Effect of Intensive Oral Hygiene Regimen During Pregnancy on Periodontal Health, Cytokine Levels, and Pregnancy Outcomes: A Pilot Study

Abstract

Background Data are limited on the potential effect of intensive oral hygiene regimens and periodontal therapy during pregnancy on periodontal health, gingival crevicular fluid (GCF) and serum cytokines, and pregnancy outcomes. Methods A clinical trial was conducted on 120 community-dwelling, 16- to 35-year-old pregnant women at 16 to 24 weeks of gestation. Each participant presented with clinical evidence of generalized, moderate-to-severe gingivitis. Oral hygiene products were provided, together with instructions for an intensive daily regimen of hygiene practices. Non-surgical therapy was provided at baseline. Oral examinations were completed at baseline and again at 4 and 8 weeks. In addition, samples of blood and GCF were collected at baseline and week 8. Mean changes in clinical variables and GCF and serum cytokine levels (interleukin [IL]-1β, IL-6, tumor necrosis factor [TNF]-α) between baseline and week 8 were calculated using paired t test. Pregnancy outcomes were recorded at parturition. Results Results indicated a statistically significant reduction in all clinical variables (P <0.0001) and decreased levels of TNF-α (P = 0.0076) and IL-1β (P = 0.0098) in GCF during the study period. The rate of preterm births (<37 weeks of gestation) was 6.7% (P = 0.113) and low birth weight (<2,500 g) was 10.2% (P = 1.00). Conclusions Among the population studied, intensive instructions and non-surgical periodontal therapy provided during 8 weeks at early pregnancy resulted in decreased gingival inflammation and a generalized improvement in periodontal health. Large-scale, randomized, controlled studies are needed to substantiate these findings.

Comparison of Endothelial Function in Healthy Patients and Patients With Chronic Periodontitis and Myocardial Infarction

“…In an observational study by Muthukumar and Diviya, 43 PISA score was compared with anaerobic periodontal infection using N‐benzoyl‐ dl ‐arginine‐β‐napthylamide assay between healthy patients and patients with CP, highlighting the PISA score as a valid tool and an indicator of anaerobic infection. PISA also has been used to calculate periodontally associated inflammatory burden in other systemic conditions, including DM, 44 kidney disease, 45 pregnancy, 46 and rheumatoid arthritis 47 . Thus, based on the above‐mentioned evidence, it is probable that the PISA score could provide a better interpretation of the inflammatory burden as a result of severe periodontitis that could have systemic ramifications and can be used to strengthen links between periodontal and chronic systemic diseases.…”

Algorithm of action of dentist dentistry during pregnancy

“…Однак, ураховуючи фізіологічні зміни в організмі жінки загалом і ПР зокрема, постає потреба у проведенні профілактичних заходів, що скеровані на усунення загострення вже існуючих стоматологічних захворювань або на виникнення нових. Дотримання щоденної гігієни ПР і неоперативна пародонтальная терапія протягом восьми тижнів на ранніх термінах вагітності призводять до ослаблення запалення ясен і загального покращення стану пародонта [35].…”

Regular consumption of Lactobacillus reuteri‐containing lozenges reduces pregnancy gingivitis: an RCT

“…In clinical practice it is usually controlled by professional tooth cleaning and the establishment of adequate oral hygiene measures (Kaur et al. ). Nevertheless already the ground breaking experiments by Löe and Silness (Loe & Silness , Silness & Loe ) suggested, that pregnancy gingivitis is not identical to common plaque‐associated gingivitis due to a significant shift in the correlation between observed bacterial plaque mass and the ensuing extent of gingival inflammation before and after pregnancy.…”