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Arbildo-Vega HI, Padilla-Cáceres T, Caballero-Apaza L, Cruzado-Oliva FH, Mamani-Cori V, Cervantes-Alagón S, Vásquez-Rodrigo H, Coronel-Zubiate FT, Aguirre-Ipenza R, Meza-Málaga JM, Luján-Valencia SA, Castillo-Cornock TB, Serquen-Olano K. Effect of Treating Periodontal Disease in Pregnant Women to Reduce the Risk of Preterm Birth and Low Birth Weight: An Umbrella Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:943. [PMID: 38929560 PMCID: PMC11205593 DOI: 10.3390/medicina60060943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 05/25/2024] [Accepted: 05/31/2024] [Indexed: 06/28/2024]
Abstract
Background: The aim of this review was to evaluate the effects of periodontal disease (PD) treatment in pregnant women to reduce the risk of preterm birth (PB) and low birth weight (LBW) by conducting an umbrella review. Methods: A comprehensive search for the literature up to April 2024 was conducted across multiple databases including PubMed, Cochrane Library, Scopus, EMBASE, Scielo, Web of Science, Google Scholar, Proquest Dissertations and Theses, and OpenGrey. We specifically targeted systematic reviews (SRs) with or without meta-analyses, irrespective of language or time constraints, focusing on primary studies examining the effect of PD treatment in pregnant women to reduce the risk of PB and LBW. Various types of non-systematic reviews, intervention studies, observational studies, preclinical and basic research, summaries, comments, case reports, protocols, personal opinions, letters, and posters were excluded from consideration. The quality and overall confidence of the included studies were assessed using the AMSTAR-2 tool. Results: After the initial search, 232 articles were identified, of which only 24 met the selection criteria after exclusion. The majority of these studies indicated that periodontal treatment reduces the risk of PB and LBW. Conclusions: According to the findings and conclusions drawn from the SRs with a high overall confidence level, PD treatment in pregnant women reduces the risk of PB and LBW.
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Affiliation(s)
- Heber Isac Arbildo-Vega
- Department of General Dentistry, Dentistry School, San Martín de Porres University, Chiclayo 14012, Peru; (H.I.A.-V.); (H.V.-R.); (T.B.C.-C.); (K.S.-O.)
- Department of Human Medicine, School of Human Medicine, San Martín de Porres University, Chiclayo 14012, Peru
| | - Tania Padilla-Cáceres
- Department of General Dentistry, Dentistry School, University of the Altiplano, Puno 21001, Peru; (T.P.-C.); (L.C.-A.); (V.M.-C.); (S.C.-A.)
- Research Institute in Environmental Sciences, Health and Biodiversity—IICASB, University of the Altiplano, Puno 21001, Peru
| | - Luz Caballero-Apaza
- Department of General Dentistry, Dentistry School, University of the Altiplano, Puno 21001, Peru; (T.P.-C.); (L.C.-A.); (V.M.-C.); (S.C.-A.)
- Department of Nursing, School of Nursing, University of the Altiplano, Puno 21001, Peru
| | - Fredy Hugo Cruzado-Oliva
- Department of Stomatology, School of Stomatology, National University of Trujillo, Trujillo 13011, Peru;
| | - Vilma Mamani-Cori
- Department of General Dentistry, Dentistry School, University of the Altiplano, Puno 21001, Peru; (T.P.-C.); (L.C.-A.); (V.M.-C.); (S.C.-A.)
- Research Institute in Environmental Sciences, Health and Biodiversity—IICASB, University of the Altiplano, Puno 21001, Peru
| | - Sheyla Cervantes-Alagón
- Department of General Dentistry, Dentistry School, University of the Altiplano, Puno 21001, Peru; (T.P.-C.); (L.C.-A.); (V.M.-C.); (S.C.-A.)
- Amazonian Andean Research and Development Institute—IIDEAA, University of the Altiplano, Puno 21001, Peru
| | - Hernán Vásquez-Rodrigo
- Department of General Dentistry, Dentistry School, San Martín de Porres University, Chiclayo 14012, Peru; (H.I.A.-V.); (H.V.-R.); (T.B.C.-C.); (K.S.-O.)
- Department of Dentistry, Dentistry School, Norbert Wiener University, Lima 15046, Peru
| | - Franz Tito Coronel-Zubiate
- Faculty of Health Sciences, Stomatology School, Toribio Rodríguez of Mendoza National University of Amazonas, Chachapoyas 01001, Peru
| | | | - Joan Manuel Meza-Málaga
- Faculty of Dentistry, Dentistry School, Católica de Santa María University, Arequipa 04013, Peru; (J.M.M.-M.); (S.A.L.-V.)
- Faculty of Medicine, Medicine School, Católica de Santa María University, Arequipa 04013, Peru
| | - Sara Antonieta Luján-Valencia
- Faculty of Dentistry, Dentistry School, Católica de Santa María University, Arequipa 04013, Peru; (J.M.M.-M.); (S.A.L.-V.)
- Postgraduate School, Católica de Santa María University, Arequipa 04013, Peru
| | - Tania Belú Castillo-Cornock
- Department of General Dentistry, Dentistry School, San Martín de Porres University, Chiclayo 14012, Peru; (H.I.A.-V.); (H.V.-R.); (T.B.C.-C.); (K.S.-O.)
- Faculty of Health Sciences, Stomatology School, Señor de Sipán University, Chiclayo 14000, Peru
| | - Katherine Serquen-Olano
- Department of General Dentistry, Dentistry School, San Martín de Porres University, Chiclayo 14012, Peru; (H.I.A.-V.); (H.V.-R.); (T.B.C.-C.); (K.S.-O.)
- Faculty of Health Sciences, Stomatology School, Señor de Sipán University, Chiclayo 14000, Peru
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Shitu K, Alemayehu M, Berassa SH. Oral hygiene behaviour and its determinants among preparatory school students in Gondar city, Northwest Ethiopia: A cross-sectional study. Int J Dent Hyg 2024; 22:177-186. [PMID: 36627237 DOI: 10.1111/idh.12666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 08/17/2022] [Accepted: 01/07/2023] [Indexed: 01/12/2023]
Abstract
OBJECTIVES This study aimed to evaluate oral hygiene behaviour and its determinants among preparatory school students in Gondar city, Northwest Ethiopia. METHODS Institutional-based cross-sectional study was conducted among 423 students to evaluate their oral hygiene behaviour and determinant factors (sociodemographic attributes, oral hygiene knowledge, and attitude to oral hygiene behaviours). Linear regression was employed to identify factors associated with oral hygiene behaviour. A p-value of <0.05 and a 95% confidence interval were used to declare statistical significance. RESULTS A total of 407 students participated with a response rate of 96.2%. The mean age of the participants was 18 (SD ±1.3). The mean oral hygiene behaviour (OHB) score was about 7.89 ± 3.43. Only 9.2%, 21.4%, and 5.7% were brushing their teeth at least twice a day, cleaning their tongue, and flossing at least once a day respectively. Father's educational status (able to read and write (β = 1.99, 95% CI: 0.62, 3.38), completed secondary school (β = 1.68, 95% CI: 0.18, 3.18), and diploma and higher (β = 1.75, 95% CI: 0.33, 3.18)), being from private school (β = 3.25, 95%CI: 2.30, 4.19), knowledge about OHB (β = 0.16, 95% CI: 0.01, 0.30), and attitude towards OHB (β = 0.11, 95% CI: 0.08, 0.14) were significant factors positively associated with better oral hygiene behaviour. CONCLUSION Oral hygiene behaviour was poor among preparatory school students in Gondar city. Father's educational status, students' oral hygiene knowledge, and attitude were found to be significant factors affecting students' oral hygiene behaviour. Thus, tailored school-based oral health communication programs are highly required to improve students' oral hygiene behaviour.
