ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title It is Unclear Whether or Not Periodontal Therapy Will Affect the Outcome of Pregnancies
Clinical Question In a pregnant woman, how does periodontal therapy affect the outcome of the pregnancy?
Clinical Bottom Line At this time, there is not a clear answer in the literature on whether or not periodontal therapy will affect pregnancy outcome. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 19254578Polyzos/20092663 Pregnant women with documented periodontal diseaseMeta-analysis
Key resultsThe meta-analysis of RCTs showed that periodontal therapy with scaling and/or root planning significantly lowered pre-term birth (odds ratio .55, 95% confidence interval .35 - .86, p = .008), borderline significantly lowered rate of low birth weight (odds ratio .48, 95% confidence interval .23 - 1, p=.049) and no significant effect on spontaneous abortion or stillbirth (odds ratio .73, confidence interval .41 - 1.31, p = .292).
#2) 19935025Newnham/20091078 women with periodontal diseaseRandomized Controlled Trial
Key resultsThere were no differences between control and treatment groups for pre-term birth, pre-eclampsia, and other obstetric endpoints.
#3) 19701034Offenbacher/20091806 pregnant women before 23 weeks gestation receiving standard obstetric care with periodontal diseaseRandomized Controlled Trial
Key resultsPeriodontal therapy did not reduce the incidence of preterm delivery, and there were no significant differences when comparing women in the treatment group with those in the control group.
Evidence Search Limits: Meta-Analysis "Premature Birth"[Mesh] Search "Periodontal Diseases/therapy"[Mesh] Search "Pregnancy"[Mesh]
Comments on
The Evidence
The first article is a meta-analysis of randomized clinical trials. It had comprehensive, detailed search criteria for the trials, and the studies were evaluated and assessed for validity. It analyzed 7 trials with 2,663 patients, the other two articles were randomized control trials. In those trials, groups were similar at the start, showed adequate completion rate, follow up and compliance. Recall bias seems unlikely. The randomized controlled trials were included in addition to the meta-analysis due to their high number of participants.
Applicability This information is applicable to any dentist who sees pregnant women with periodontal disease in his/her practice.
Specialty/Discipline (Public Health) (Endodontics) (General Dentistry) (Oral Surgery) (Orthodontics) (Periodontics) (Prosthodontics) (Restorative Dentistry)
Keywords Periodontal therapy, pregnancy, pregnancy outcome, low birth weight, pre-term birth
ID# 560
Date of submission: 03/31/2010spacer
E-mail PatelNK@livemail.uthscsa.edu
Author Niraj Patel
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Guy Huynh-Ba, DDS
Faculty mentor/Co-author e-mail HuynhBa@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?)
post a rationale
None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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by Akshay Thusu (San Antonio, TX) on 04/19/2012
I conducted a PubMed search on this topic in April 2012 and found a more recent publication: PubMed ID 21190966. This Systematic review and meta-analysis of RCT was conducted by few of the same authors as the first evidence noted in this CAT. The article provides evidence contradictory mentioned in the key results section. It concluded that periodontal therapy cannot be considered to be an efficient way of reducing the incidence of pre-term birth.
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