Every day, dentists across the country decide whether or not to provide
dental care to a patient who is pregnant. On the one hand, they realize
the patient needs to maintain her good oral health, especially if she
has periodontal disease. On the other hand, dentists traditionally have
lacked the scientific evidence to make informed decisions about the
possible effects of dental care, if any, to the developing child. The
lack of data has caused many dentists to err strongly on the side of
caution, especially during the second trimester when the child's
development accelerates and, in theory, exposure to infectious oral
bacteria or dental products could have adverse effects. However, the
fundamental questions remain: Should dentists provide dental care to
pregnant women through the second trimester? If so, which types of
treatment are safe to provide?
During
the last 5 years, newer scientific evidence has provided answers to
these important questions. The data so far indicate that mothers who
receive dental care through the second trimester—both general and
periodontal treatment—do not appear to increase their risk of adverse
events during pregnancy. Some of the most scientifically rigorous data
come from the National Institute of Dental and Craniofacial Research
(NIDCR)-supported Obstetrics and Periodontal Therapy Trial (OPT). In
2006, the OPT reported in the New England Journal of Medicine that pregnant women, most with early to moderate periodontitis,
benefitted from general and periodontal care without an increase in
preterm births or other negative pregnancy outcomes. As published online in the journalPediatrics on April 11, the investigators report findings from a follow-up study
of the OPT patients and their children born during the original trial.
The researchers evaluated the neurodevelopment of 411 children,
including 32 preterm infants, 2 years after the study. The scientists
found no difference in the neurodevelopment of children from mothers
previously assigned to the treatment or control group. They also report
slight associations between improvements in a mother's periodontal
attachment loss during the original study and higher cognitive and motor
skills in their children. But both the associations are so weak, the
scientists considered them "to be of little or no clinical
significance." (From Dentistry Today, Source: NIDCR, Science News in Brief, April 19, 2011) |