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Affiliation(s)
- Kegnie Shitu
- Department of Health Promotion and Health Behavior, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mekuriaw Alemayehu
- Department of Environmental Health and Occupational Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Al Agili D. Trends in maternal oral health services at primary healthcare centers in Saudi Arabia: a cross-sectional study. BMC Oral Health 2023; 23:1031. [PMID: 38129865 PMCID: PMC10740224 DOI: 10.1186/s12903-023-03712-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 11/24/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND During pregnancy, many complex physiological changes and increased levels of pregnancy hormones are associated with adverse oral health and increased prevalence of periodontal disease. Our study aimed to assess the oral health needs of pregnant women and describe the patterns of dental services provided to them before, during, and after pregnancy. Assessing the oral health needs of pregnant women and understanding the patterns of dental services provided to them are important to facilitate efficient utilization of oral health services to promote better health outcomes for the mother and baby. METHODS Our study utilized a cross-sectional design to examine the prevalence of dental problems and use of dental services among a sample of postpartum women who visited primary healthcare centers (PHCs) in Jeddah for antenatal care, between 2018 and 2019. A link to a questionnaire adapted from the Pregnancy Risk Assessment Monitoring System (PRAMS) was sent to participants via the WhatsApp messaging platform. A total of 1350 postpartum women responded to the online survey. We estimated the prevalence of dental problems among women before and during pregnancy and assessed the association between their dental problems and their respective demographic characteristics. We calculated the prevalence of each dental service received before, during, and after pregnancy and examined the trends in dental services over these three periods. All bivariate associations were tested using Pearson's chi-squared test. RESULTS We found that significantly fewer women visited a dental clinic during pregnancy (31.0%) compared to pre-pregnancy (38.2%) and post-pregnancy (47.3%). The prevalence of toothache, dental caries, gum disease, and dental extraction need before pregnancy was 45.9%, 57.0%, 27.3%, and 40.0%, respectively. These percentages remained the same during pregnancy, except for the need for dental extraction, which significantly decreased to 35.3%. Check-up dental visits increased significantly to 70.6% during pregnancy compared to pre-pregnancy (51.7%) and post-pregnancy (59.9%). CONCLUSION Increasing women's awareness of the importance and safety of oral healthcare during pregnancy, training dental students and primary healthcare dentists in the practice guidelines for the dental management of pregnant women, and developing and monitoring key performance indicators for maternal oral healthcare are the starting steps for improving the oral health and well-being of women and their children.
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Affiliation(s)
- Dania Al Agili
- Department of Dental Public Health, King Abdulaziz University, P.O. Box 80200, 21589, Jeddah, Saudi Arabia.
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Karimi N, Samiee N, Moradi Y. The association between periodontal disease and risk of adverse maternal or neonatal outcomes: A systematic review and meta-analysis of analytical observational studies. Health Sci Rep 2023; 6:e1630. [PMID: 37867783 PMCID: PMC10587389 DOI: 10.1002/hsr2.1630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/26/2023] [Accepted: 10/05/2023] [Indexed: 10/24/2023] Open
Abstract
Background and Aim The aim of this meta-analysis was to find the association between periodontal disease (PD) and the risk of adverse pregnancy outcomes, including Pre-eclampsia (PE), premature rupture of the amniotic sac, gestational diabetes (GDM), or low birth weight (LBW) in pregnant women, which should be investigated in a systematic meta-analysis. Methods Studies that reported the association between PD and pregnancy or neonatal outcomes and were published from January 1990 to December 2022, were identified by an extensive search in PubMed (Medline), Scopus, Web of Sciences, and Medline (Elsevier). After retrieving the studies, the screening stage was performed based on their titles, abstracts, and full texts, and after selecting the final articles, their information was extracted and their quality was assessed using the Newcastle Ottawa Scale checklist. Results Pregnant women with PD had a 1.39 higher chance of developing GDM than those who did not have the infection (risk ratio [RR]: 1.39; 95% confidence interval [CI]: 1.21-1.61; I square: 49.67%; p: 0.03). Additionally, the pooled RR of LBW was 2.19, which indicates that pregnant women with PD had a 2.19-fold higher risk of LBW than pregnant women who do not have the infection (RR: 2.19; 95% CI: 1.82-2.64; I square: 0.00%; p: 0.65). The relationship between the risk of PE and the existence of PD was examined in 33 cohort and case-control studies for this meta-analysis. These results were combined, and the pooled RR was 1.43. This indicates that pregnant women with PD are 1.43 times more likely to experience PE than pregnant women without PD (RR: 1.43; 95% CI: 1.32-1.54; I square: 82.64%; p: 0.00). Conclusion According to the findings of the current meta-analysis, PD may contribute to a higher risk of poor maternal and newborn outcomes in pregnant women.
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Affiliation(s)
- Newsha Karimi
- Student Research Committee, Facualty of DentistryKurdistan University of Medical SciencesSanandajIran
| | - Negin Samiee
- Oral and Maxillofacial Medicine Department, Facualty of DentistryKurdistan University of Medical SciencesSanandajIran
| | - Yousef Moradi
- Social Determinant of the Health Research Center, Research Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
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Machado V, Ferreira M, Lopes L, Mendes JJ, Botelho J. Adverse Pregnancy Outcomes and Maternal Periodontal Disease: An Overview on Meta-Analytic and Methodological Quality. J Clin Med 2023; 12:jcm12113635. [PMID: 37297830 DOI: 10.3390/jcm12113635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/19/2023] [Accepted: 05/21/2023] [Indexed: 06/12/2023] Open
Abstract
This umbrella review aims to appraise the methodological quality and strength of evidence on the association between maternal periodontitis and adverse pregnancy outcomes (APOs). PubMed, CENTRAL, Web-of-Science, LILACS, and Clinical Trials were searched until February 2023, without date or language restrictions. Two authors independently screened studies, extracted data, performed the risk-of-bias analysis, and estimated the meta-analytic strengths and validity and the fail-safe number (FSN). A total of 43 SRs were identified, of which 34 conducted meta-analyses. Of the 28 APOs, periodontitis had a strong association with preterm birth (PTB), low birth weight (LBW), and gestational diabetes mellitus (GDM), PTB and LBW showed all levels of strength, and pre-eclampsia showed only suggestive and weak strength. Regarding the consistency of the significant estimates, only 8.7% were likely to change in the future. The impact of periodontal treatment on APOs was examined in 15 SRs, 11 of which conducted meta-analyses. Forty-one meta-analyses were included and showed that periodontal treatment did not have a strong association with APOs, although PTB revealed all levels of strength and LBW showed only suggestive and weak evidence. Strong and highly suggestive evidence from observational studies supports an association of periodontitis with a higher risk of PTB, LBW, GDM, and pre-eclampsia. The effect of periodontal treatment on the prevention of APOs is still uncertain and requires future studies to draw definitive and robust conclusions.
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Affiliation(s)
- Vanessa Machado
- Clinical Research Unit (CRU), Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, 2829-511 Caparica, Portugal
- Evidence-Based Hub, Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, 2829-511 Almada, Portugal
| | - Madalena Ferreira
- Clinical Research Unit (CRU), Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, 2829-511 Caparica, Portugal
| | - Luísa Lopes
- Clinical Research Unit (CRU), Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, 2829-511 Caparica, Portugal
| | - José João Mendes
- Clinical Research Unit (CRU), Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, 2829-511 Caparica, Portugal
- Evidence-Based Hub, Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, 2829-511 Almada, Portugal
| | - João Botelho
- Clinical Research Unit (CRU), Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, 2829-511 Caparica, Portugal
- Evidence-Based Hub, Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health and Science, 2829-511 Almada, Portugal
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Association between the Risk of Preterm Birth and Low Birth Weight with Periodontal Disease in Pregnant Women: An Umbrella Review. Dent J (Basel) 2023; 11:dj11030074. [PMID: 36975571 PMCID: PMC10047843 DOI: 10.3390/dj11030074] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/17/2022] [Accepted: 01/29/2023] [Indexed: 03/09/2023] Open
Abstract
Background: The purpose of this review is to determine the association between the risk of preterm birth and low birth weight in newborns and periodontal disease in pregnant women. Methods: A bibliographic search was carried out until November 2021 in the following biomedical databases: PubMed/Medline, Cochrane Library, Scopus, EMBASE, Web of Science, Scielo, LILACS and Google Scholar. Studies reporting the association between the risk of preterm birth and low birth weight in newborns with periodontal disease in pregnant women, which were systematic reviews, in English and without time limits were included. AMSTAR-2 was used to assess the risk of the included studies, and the GRADEPro GDT tool was used to assess the quality of the evidence and the strength of the recommendation of the results. Results: The preliminary search yielded a total of 161 articles, discarding those that did not meet the selection criteria, leaving only 15 articles. Seven articles were entered into a meta-analysis, and it was found that there is an association between the risk of preterm birth and low birth weight in newborns with periodontal disease in pregnant women. Conclusions: There is an association between the risk of preterm birth and low birth weight in newborns with periodontal disease in pregnant women.
