogens could be link to the risk of pre-eclampsia. Objectives: This article aims to review recent studies focusing on periodontal conditions and pathogens associated with pre-eclampsia. Methods: The process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Results: Metabolic conditions, immunological changes, fluctuating progesterone and estrogen levels of the pregnant woman induce a dysbiosis of the oral microbiota and contribute to increase inflammation of periodontal tissues. Periodontal pathogens could diffuse through the bloodstream inducing a placenta inflammatory response as well as inflammatory molecules produced in response to periodontopathogens could migrate through the bloodstream leading to a placenta inflammatory response. Also, periodontopathogens can colonize the vaginal microbiota through the gastrointestinal tract or during oro-genital contacts. Conclusion: A cumulative bi-directional relationship between periodontal conditions, pathogens and the pre-eclampsia exists.
The scope of this study was to assess the prevalence, severity of extension, and risk factors of gingivitis among pregnant women. In this cross-sectional study, 220 nulliparous women at 3 months of pregnancy were recruited in 2022 at the first obstetrical visit in Dakar, Senegal. Demographic characteristics, lifestyle habits, prenatal clinical status, and oral clinical parameters were recorded. Multivariable logistic regression modeling was used to assess relationships between gingivitis and risk factors. Eighty-eight percent of women had gingivitis, 15% were classified as moderate and 73% as severe. A total of 66.7% (95% CI [28.8–92.1]) of the sites had bleeding on interdental brushing. The odds for gingivitis decreased significantly for women consuming more than five portions of fruits and vegetables per day (OR = 0.15; 95% CI [0.03–0.66]) and increased in women who had a professional activity (OR = 6.75; 95% CI [1.27–35.87]) and high education. Concomitantly, the percentage of dental plaque (OR = 131.6; 95% CI [10.80–1619.71] and the severity of clinical attachment loss (OR = 7.70; 95% CI [3.16–18.92]) were important risk factors. Inverse associations were observed with increasing body mass index (OR = 0.76; 95% CI [0.63–0.93]). Our results underline that gingivitis cases and bleeding were particularly high among 3-month pregnant women. Literacy and adequate oral hygiene actions to modify behaviors and to achieve meticulous biofilm disorganization could make a favorable change in the gingival health outcome. Additionally, further research is necessary to precisely determine the role of biofilm-induced gingivitis and systemic-induced gingivitis in improving gingival conditions.
Background: Head and neck cellulitis of dental origin are polymicrobial bacterial infections involving the cellulo-adipose spaces of the face and neck. The objective of this work was to describe the epidemiological and clinical profile of patients with head and neck cellulitis. Methods: This was a cross-sectional study conducted from 1 January to 30 June 2020. All patients consulting for cervico-facial cellulitis of dental origin in 2 university hospitals in Ouagadougou were included in the study. The usual parameters of descriptive statistics were estimated for each variable. Results: Two hundred and ninety-two cases (184 men and 108 women), aged 3 to 85 years were collected. The 25 -35 years old were the most affected (33%). Decay was the leading dental cause (95.6%). The delay in consultation was included within 7 days in 74.66% of cases. Ninety-one-point forty-four percent of patients had poor oral hygiene. Diffuse cellulitis was the most common (64.04%) and peri-mandibular regions were the most invaded (42.81%). Conclusion: The frequencies observed in our study allow us to conclude that cervicofacial cellulitis of dental origin is still frequent and affects a young and disadvantaged population.
Pre-eclampsia (PE), a pregnancy-specific hypertensive disorder, characterized by the development of placental endothelial dysfunction, remains a major source of maternal and perinatal morbidity and mortality, especially in low- and middle-income settings. Periodontal disorders during pregnancy, and particularly periodontal pathogens, may be related to the risk of PE. Standard oral hygiene methods, based mainly on the joint use of toothbrushes and interdental brushes, reduce periodontal inflammatory risk and modulate the dysbiosis of the oral microbiome. The aim of this trial is to compare the PE outcomes in high-risk pregnant women receiving oral prophylactic measures to a control group. This trial is designed as a two-arm, parallel, cluster randomized controlled trial with the antenatal obstetric clinic as the unit of randomization and an allocation ratio of 1:1. The pregnant women will be included at 3 months of pregnancy and will be followed throughout the pregnancy. The primary outcome measure will be the incidence of PE from a baseline during the pregnancy. Secondary outcomes measures will include changes from the baseline in quantification of the pathogenic bacterial load of the interdental microbiota, the severity scores of periodontal indicators, and the incidence of adverse perinatal outcomes. This trial should demonstrate that the implementation of daily oral hygiene reduces oral dysbiosis, the incidence of periodontal disease, and the risk of PE.
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