Title	Oral Health Education and Prophylaxis May Lower the Incidence of Gingivitis in Pregnant Patients
Clinical Question	For pregnant patients, does oral health education and prophylaxis result in a lower incidence of gingivitis?
Clinical Bottom Line	Pregnancy gingivitis may be decreased with oral health education and dental prophylaxis.
Best Evidence
PubMed ID Author / Year Patient Group Study type (level of evidence) 24164645 Geisinger/2014 120 pregnant women between 16-24 weeks gestation with Gingival index ≥ 2 Clinical Trial Key results All enrolled patients received dental prophylaxis at baseline and oral hygiene instructions at baseline, 4 and 8 weeks. Statistically significant reductions were noted in gingival index (GI), plaque index (PI), probing depth (PD) and clinical attachment levels (CAL). “Mean whole mouth PI and GI scores decreased approximately 50% and the percentage of sites with PI and GI ≥ 2 decreased from 40% to 17% and 53% to 21.8%, respectively. Mean decreases in whole mouth PD and CAL of 0.45 and 0.24 mm, respectively, were seen.” 25518813 Moreira/2015 109 pregnant women Randomized Controlled Trial Key results Enrolled patients were randomized into two groups. The test group received periodontal therapy before giving birth and the control group received periodontal therapy after giving birth. Periodontal therapy significantly reduced periodontal inflammation in both groups. No statistically significant differences were observed between groups for PI, GI, PD or CAL. These results show that “hormonal changes during pregnancy do not interfere in treatment outcomes in women with widespread gingival inflammation and limited periodontal destruction.” Therefore, “periodontal health can be reestablished irrespective of the hormonal challenge that takes place during pregnancy.”
Evidence Search	"Periodontal Diseases/therapy"[Mesh] Search "Pregnancy"[Mesh]
Comments on The Evidence	It is difficult to draw conclusions about the effectiveness of an oral hygiene regimen from Geisinger/2014 because the study design lacks the use of control subjects who neither received the prophylaxis nor oral hygiene instructions during pregnancy. The Moreira/2015 study included a control group and randomization, providing better evidence to show that an oral hygiene regimen is equally effective in pregnant and non-pregnant patients.
Applicability	Pregnancy causes hormonal changes that can increase gingival inflammation. Therefore it is important to create awareness in pregnant women regarding oral hygiene maintenance. The results of clinical studies on the effect of oral prophylaxis and oral health education on pregnant women support public health interventions such as prophylaxis that may result in overall improvement of maternal and fetal oral and systemic health. Dentists should counsel their pregnant patients about the importance of oral health during pregnancy.
Specialty	(Public Health) (Oral Medicine/Pathology/Radiology) (General Dentistry) (Periodontics)
Keywords	Pregnancy gingivitis, oral prophylaxis, oral health education.
ID#	3261
Date of submission	06/26/2017
E-mail	tofauzia@gmail.com
Author	Fauzia Dadarkar, DDS
Co-author(s)
Co-author(s) e-mail
Faculty mentor	Kelly C. Lemke, DDS
Faculty mentor e-mail	LemkeK@uthscsa.edu
Basic Science Rationale (Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) None available
Comments and Evidence-Based Updates on the CAT (FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) None available