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Wu TT, Sohn M, Manning S, Beblavy R, Gill S, Quataert S, Vasani S, Jang H, Zeng Y, Bruno J, Vazquez A, Fiscella K, Xiao J. Metagenomic analysis examines oral microbiome changes and interplay with immune response following prenatal total oral rehabilitation. J Transl Med 2023; 21:172. [PMID: 36871005 PMCID: PMC9985285 DOI: 10.1186/s12967-023-03997-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 02/15/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND Suboptimal maternal oral health during pregnancy is potentially associated with adverse birth outcomes and increased dental caries risks in children. This study aimed to assess the oral microbiome and immune response following an innovative clinical regimen, Prenatal Total Oral Rehabilitation (PTOR), that fully restores women's oral health to a "disease-free status" before delivery. METHODS This prospective cohort study assessed 15 pregnant women at baseline and 3 follow-up visits (1 week, 2 weeks, and 2 months) after receiving PTOR. The salivary and supragingival plaque microbiomes were analyzed using metagenomic sequencing. Multiplexed Luminex cytokine assays were performed to examine immune response following PTOR. The association between salivary immune markers and oral microbiome was further examined. RESULTS PTOR was associated with a reduction of periodontal pathogens in plaque, for instance, a lower relative abundance of Tannerella forsythia and Treponema denticola at 2 weeks compared to the baseline (p < 0.05). The alpha diversity of plaque microbial community was significantly reduced at the 1-week follow-up (p < 0.05). Furthermore, we observed significant changes in the Actinomyces defective-associated carbohydrate degradation pathway and Streptococcus Gordonii-associated fatty acid biosynthesis pathway. Two immune markers related to adverse birth outcomes significantly differed between baseline and follow-up. ITAC, negatively correlated with preeclampsia severity, significantly increased at 1-week follow-up; MCP-1, positively correlated with gestational age, was elevated at 1-week follow-up. Association modeling between immune markers and microbiome further revealed specific oral microorganisms that are potentially correlated with the host immune response. CONCLUSIONS PTOR is associated with alteration of the oral microbiome and immune response among a cohort of underserved US pregnant women. Future randomized clinical trials are warranted to comprehensively assess the impact of PTOR on maternal oral flora, birth outcomes, and their offspring's oral health.
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Affiliation(s)
- Tong Tong Wu
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Michael Sohn
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Samantha Manning
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Robert Beblavy
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Steven Gill
- Immunology and Microbiology, University of Rochester Medical Center, Rochester, NY, USA
| | - Sally Quataert
- Immunology and Microbiology, University of Rochester Medical Center, Rochester, NY, USA
| | - Shruti Vasani
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Hoonji Jang
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA.,Temple University Maurice H. Kornberg School of Dentistry, Philadelphia, USA
| | - Yan Zeng
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Jennifer Bruno
- Immunology and Microbiology, University of Rochester Medical Center, Rochester, NY, USA
| | | | - Kevin Fiscella
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Jin Xiao
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA.
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Muacevic A, Adler JR, Alghamdi WK, Alghamdi FT. The Potential Association Between Periodontal Diseases and Adverse Pregnancy Outcomes in Pregnant Women: A Systematic Review of Randomized Clinical Trials. Cureus 2023; 15:e33216. [PMID: 36733569 PMCID: PMC9888319 DOI: 10.7759/cureus.33216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2022] [Indexed: 01/02/2023] Open
Abstract
Preceding studies have demonstrated that periodontitis might increase the liability of adverse pregnancy outcomes such as preterm birth, preeclampsia, low birth weight, and perinatal fatality in pregnant women. Nonetheless, there is no convincing testimony that periodontitis is related directly to adverse pregnancy outcomes in pregnant women. This systematic review intended to assess and review all the available randomized clinical trials that concentrated on the association between periodontal diseases and adverse pregnancy outcomes, and the impact of periodontal disease therapy on adverse pregnancy outcomes. The databases like Scopus, PubMed, Google Scholar, and Web of Science were consumed to explore relevant and suitable studies after adopting the inclusion and exclusion criteria. The search included articles with no time restrictions and certain keywords were utilized in the databases. The investigation was done through four independent reviewers employing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Twenty-three studies fulfilled the exclusion and inclusion criteria and were used and included in this systematic review. The above-mentioned studies assessed the association between periodontal diseases and adverse pregnancy outcomes and the effect of periodontal disease treatment in reducing the influence of adverse pregnancy outcomes. This systematic review revealed that there is a relationship between periodontitis and adverse pregnancy outcomes, and periodontal treatment has a reducing impact on adverse pregnancy outcomes in pregnant women with periodontitis. Prospect studies are warranted to investigate the relationship between periodontitis and different adverse pregnancy outcomes and to decide the best type and the most effective therapy to treat periodontitis in pregnant women.
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Periodontitis and Preeclampsia in Pregnancy: A Systematic Review and Meta-Analysis. Matern Child Health J 2022; 26:2419-2443. [PMID: 36209308 PMCID: PMC9747857 DOI: 10.1007/s10995-022-03556-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVES A conflicting body of evidence suggests localized periodontal inflammation spreads systemically during pregnancy inducing adverse pregnancy outcomes. This systematic review and meta-analysis aim to specifically evaluate the relationship between periodontitis and preeclampsia. METHODS Electronic searches were carried out in Medline, Pubmed, Embase, Lilacs, Cochrane Controlled Clinical Trial Register, CINAHL, ClinicalTrials.gov, and Google Scholar with no restrictions on the year of publication. We identified and selected observational case-control and cohort studies that analyzed the association between periodontal disease and preeclampsia. This meta-analysis was conducted following the PRISMA checklist and MOOSE checklist. Pooled odds ratios, mean difference, and 95% confidence intervals were calculated using the random effect model. Heterogeneity was tested with Cochran's Q statistic. RESULTS Thirty studies including six cohort- and twenty-four case-control studies were selected. Periodontitis was significantly associated with increased risk for preeclampsia (OR 3.18, 95% CI 2.26 - 4.48, p < 0.00001), especially in a subgroup analysis including cohort studies (OR 4.19, 95% CI 2.23 - 7.87, p < 0.00001). The association was even stronger in a subgroup analysis with lower-middle-income countries (OR 6.70, 95% CI 2.61 - 17.19, p < 0.0001). CONCLUSIONS Periodontitis appears as a significant risk factor for preeclampsia, which might be even more pronounced in lower-middle-income countries. Future studies to investigate if maternal amelioration of periodontitis prevents preeclampsia might be warranted.
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BASHİRİAN S, BARATİ M, BARATİ M, KHAZAEİ S, JENABİ E, GHOLAMİ L, SHİRAHMADİ S. Assessment of Periodontal Disease status in Pregnant Women and Related Demographic Factors in arak, Iran. CUMHURIYET DENTAL JOURNAL 2022. [DOI: 10.7126/cumudj.1112636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Zhang Y, Feng W, Li J, Cui L, Chen ZJ. Periodontal Disease and Adverse Neonatal Outcomes: A Systematic Review and Meta-Analysis. Front Pediatr 2022; 10:799740. [PMID: 35601423 PMCID: PMC9114501 DOI: 10.3389/fped.2022.799740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 03/31/2022] [Indexed: 11/13/2022] Open
Abstract
Objective The aim of this study was to evaluate the association between maternal periodontal disease (PD) and three main adverse neonatal outcomes, namely, preterm birth (PTB), low birth weight (LBW), and small for gestational age (SGA). Methods The Ovid Medline, Web of Science, Embase, and Cochrane Library were searched up to 6 December 2020 for relevant observational studies on an association between PD and risk of PTB, LBW, and SGA. Eligibility criteria included observational studies which compared the prevalence of PTB and/or LBW and/or SGA between PD women and periodontal health controls. The exclusion criteria included incomplete data, animal research, and mixing up various pregnancy outcomes, such as "preterm low birth weight" and languages other than Chinese and English. Data were extracted and analyzed independently by two authors. The meta-analysis was performed using Stata Statistical Software, Release 12 (StataCorp LP, College Station, TX, USA). Odds ratio (OR), confidence intervals (CIs), and heterogeneity (I 2) were computed. Results Fourteen case-control studies and 10 prospective cohort studies, involving 15,278 participants, were identified. Based on fixed effect meta-analysis, PTB showed a significant association with PD (OR = 1.57, 95% CI: 1.39-1.77, P < 0.00001) and LBW also showed a significant association with PD (OR = 2.43, 95% CI: 1.75-3.37, P < 0.00001) in a random effect meta-analysis. However, a random effect meta-analysis showed no relationship between PD and SGA (OR = 1.62, 95% CI: 0.86-3.07, P = 0.136). Conclusion Our findings indicate that pregnant women with PD have a significantly higher risk of PTB and LBW. However, large prospective, blinded cohort studies with standardized diagnostic criteria of PD and adequate control of confounding factors are still required to confirm the relationship between PD and adverse neonatal outcomes.
