Poor Oral Care | Risks for Pre-Term Birth

Pre-term births are a leading cause of infant mortality in multiple developed countries. They are also linked to an increased risk for poor health, decreased IQs, and chronic diseases later in life. According to the American College of Obstetrics and Gynecologists (ACOG), about 500,000 babies are born too early every year in the United States alone.

A new study has revealed that poor oral health can significantly increase the risk of pre-term birth (PTB). The findings support previous research suggesting that periodontal diseases are associated with the development of several other conditions, such as cardiovascular diseases and respiratory infections, which are known risk factors for Preterm Birth. The study followed 328 pregnant women at three different stages of their pregnancy. Among other things, their oral hygiene status was assessed by measuring gingival bleeding using an Oral Health Index (OHI-S). 

Their dental calculus level was measured using the Single Intradermal Comparative Cervical Test (SICCT). The researchers also measured the women's plaque levels per tooth using a plaque index. Finally, the women's ability to taste was measured using Phenol Threshold Test (PST). Assessments were done during their first trimester, second trimester, and delivery. This research found out that women who had bleeding gums or dental plaque at any stage of their pregnancy were 159% more likely to have a premature birth compared to the rest. In addition, women who continuously presented bleeding gums throughout the entire pregnancy were 324% more likely to have pre-term births. Lastly, those with high dental calculus levels were 249% more likely to get pre-term babies. The study found a dose-response relationship between poor oral hygiene and pre-term birth. In other words, the greater the level of gum disease, the more likely a woman would experience delivery before her expected delivery date.

This study also found that systemic inflammation may play a key role in oral health's effect on preterm birth. Poor oral hygiene is correlated with chronic low-grade systemic inflammation, which may, in turn, induce an inflammatory response in the uterus. Inflammation of this nature resulted in changes to the uterus, including increased contractility and decreased thickness which are known risk factors for pre-term births PTB.

Although the exact mechanism behind the development of pre-term birth is still unknown, it's clear that poor oral hygiene can significantly increase a woman's chances of delivering early. Therefore, dental care should be considered an integral part of prenatal care to ensure healthy pregnancies and deliveries for both women and their babies.

The solution outlined in the study was to educate expecting mothers about good oral health practices. This included brushing teeth regularly and eating a well-balanced diet, including calcium sources for healthy bone development in children. Additionally, they recommended that expecting mothers use fluoride toothpaste. This would prevent them from further exacerbating their risk through additional cavities caused by poor dietary choices, which could impact the unborn child's mental development (cavities). In addition to these findings, an additional study from "Birth" looked at how dental care affects pregnant women. This study found that pregnant women who had more cavities were three times more likely to have babies with low birth weight than those without cavities. Those with poor oral health were eight times as likely to have infants weighing less than 5 pounds 14 ounces - considered to be extremely low birth weight.

Elsewhere, "The Journal of Maternal-Fetal & Neonatal Medicine" published a third study on the same topic in February 2016. This study simulated what would happen if every expectant mother brushed her teeth twice daily, beginning at ten weeks until delivery. The study estimated that this simple regimen could prevent over 6% of pre-term births per year worldwide - over 150,000 cases. But, more importantly, the study found that this would save over 1 million infant lives per year.

Researchers believe there could be several ways in which poor dental health may lead to early deliveries. For example, oral bacteria could enter the bloodstream and trigger an immune response, leading to inflammation. Alternatively, harmful chemical compounds produced by oral bacteria could be absorbed directly into the body during digestion, inducing early labor.

All three studies strongly support each other's findings - poor oral hygiene contributes significantly to pre-term birth. The solution is simple: increase education about proper oral health care during pregnancy through prenatal sources such as doctors or midwives. It is recommended that pregnant women discuss their oral health status with their doctors as early as during the first 8 weeks of pregnancy to create a treatment plan where the presentation of issues could be harmful to the pregnancy.

References:

Mokeem, Sameer Abdullah, Ghadeer Nabeel Molla, and Thikriat Saleh Al-Jewair. "The prevalence and relationship between periodontal disease and pre-term low birth weight infants at King Khalid University Hospital in Riyadh, Saudi Arabia." J Contemp Dent Pract 5.2 (2004): 40-56.

Mitchell‐Lewis, Dennis, et al. "Periodontal infections and pre‐term birth: early findings from a cohort of young minority women in New York." European journal of oral sciences 109.1 (2001): 34-39.

Davenport, E. S., et al. "The effects of diet, breast‐feeding and weaning on caries risk for pre‐term and low birth weight children." International journal of pediatric dentistry 14.4 (2004): 251-259.