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LETTER TO THE EDITOR |
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Year : 2015 | Volume
: 7
| Issue : 1 | Page : 67-68 |
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Periodontal diseases and pregnancy
Shilpa Trivedi, Nand Lal, Rameshwari Singhal
Department of Periodontology, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
Date of Web Publication | 20-May-2015 |
Correspondence Address: Dr. Shilpa Trivedi Department of Periodontology, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0975-8844.157408
How to cite this article: Trivedi S, Lal N, Singhal R. Periodontal diseases and pregnancy. J Orofac Sci 2015;7:67-8 |
Sir,
We write to you in regards to an article "oral changes in pregnant and nonpregnant women: A case-control study" authored by Patil [1] in the July-December 2013 issue of Journal of Orofacial Sciences. The author has nicely highlighted the oral changes such as gingivitis and pyogenic granuloma which showed an increased chance of occurrence in pregnancy.
In this context, we would like to add a very crucial piece of information. Though the oral changes such as gingivitis and pyogenic granuloma in pregnancy are related to hormonal disturbances and usually regress after the postpartum period, periodontitis can have adverse pregnancy outcomes such as low birth weight, preterm birth, preeclampsia, and even miscarriages.
Periodontitis is suggested as an important and clinically significant risk factor for low birth weight, which is a major national health problem in developing countries like India. [2]
Macedo et al. [3] have suggested that periodontal diseases along with an increased appetite and decreased frequency of brushing during pregnancy, are associated with preterm birth. Furthermore, in a systematic review and meta-analysis by Kim et al., [4] it has been indicated that scaling and root planing in pregnant women with periodontitis has a statistically significant effect in a reduction of the risk of preterm birth.
In a questionnaire-based study [5] to assess the knowledge and attitudes of practicing obstetricians in North India regarding the relationship between oral health and pregnancy outcomes, it was found that 70% of the obstetricians correctly knew about the effects of periodontitis on preterm birth and low birth weight. But, the irony was that only 40% recommended a dental examination during pregnancy. The knowledge about these adverse consequences could not be translated into an appropriate practice behavior.
Keeping the above facts in mind, it may be logical to recommend that a dental and specifically periodontal evaluation should form a part of prenatal check-up. Our medical counterparts should be well-informed about these relationships and should refer all the pregnant patients for dental evaluation as well. Further, a proper patient education and motivation regarding the adverse outcomes should be done. Oral hygiene reinforcement and nonsurgical treatments should be done to adverse the consequences. This would be helpful in improving both the maternal and child health and may be a step in decreasing the new-born morbidity and mortality, which usually occurs due to preterm and low - birth weight. It may be concluded that maintaining good oral health, patient and obstetrician information and proper treatment when required will go a long way in improving the maternal and infant health particularly in rural India.
References | |  |
1. | Patil SR. Oral changes in pregnant and nonpregnant women: A case-control study. J Orofac Sci 2013;5:118-22. |
2. | Jacob PS, Nath S. Periodontitis among poor rural Indian mothers increases the risk of low birth weight babies: A hospital-based case control study. J Periodontal Implant Sci 2014;44:85-93. |
3. | Macedo JF, Ribeiro RA, Machado FC, Assis NM, Alves RT, Oliveira AS, et al. Periodontal disease and oral health-related behavior as factors associated with preterm birth: A case-control study in south-eastern Brazil. J Periodontal Res 2014;49:458-64. |
4. | Kim AJ, Lo AJ, Pullin DA, Thornton-Johnson DS, Karimbux NY. Scaling and root planing treatment for periodontitis to reduce preterm birth and low birth weight: A systematic review and meta-analysis of randomized controlled trials. J Periodontol 2012;83:1508-19. |
5. | Suri V, Rao NC, Aggarwal N. A study of obstetricians' knowledge, attitudes and practices in oral health and pregnancy. Educ Health (Abingdon) 2014;27:51-4. |
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