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Affiliation(s)
- Youzhen Zhang
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
| | - Wanbing Feng
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
| | - Jingyu Li
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
| | - Linlin Cui
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
| | - Zi-Jiang Chen
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, China
- Shandong Key Laboratory of Reproductive Medicine, Jinan, China
- Shandong Provincial Clinical Research Center for Reproductive Health, Jinan, China
- National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China
- Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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12
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Starzyńska A, Wychowański P, Nowak M, Sobocki BK, Jereczek-Fossa BA, Słupecka-Ziemilska M. Association between Maternal Periodontitis and Development of Systematic Diseases in Offspring. Int J Mol Sci 2022; 23:ijms23052473. [PMID: 35269617 PMCID: PMC8910384 DOI: 10.3390/ijms23052473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/18/2022] [Accepted: 02/20/2022] [Indexed: 12/24/2022] Open
Abstract
Periodontal disease (PD) is one of the most common oral conditions affecting both youths and adults. There are some research works suggesting a high incidence of PD in pregnant women. As an inflammatory disease of bacterial origin, PD may result in the activation of the pathways affecting the course and the pregnancy outcome. The authors, based on the literature review, try to answer the PICO question: Does maternal periodontitis (exposure) influence the incidence of complications rates in pregnancy and the development of systemic diseases in childhood and adult offspring (outcome) in the humans of any race (population) compared to the offspring of mothers with healthy periodontium (comparison)? The authors try to describe the molecular pathways and mechanisms of these interdependencies. There is some evidence that maternal periodontitis may affect the pregnancy course and outcome, resulting in preeclampsia, preterm delivery, vulvovaginitis and low birth weight. It can be suggested that maternal periodontitis may affect offspring epigenome and result in some health consequences in their adult life.
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Affiliation(s)
- Anna Starzyńska
- Department of Oral Surgery, Medical University of Gdańsk, 7 Dębinki Street, 80-211 Gdańsk, Poland;
- Correspondence:
| | - Piotr Wychowański
- Department of Oral Surgery, Medical University of Warsaw, 6 Binieckiego Street, 02-097 Warsaw, Poland;
- Specialized Private Implantology Clinic Wychowanski Stomatologia, 9/33 Rakowiecka Street, 02-517 Warsaw, Poland
| | - Maciej Nowak
- Department of Periodontology and Oral Diseases, Medical University of Warsaw, 6 Binieckiego Street, 02-097 Warsaw, Poland;
| | - Bartosz Kamil Sobocki
- Department of Oral Surgery, Medical University of Gdańsk, 7 Dębinki Street, 80-211 Gdańsk, Poland;
| | - Barbara Alicja Jereczek-Fossa
- Department of Oncology and Hemato-Oncology, University of Milan, 7 Festa del Perdono Street, 20-112 Milan, Italy;
- Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, 435 Ripamonti Street, 20-141 Milan, Italy
| | - Monika Słupecka-Ziemilska
- Department of Human Epigenetics, Mossakowski Medical Research Institute, Polish Academy of Sciences, 5 Pawińskiego Street, 02-106 Warsaw, Poland;
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13
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Althumairy RI. Exploring the Quality of Life for Saudi Patients Utilizing Dental Healthcare Services: A Systematic Review. J Multidiscip Healthc 2022; 15:309-315. [PMID: 35221692 PMCID: PMC8881009 DOI: 10.2147/jmdh.s344963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 01/26/2022] [Indexed: 11/23/2022] Open
Abstract
Over three billion people globally are affected by oral diseases. The Kingdom of Saudi Arabia (KSA) has declared a new vision for 2030, which includes an aim to improve the quality of healthcare in the Kingdom while maintaining the efficacy of spending. The Oral Health Impact Profile (OHIP) is a quality of life instrument that helps evaluate health status. This study aims to evaluate equity in accessing dental services and the integration of different types of dental services in the Kingdom of Saudi Arabia. A systematic review of the MEDLINE, ClinicalTrials.gov, and EBSCOhost Research Databases was conducted on August 1, 2021. To answer the research question, the SPIDER search tool that identified the sample, the phenomenon of interest, design, evaluation, and research type prior to conducting the review was adapted. Multiple steps were followed to identify the results. The first step was scanning and selecting the related titles. The second step involved reviewing the abstracts, and the third step involved scanning the full manuscript for all criteria to determine and validate the eligibility of the articles. Twenty-two articles remained in the final stage of the study. The first study applying the OHIP instrument in the KSA was in 2010, and the latest was in 2021. In terms of cities, nine cities accounted for research within eight administrative regions. Of the 4794 patients recruited within these reviewed articles, the highest number of patients reported was 1141 for fashion braces, while the minimum number of patients was 32 for conventional complete dentures. This study shows that the Arabic OHIP tool was successfully adapted by multiple dental studies in the KSA with various dental services and results were reported. The reviewed studies suggest that equity and integration of dental health services are well established in Saudi Arabia. Moreover, the major role of dental academic researchers has been identified.
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Affiliation(s)
- Riyadh I Althumairy
- Division of Endodontics, Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, 11545, Saudi Arabia
- Correspondence: Riyadh I Althumairy, Tel +966 114677420, Email
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14
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ABANTO J, OLIVEIRA LB, PAIVA SM, GUARNIZO-HERREÑO C, SAMPAIO FC, BÖNECKER M. Impact of the first thousand days of life on dental caries through the life course: a transdisciplinary approach. Braz Oral Res 2022; 36:e113. [DOI: 10.1590/1807-3107bor-2022.vol36.0113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 04/04/2022] [Indexed: 12/23/2022] Open
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15
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Porto ECL, Gomes Filho IS, Batista JET, Lyrio AO, Souza ES, Figueiredo ACMG, Pereira MG, Cruz SSD. [Maternal periodontitis and low birth weight: systematic review and meta-analysis]. CIENCIA & SAUDE COLETIVA 2021; 26:5383-5392. [PMID: 34787227 DOI: 10.1590/1413-812320212611.3.32362019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 04/20/2020] [Indexed: 11/22/2022] Open
Abstract
Recent evidence points to the influence of periodontal inflammatory processes on the occurrence of low birth weight. Although many studies employed robust investigation methods, there is still no general agreement on the relationship between maternal periodontitis and low birth weight. The search for studies was conducted until April 2019. The studies included cohort and case-control studies that estimated the association between periodontitis and low birth weight, with no restriction on language or date of publication. Analysis of the heterogeneity of studies, subgroup analyses and meta-analyses with a random effects model were performed. Summary association measurements were estimated using the crude and adjusted Odds Ratio, with respective 95% confidence intervals. Visual inspection of graphs was used to assess publication bias. A total of 21 articles were identified, all of which were selected for the meta-analysis. The final model indicates that periodontitis in pregnant women was associated with low birth weight (ORgross=2.13; CI95%=1.60-2.83; I2=80.0% and ORadjusted=2.64; CI95%=2.04-3.42; I2=17.4%). Pregnant women with periodontitis may be more than twice as likely to have low birth weight babies.
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Affiliation(s)
- Edla Carvalho Lima Porto
- Universidade Estadual de Feira de Santana. Av. Transnordestina s/n, Feira de Santana. 44036-900 Novo Horizonte BA Brasil.
| | - Isaac Suzart Gomes Filho
- Universidade Estadual de Feira de Santana. Av. Transnordestina s/n, Feira de Santana. 44036-900 Novo Horizonte BA Brasil.
| | - Josicélia Estrela Tuy Batista
- Universidade Estadual de Feira de Santana. Av. Transnordestina s/n, Feira de Santana. 44036-900 Novo Horizonte BA Brasil.
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16
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Hosoda A, Komagamine Y, Kanazawa M, Hama Y, Kojo A, Minakuchi S. The Association between Dietary Habits and Periodontal Disease in Young Adult Women. J Nutr Sci Vitaminol (Tokyo) 2021; 67:48-56. [PMID: 33642464 DOI: 10.3177/jnsv.67.48] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Dietary habits of middle-aged and elderly individuals affected by periodontal disease (PD) differ from those who are unaffected by it, according to previous reports. However, in young adults, there are only a few reports that show a correlation between nutrient/food intake and PD. Moreover, no report till date has assessed the correlation between dietary habits and PD using a self-administered diet history questionnaire (DHQ). Therefore, we assessed this correlation using a DHQ in young adult women who are likely to develop PD. The participants were enrolled from 2 universities and included 120 female college students a mean age of 20.4 y. The participants were assessed for the presence of PD according to the community periodontal index and were divided into two groups, the PD group and the non-PD group. Their dietary habits were investigated using a DHQ and the level of difficulty in chewing food was assessed. The PD group had a significantly lower nutrient intake of minerals, fat-soluble vitamins, water-soluble vitamins, and dietary fiber than the non-PD group. In terms of food groups, the PD group consumed significantly lesser amounts of green and yellow vegetables (GYV) than the non-PD group. Multivariate analysis revealed that the PD group had significantly lower intakes of vitamin E and GYV than the non-PD group. The PD group consumed significantly lesser amounts of hard foods than the non-PD group. In conclusion, young adult women who were evaluated for PD by a screening test had a significantly lower nutrient/food intake than those without a PD.
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Affiliation(s)
- Akemi Hosoda
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University.,Division of Medical Nutrition, Faculty of Healthcare, Tokyo Healthcare University
| | - Yuriko Komagamine
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Manabu Kanazawa
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Yohei Hama
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Akiko Kojo
- Division of Medical Nutrition, Faculty of Healthcare, Tokyo Healthcare University
| | - Shunsuke Minakuchi
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
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17
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Maternal Neutrophil Depletion Fails to Avert Systemic Lipopolysaccharide-Induced Early Pregnancy Defects in Mice. Int J Mol Sci 2021; 22:ijms22157932. [PMID: 34360700 PMCID: PMC8347248 DOI: 10.3390/ijms22157932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 11/17/2022] Open
Abstract
Maternal infection-induced early pregnancy complications arise from perturbation of the immune environment at the uterine early blastocyst implantation site (EBIS), yet the underlying mechanisms remain unclear. Here, we demonstrated in a mouse model that the progression of normal pregnancy from days 4 to 6 induced steady migration of leukocytes away from the uterine decidual stromal zone (DSZ) that surrounds the implanted blastocyst. Uterine macrophages were found to be CD206+ M2-polarized. While monocytes were nearly absent in the DSZ, DSZ cells were found to express monocyte marker protein Ly6C. Systemic endotoxic lipopolysaccharide (LPS) exposure on day 5 of pregnancy led to: (1) rapid (at 2 h) induction of neutrophil chemoattractants that promoted huge neutrophil infiltrations at the EBISs by 24 h; (2) rapid (at 2 h) elevation of mRNA levels of MyD88, but not Trif, modulated cytokines at the EBISs; and (3) dose-dependent EBIS defects by day 7 of pregnancy. Yet, elimination of maternal neutrophils using anti-Ly6G antibody prior to LPS exposure failed to avert LPS-induced EBIS defects allowing us to suggest that activation of Tlr4-MyD88 dependent inflammatory pathway is involved in LPS-induced defects at EBISs. Thus, blocking the activation of the Tlr4-MyD88 signaling pathway may be an interesting approach to prevent infection-induced pathology at EBISs.
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18
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Wang L, Ren J, Fiscella KA, Bullock S, Sanders MR, Loomis EL, Eliav E, Mendoza M, Cacciato R, Thomas M, Kopycka-Kedzierawski DT, Billings RJ, Xiao J. Interprofessional collaboration and smartphone use as promising strategies to improve prenatal oral health care utilization among US underserved women: results from a qualitative study. BMC Oral Health 2020; 20:333. [PMID: 33228617 PMCID: PMC7685586 DOI: 10.1186/s12903-020-01327-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/12/2020] [Indexed: 12/12/2022] Open
Abstract
Background Data on barriers and facilitators to prenatal oral health care among low-income US women are lacking. The objective of this study was to understand barriers/facilitators and patient-centered mitigation strategies related to the use of prenatal oral health care among underserved US women.
Methods We used community-based participatory research to conduct two focus groups with eight pregnant/parenting women; ten individual in-depth interviews with medical providers, dental providers and community/social workers; and one community engagement studio with five representative community stakeholders in 2018–2019. Using an interpretive description research design, we conducted semi-structured interviews and focus groups which were audio-recorded, transcribed, and analyzed for thematic content. Results We identified individual and systemic barriers/facilitators to the utilization of prenatal oral health care by underserved US women. Strategies reported to improve utilization included healthcare system-wide changes to promote inter-professional collaborations, innovative educational programs to improve dissemination and implementation of prenatal oral health care guidelines, and specialized dental facilities providing prenatal oral health care to underserved women. Moreover, smartphones have the potential to be an innovative entry point to promote utilization of prenatal oral care at the individual level. Conclusions Low-income women face multiple, addressable barriers to obtaining oral health care during pregnancy. Inter-professional collaboration holds strong promise for improving prenatal oral health care utilization.
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Affiliation(s)
- Lin Wang
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA.,Peking University School of Stomatology, Beijing, China
| | - Johana Ren
- University of Rochester River Campus, Rochester, NY, USA
| | - Kevin A Fiscella
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | | | - Mechelle R Sanders
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Elizabeth L Loomis
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Eli Eliav
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Michael Mendoza
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA.,Monroe County Department of Public Health, Rochester, NY, USA
| | - Rita Cacciato
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Marie Thomas
- University of Rochester River Campus, Rochester, NY, USA
| | | | - Ronald J Billings
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Jin Xiao
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA.
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19
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Kong AC, Sousa MS, Ramjan L, Dickson M, Goulding J, Gwynne K, Talbot F, Jones N, Srinivas R, George A. "Got to build that trust": the perspectives and experiences of Aboriginal health staff on maternal oral health. Int J Equity Health 2020; 19:187. [PMID: 33097061 PMCID: PMC7585174 DOI: 10.1186/s12939-020-01301-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 10/14/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND In Australia, models of care have been developed to train antenatal care providers to promote oral health among pregnant women. However, these models are underpinned by Western values of maternity care that do not consider the cultural needs of Aboriginal and Torres Strait Islander women. This study aimed to explore the perceptions and experiences of Aboriginal health staff towards oral health care during pregnancy. It is part of a larger program of research to develop a new, culturally safe model of oral health care for Aboriginal women during pregnancy. METHODS A descriptive qualitative methodology informed the study. Focus groups were convened to yarn with Aboriginal Health Workers, Family Partnership Workers and Aboriginal management staff at two antenatal health services in Sydney, Australia. RESULTS A total of 14 people participated in the focus groups. There were four themes that were constructed. These focused on Aboriginal Health Workers and Family Partnership Workers identifying their role in promoting maternal oral health, where adequate training is provided and where trust has been developed with clients. Yet, because the Aboriginal health staff work in a system fundamentally driven by the legacy of colonisation, it has significantly contributed to the systemic barriers Aboriginal pregnant women continue to face in accessing health services, including dental care. The participants recommended that a priority dental referral pathway, that supported continuity of care, could provide increased accessibility to dental care. CONCLUSIONS The Aboriginal health staff identified the potential role of Aboriginal Health Workers and Family Partnership Workers promoting oral health among Aboriginal pregnant women. To develop an effective oral health model of care among Aboriginal women during pregnancy, there is the need for training of Aboriginal Health Workers and Family Partnership Workers in oral health. Including Aboriginal staff at every stage of a dental referral pathway could reduce the fear of accessing mainstream health institutions and also promote continuity of care. Although broader oral health policies still need to be changed, this model could mitigate some of the barriers between Aboriginal women and both dental care providers and healthcare systems.
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Affiliation(s)
- Ariana C. Kong
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District / Ingham Institute for Applied Medical Research, Liverpool, 2170 NSW Australia
| | - Mariana S. Sousa
- IMPACCT - Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology Sydney, Broadway, 2007 NSW Australia
| | - Lucie Ramjan
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District / Ingham Institute for Applied Medical Research, Liverpool, 2170 NSW Australia
- Translational Health Research Institute, Campbelltown, 2560 NSW Australia
| | - Michelle Dickson
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, 2006 NSW Australia
| | - Joanne Goulding
- Primary and Community Services, South Western Sydney Local Health District, Liverpool, 2170 NSW Australia
| | - Kylie Gwynne
- Faculty of Medicine and Health Sciences, Macquarie University, Macquarie Park, 2109 NSW Australia
| | - Folau Talbot
- Faculty of Medicine and Health, University of Sydney, Camperdown, 2006 NSW Australia
| | - Nathan Jones
- Aboriginal Health Unit, South Western Sydney Local Health District, Liverpool, 2170 NSW Australia
| | - Ravi Srinivas
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District / Ingham Institute for Applied Medical Research, Liverpool, 2170 NSW Australia
- Oral Health Services, South Western Sydney Local Health District, Liverpool, 2170 NSW Australia
- School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, 2006 NSW Australia
| | - Ajesh George
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District / Ingham Institute for Applied Medical Research, Liverpool, 2170 NSW Australia
- Translational Health Research Institute, Campbelltown, 2560 NSW Australia
- School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, 2006 NSW Australia
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20
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Cobo T, Kacerovsky M, Jacobsson B. Risk factors for spontaneous preterm delivery. Int J Gynaecol Obstet 2020; 150:17-23. [PMID: 32524595 DOI: 10.1002/ijgo.13184] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 03/23/2020] [Accepted: 04/23/2020] [Indexed: 01/26/2023]
Abstract
BACKGROUND There is a substantial variation in rates of preterm delivery between different parts of the world. The understanding of these variations, as well as the biological mechanisms behind spontaneous preterm delivery, is limited. Although the benefit of antenatal interventions has been shown to be limited, using well-known risk factors for spontaneous preterm delivery to select the correct pregnant women for targeted interventions is important from both a medical and caregiving perspective. OBJECTIVE To provide an introduction to a substantial research area dealing with risk factors of spontaneous preterm delivery. METHODS Risk factors in this review were classified as demographical, obstetrical, and gynecological and those related to the current pregnancy according to high-quality evidence of recent literature. RESULTS AND CONCLUSION An introduction to a substantial research area in maternal and fetal medicine was provided that might help clinicians to better understand the risk factors related to preterm delivery and select the correct pregnant women for targeted interventions.
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Affiliation(s)
- Teresa Cobo
- BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clinic and Hospital Sant Joan de Deu), Fetal i+D Fetal Medicine Research Center, IDIBAPS, University of Barcelona, Barcelona, Spain.,Center for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
| | - Marian Kacerovsky
- Biomedical Research Center, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.,Department of Obstetrics and Gynecology, Faculty of Medicine Hradec Kralove, Charles University in Prague, Hradec Kralove, Czech Republic
| | - Bo Jacobsson
- Department of Obstetrics and Gynecology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.,Department of Genetics and Bioinformatics, Domain of Health Data and Digitalization, Norwegian Institute of Public Health, Oslo, Norway
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21
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Boggess KA. Choosing the left fork: Steven Offenbacher and understanding maternal periodontal disease and adverse pregnancy outcomes. J Periodontol 2020; 91 Suppl 1:S40-S44. [PMID: 32614074 DOI: 10.1002/jper.20-0090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/16/2020] [Accepted: 04/19/2020] [Indexed: 12/11/2022]
Abstract
Steven Offenbacher was one of the first researchers to identify periodontal disease as a risk factor for various adverse pregnancy outcomes. Cohort and case-controlled studies of pregnant women have demonstrated periodontal disease as a risk factor for preterm birth, preeclampsia, and fetal growth restriction. Periodontal therapy during the second trimester improves maternal oral health but fails to reduce the risk of preterm birth. A possible association between periodontal disease and gestational diabetes has also been reported. In one model, periodontal bacteria gain access to the systemic circulation, and thereby the placenta, resulting in local inflammation, placental dysfunction, and, consequently, adverse pregnancy outcomes. It is crucial to increase awareness of the links between maternal periodontal and adverse pregnancy outcomes and to promote oral health prophylaxis during pregnancy.
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Affiliation(s)
- Kim A Boggess
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of North Carolina, Chapel Hill, NC
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22
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Ye C, Katagiri S, Miyasaka N, Kobayashi H, Khemwong T, Nagasawa T, Izumi Y. The periodontopathic bacteria in placenta, saliva and subgingival plaque of threatened preterm labor and preterm low birth weight cases: a longitudinal study in Japanese pregnant women. Clin Oral Investig 2020; 24:4261-4270. [PMID: 32333174 DOI: 10.1007/s00784-020-03287-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 04/14/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVES This study determined the quantity of periodontopathic bacteria in saliva, subgingival plaque, and placenta on the threatened preterm labor (TPL) and preterm low birth weight (PLBW) subjects in order to identify specific periodontal pathogens with high association to adverse pregnancy outcomes. METHODS We used real-time PCR with TaqMan probe and ELISA to detect the amount of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Fusobacterium nucleatum, and Prevotella intermedia in subgingival plaque, saliva, and placenta tissue, in addition to serum IgG titers against these bacteria in 28 patients with TPL and 36 healthy pregnant women. RESULTS Thirteen of 64 births delivered PLBW infants. All 6 periodontopathic bacteria were detected in the placenta samples. The amount of F. nucleatum and detection frequency of T. denticola in placental samples was significantly higher in the TPL group than in the healthy group. Meanwhile, the age, anti-P. gingival IgG in serum, amount of P. gingivalis and T. forsythia in plaque samples, detection frequency of P. intermedia in saliva, and percentage of pocket probing depth ≥ 5 mm were higher in TPL-PLBW births than those in TPL-Healthy delivery (HD) group and/or in H-HD group. Ordinal logistic regression analysis revealed that the presence of F. nucleatum in placental tissues was significantly associated with TPL, while the maternal age was significantly associated with PLBW in TPL. CONCLUSION Our findings suggested all 6 bacteria may access the placenta. The increased presence of F. nucleatum in placenta might be related to TPL, while advanced maternal age might be associated with PLBW in TPL. CLINICAL RELEVANCE Periodontal therapy should be applied to reduce the deep periodontal pocket sites and the colonization of periodontal pathogens in high-risk population.
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Affiliation(s)
- Changchang Ye
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Periodontology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Sayaka Katagiri
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Naoyuki Miyasaka
- Department of Pediatrics, Perinatal and Maternal Medicine, Tokyo Medical and Dental University Medical Hospital, Tokyo, Japan
| | - Hiroaki Kobayashi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
| | - Thatawee Khemwong
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Toshiyuki Nagasawa
- Division of Periodontology and Endodontology, Department of Oral Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido, Sapporo, Japan
| | - Yuichi Izumi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
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23
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The impact of maternal periodontitis in the development of asthma in the offspring. J Dev Orig Health Dis 2020; 12:293-299. [PMID: 32314681 DOI: 10.1017/s2040174420000203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Clinical and experimental studies show an association between maternal periodontitis and adverse outcomes during gestation. On the other hand, there were no studies evaluating the impact of maternal periodontitis on the offspring. Thus, our objective was to investigate the repercussion of maternal periodontitis on the development of asthma in the offspring. Pregnant rats were submitted or not to periodontitis by ligature technique. Thirty days after birth, the puppies were sensitized and challenged with ovalbumin (OVA) in order to induce asthmatic response. Our results showed that maternal periodontitis reduced cellular infiltrate in the parenchyma of offspring, tracheal responsiveness, lung edema, and anti-OVA antibodies, without alter mucus as well as cytokines production. We concluded that periodontitis has relevant impact on the offspring's immune system, blunting the response to allergic and inflammatory stimulus. This study shows the important role of oral health during pregnancy and opens possibilities for future studies in order to explain the effects of periodontitis during pregnancy in the offspring.
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Baskaradoss JK, Geevarghese A. Utilization of dental services among low and middle income pregnant, post-partum and six-month post-partum women. BMC Oral Health 2020; 20:120. [PMID: 32312257 PMCID: PMC7171727 DOI: 10.1186/s12903-020-01076-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 03/11/2020] [Indexed: 11/26/2022] Open
Abstract
Background This study aims to explore the difference in the utilization pattern of dental services among pregnant, post-partum and six-month post-partum women. Methods This cross-sectional questionnaire survey was performed at two maternity and child care hospitals in India that primarily cater to middle and low income communities. Data were collected from 3 groups: 1) pregnant women in their first trimester; 2) post-partum women (< 48 h after delivery); and 3) six-month post-partum women. The primary outcome of interest was dental service utilization during pregnancy. Self-perceived oral health (SPOH) was calculated based on the four global dimensions- knowledge, function, quality of life and social. Multiple logistic regression analysis was carried out to assess the effect of each independent variable after adjustment for the effect of all other variables in the model. Results Responses of 450 (150 pregnant, 150 post-partum and 150 six-month post-partum) women were analyzed (response rate = 72%). Significant differences in the dental attendance pattern was observed between the study groups (p < 0.01). Dental attendance among pregnant and six-month post-partum women were 60 and 75%, respectively, however, only about 15% of the post-partum women reported to have sought dental care within the 6 months prior to the study. Post-partum women had the highest SPOH scores, indicating poor self-perceived oral health, followed by pregnant and then six-month post-partum women, which was statistically significant (p < 0.05). A significantly higher percentage of post-partum women reported to have poor oral and general health, as compared to both, pregnant and six-month post-partum women (p < 0.01). Higher percentage of women reporting ‘good’ oral and general health had sought dental care compared with others (p < 0.01). After adjusting for all the other variables in the model, women with lower levels of education (ORa = 1.42; 95% CI: 1.01–2.00), women with poor self-perceived oral health (ORa = 1.08; 95% CI: 1.02–1.14) and post-partum women (ORa = 0.15; 95% CI: 0.09–0.24) were found to be less likely to seek regular dental care. Conclusion Pattern of dental service utilization among women in this population varied according to their pregnancy status, level of education and self-perceived oral health.
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Affiliation(s)
- Jagan Kumar Baskaradoss
- Division of Dental Public Health, Department of Developmental and Preventive Sciences, Faculty of Dentistry, Kuwait University, 13110, Kuwait City, Kuwait.
| | - Amrita Geevarghese
- Resident, Dental Public Health, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California San Francisco, 707 Parnassus Avenue, San Francisco, CA, 94143, USA
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Xiao J, Fogarty C, Wu TT, Alkhers N, Zeng Y, Thomas M, Youssef M, Wang L, Cowen L, Abdelsalam H, Nikitkova A. Oral health and Candida carriage in socioeconomically disadvantaged US pregnant women. BMC Pregnancy Childbirth 2019; 19:480. [PMID: 31805881 PMCID: PMC6896277 DOI: 10.1186/s12884-019-2618-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 11/21/2019] [Indexed: 12/13/2022] Open
Abstract
Background Despite the well-documented associations between poor maternal oral health and increased risk for adverse birth outcomes and dental caries in children after birth, prenatal oral health care is under-utilized, especially among the underserved population. In addition, oral Candida has recently been suggested as a potential culprit for children’s dental caries, with evident maternal contributions. Therefore, this study aimed to obtain epidemiological data on the oral health and oral Candida carriage in a cohort of underserved US pregnant women, and reveal factors associated with their oral Candida carriage. Methods Demographic-medical-oral hygiene practice data were collected. Comprehensive oral examination was conducted. Caries status and plaque index were recorded. Oral samples (saliva, plaque and swab) were processed to identify Candida species and Streptococcus mutans by culturing-dependent and -independent methods. Multiple logistic regression analyses were used to identify factors associated with oral Candida carriage and caries severity. Results Eighty-two socioeconomically disadvantaged women (48 pregnant and 34 non-pregnant) were enrolled. More pregnant women (79.1%) had > = 1 untreated decayed tooth when compared to their non-pregnant counterparts (47.1%) (p = 0.01). The average number of decayed teeth in pregnant and non-pregnant women was 3.9 and 3.1 (p > 0.05). Caries severity was positively associated with race (African American vs. white), plaque index and salivary Candida albicans level. C. albicans was the most predominant/abundant Candida strain, with cheek and tonsil as the most common colonized sites. The detection of C. albicans was 56%/56% in saliva and 40%/47% in plaque of the pregnant and non-pregnant groups, respectively. Study women’s oral Candida carriage is positively associated with hypertension [p = 0.03, odds ratio = 14.47(1.28, 163.51)], decayed teeth number [p = 0.04, odds ratio = 1.31 (1.01,1.69)] and salivary S. mutans level [p = 0.03, odds ratio = 4.80 (1.18–19.43)]. Conclusions Socioeconomically disadvantaged US women are in need of improved prenatal oral health, a large proportion of them have untreated decayed teeth and high carriage of oral Candida. Due to the observed significant association between the decayed teeth number and oral Candida carriage, providing oral health care during pregnancy (including limiting decayed teeth) will not only improve women’s oral health, but also present as a promising approach to reduce oral Candida carriage in women.
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Affiliation(s)
- Jin Xiao
- Eastman Institute for Oral Health, University of Rochester Medical Center, 625 Elmwood Ave, Rochester, USA.
| | - Colleen Fogarty
- Department of Family Medicine, University of Rochester Medical Center, Rochester, USA
| | - Tong Tong Wu
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, USA
| | - Naemah Alkhers
- Eastman Institute for Oral Health, University of Rochester Medical Center, 625 Elmwood Ave, Rochester, USA
| | - Yan Zeng
- Eastman Institute for Oral Health, University of Rochester Medical Center, 625 Elmwood Ave, Rochester, USA.,Department of Forensic Medicine, North Sichuan Medical College, Nanchong, China
| | - Marie Thomas
- Department of Family Medicine, University of Rochester Medical Center, Rochester, USA
| | - Moustafa Youssef
- Eastman Institute for Oral Health, University of Rochester Medical Center, 625 Elmwood Ave, Rochester, USA
| | - Lin Wang
- Eastman Institute for Oral Health, University of Rochester Medical Center, 625 Elmwood Ave, Rochester, USA.,College of Stomatology, Peking University, Beijing, China
| | - Lauren Cowen
- Department of Family Medicine, University of Rochester Medical Center, Rochester, USA
| | - Hossam Abdelsalam
- Eastman Institute for Oral Health, University of Rochester Medical Center, 625 Elmwood Ave, Rochester, USA
| | - Anna Nikitkova
- Eastman Institute for Oral Health, University of Rochester Medical Center, 625 Elmwood Ave, Rochester, USA
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26
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Costa EM, de Araujo Figueiredo CS, Martins RFM, Ribeiro CCC, Alves CMC, Sesso MLT, Nogueira RD, da Conceição Saraiva M, Barbieri MA, Bettiol H, da Silva AAM, Thomaz EBAF. Periodontopathogenic microbiota, infectious mechanisms and preterm birth: analysis with structural equations (cohort-BRISA). Arch Gynecol Obstet 2019; 300:1521-1530. [PMID: 31677089 DOI: 10.1007/s00404-019-05355-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 10/18/2019] [Indexed: 12/31/2022]
Abstract
PURPOSE The association between periodontopathogenic microbiota and preterm birth (PTB) has been overly studied. However, the biological mechanisms involved are little known. The objective is to evaluate the effect of periodontopathogenic bacteria burden (PBB), periodontal disease and other infections during pregnancy on preterm birth (PTB), through Structural Equation Modeling. METHODS This was a case-control study nested in a prospective cohort called BRISA, including 330 pregnant women, 110 cases and 220 controls. This study included the following variables: cytokines interleukin-10 (IL-10) and transforming growth factor beta (TGF-β), periodontal disease, PBB, age, socioeconomic status (SES), systemic infections and PTB. The correlations between variables were analyzed using Standardized Coefficient (SC). RESULTS Greater PBB interfered positively with the occurrence of periodontal disease (SC: 0.027; p: 0.011), but these were not associated with the cytokines studied, nor with PTB. The lower serum levels of IL-10 (SC - 0.330; p 0.022) and TGF-β (SC - 0.612; p < 0.001), and the presence of other systemic infections during pregnancy (SC 0.159; 0.049) explained the higher occurrence of PTB. CONCLUSION It is possible that only the more severe periodontal disease and other systemic infections are capable of altering the cascade of cytokines regulating the inflammatory process and have an effect on the occurrence of PTB.
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Affiliation(s)
- Elisa Miranda Costa
- Department of Public Health, Federal University of Maranhão, Rua Barão de Itapary, 155 - Centro, São Luís, Maranhão, CEP 65020-070, Brazil.
| | | | - Rafiza Félix Marão Martins
- Department of Public Health, Federal University of Maranhão, Rua Barão de Itapary, 155 - Centro, São Luís, Maranhão, CEP 65020-070, Brazil
| | - Cecília Claudia Costa Ribeiro
- Department of Public Health, Federal University of Maranhão, Rua Barão de Itapary, 155 - Centro, São Luís, Maranhão, CEP 65020-070, Brazil.,Department of Dentistry II, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - Claudia Maria Coelho Alves
- Department of Public Health, Federal University of Maranhão, Rua Barão de Itapary, 155 - Centro, São Luís, Maranhão, CEP 65020-070, Brazil.,Department of Dentistry II, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - Maria Lúcia Talarico Sesso
- Department of Pediatrics, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | - Maria da Conceição Saraiva
- Department of Pediatrics and Social Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Marco Antônio Barbieri
- Department of Puericulture and Pediatrics, Graduate Program in Child and Adolescent Health, São Paulo University, Ribeirão Preto, São Paulo, Brazil
| | - Heloisa Bettiol
- Department of Puericulture and Pediatrics, Graduate Program in Child and Adolescent Health, São Paulo University, Ribeirão Preto, São Paulo, Brazil
| | - Antônio Augusto Moura da Silva
- Department of Public Health, Federal University of Maranhão, Rua Barão de Itapary, 155 - Centro, São Luís, Maranhão, CEP 65020-070, Brazil
| | - Erika Bárbara Abreu Fonseca Thomaz
- Department of Public Health, Federal University of Maranhão, Rua Barão de Itapary, 155 - Centro, São Luís, Maranhão, CEP 65020-070, Brazil.,Department of Dentistry II, Federal University of Maranhão, São Luís, Maranhão, Brazil
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Márquez-Corona MDL, Tellez-Girón-Valdez A, Pontigo-Loyola AP, Islas-Zarazúa R, Robles-Bermeo NL, Gonzalez-López BS, Medina-Solís CE. Preterm birth associated with periodontal and dental indicators: a pilot case-control study in a developing country. J Matern Fetal Neonatal Med 2019; 34:690-695. [PMID: 31035800 DOI: 10.1080/14767058.2019.1613363] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Introduction: Preterm delivery is a multifactorial health problem that represents a serious public health problem around the world. In recent years, there has been an increase in scientific evidence suggesting associations between oral health status (mainly periodontal disease and tooth loss) and an increased risk of systemic diseases and various adverse pregnancy outcomes. This study explores the association between indicators of oral health and preterm delivery in a sample of Mexican pregnant women.Materials and methods: A case-control study was carried out with 111 pregnant (36 cases, 75 controls) who received prenatal care and delivered in an obstetric hospital in Pachuca, Mexico. Clinical files were reviewed to obtain the necessary information for the variables studied. The dependent variable was preterm delivery and the independent variables were gingivitis, periodontitis, DMFT index and its components, the number of decayed teeth with pulpal exposure or endodontic lesions, age of the mother, education, alcohol use, smoking status, number of gestations, and sex of the newborn.Results: The average ages were similar between the cases and the controls (24.29 ± 5.42 versus 24.89 ± 5.67, p = .5781). Significant differences were observed with gingivitis (p < .01) and periodontitis (p < .001). In addition, when the severity of gingivitis or periodontitis increased, the percentage of cases of preterm delivery increased (p < .01). The average number of teeth lost was higher among the cases than among the controls (1.33 ± 1.89 versus 0.81 ± 1.82, p < .05).Conclusions: It was found that gingivitis, periodontitis, and tooth loss were associated with preterm delivery. It is necessary to carry out actions aimed at the preservation of oral health in pregnant patients to avoid adverse results. These findings indicate a likely association, but it needs to be confirmed by large and well-designed studies.
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Affiliation(s)
| | - Aldo Tellez-Girón-Valdez
- Academic Area of Dentistry of Health Sciences Institute at Autonomous University of Hidalgo State, Pachuca, Mexico
| | | | - Rosalina Islas-Zarazúa
- Academic Area of Dentistry of Health Sciences Institute at Autonomous University of Hidalgo State, Pachuca, Mexico
| | - Norma Leticia Robles-Bermeo
- Advanced Studies and Research Center in Dentistry, "Dr. Keisaburo Miyata" of Faculty of Dentistry, Autonomous University State of Mexico, Toluca, Mexico
| | - Blanca Silvia Gonzalez-López
- Advanced Studies and Research Center in Dentistry, "Dr. Keisaburo Miyata" of Faculty of Dentistry, Autonomous University State of Mexico, Toluca, Mexico
| | - Carlo Eduardo Medina-Solís
- Academic Area of Dentistry of Health Sciences Institute at Autonomous University of Hidalgo State, Pachuca, Mexico.,Advanced Studies and Research Center in Dentistry, "Dr. Keisaburo Miyata" of Faculty of Dentistry, Autonomous University State of Mexico, Toluca, Mexico
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Lutfiyya MN, Gross AJ, Soffe B, Lipsky MS. Dental care utilization: examining the associations between health services deficits and not having a dental visit in past 12 months. BMC Public Health 2019; 19:265. [PMID: 30836954 PMCID: PMC6402128 DOI: 10.1186/s12889-019-6590-y] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 02/25/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND A growing literature supports the contention that closing the divide between dental and medical care can improve access to and coordination of patient care. Health service deficits (HSDs) entail: no routine medical exam, no personal healthcare provider (HCP), no health insurance, and/or delaying medical care because of cost all within the last 12 months. Examining the associations between HSDs and dental care utilization could inform strategies and interventions aimed at narrowing the gap between the medical and dental professions. This study explored whether HSDs are associated with not having a dental care visit within the last 12 months. In addition, the study sought to provide an updated analysis of the characteristics and factors associated with dental care utilization. METHODS Two thousand sixteen Behavioral Risk Factor Surveillance System survey data were analyzed using bivariate and multivariable techniques. The outcome variable for this study was: last dental visit was longer than 12 months ago. RESULTS US adults without healthcare insurance, without a personal HCP, who had delayed medical care because of cost, and who had their last routine medical visit longer than 12 months ago had greater odds of not having a dental visit within the last 12 months. Further, this study identified disparities in dental care utilization among males, rural residents, those earning less than $50,000 per year, Non-Hispanic Blacks and Non-Hispanic other races. Individuals with six or more and/or all of their permanent teeth removed and current smokers also had greater odds of not having had a dental care visit in the past 12 months. CONCLUSIONS Findings suggest that a stronger integration of medical and dental care might increase dental care utilization. In addition, persistent disparities in dental care utilization remain for several demographic groups. Targeted interventions offer the promise of helping achieve HP 2020 goals for improved oral health.
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Affiliation(s)
- M. Nawal Lutfiyya
- Department of Pharmacy Practice and Pharmaceutical Sciences, College of Pharmacy, University of Minnesota, Minneapolis, MN USA
- College of Dental Medicine, Roseman University of Health Sciences, 10920 S. River Front Parkway, South Jordan, Utah 84095 USA
| | - Andrew J. Gross
- College of Dental Medicine, Roseman University of Health Sciences, 10920 S. River Front Parkway, South Jordan, Utah 84095 USA
| | - Burke Soffe
- College of Dental Medicine, Roseman University of Health Sciences, 10920 S. River Front Parkway, South Jordan, Utah 84095 USA
| | - Martin S. Lipsky
- College of Dental Medicine, Roseman University of Health Sciences, 10920 S. River Front Parkway, South Jordan, Utah 84095 USA
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Haque M, Sartelli M, Haque SZ. Dental Infection and Resistance-Global Health Consequences. Dent J (Basel) 2019; 7:dj7010022. [PMID: 30823670 PMCID: PMC6473604 DOI: 10.3390/dj7010022] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 02/03/2019] [Accepted: 02/20/2019] [Indexed: 12/15/2022] Open
Abstract
Antibiotics are widely used in dental caries and another dental related issues, both for therapeutic and prophylactic reasons. Unfortunately, in recent years the use of antibiotics has been accompanied by the rapid emergence antimicrobial resistance. Dental caries and periodontal diseases are historically known as the top oral health burden in both developing and developed nations affecting around 20⁻50% of the population of this planet and the uppermost reason for tooth loss. Dental surgeons and family practitioners frequently prescribed antimicrobials for their patients as outpatient care. Several studies reported that antibiotics are often irrationally- and overprescribed in dental diseases which is the basis of antimicrobial resistance. The aim of this review is to evaluate the use of antibiotics in dental diseases. Almost certainly the promotion of primary oral health care (POHC) in primary health care program especially among the least and middle-income countries (LMIC) may be the answer to ensure and promote rational dental care.
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Affiliation(s)
- Mainul Haque
- Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kem Sungai Besi, 57000 Kuala Lumpur, Malaysia.
| | - Massimo Sartelli
- Department of Surgery, Macerata Hospital, via Santa Lucia 2, 62100 Macerata, Italy.
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Manrique-Corredor EJ, Orozco-Beltran D, Lopez-Pineda A, Quesada JA, Gil-Guillen VF, Carratala-Munuera C. Maternal periodontitis and preterm birth: Systematic review and meta-analysis. Community Dent Oral Epidemiol 2019; 47:243-251. [PMID: 30812054 DOI: 10.1111/cdoe.12450] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 01/21/2019] [Accepted: 02/09/2019] [Indexed: 11/28/2022]
Abstract
AIM To assess the association between periodontitis and preterm birth in women of childbearing age. MATERIALS AND METHODS This review included analytical case-control studies and prospective cohort studies evaluating the association between maternal periodontitis and preterm birth. Of the 3104 screened articles, 31 met the inclusion criteria for the review, and 20 met the quality criteria. The selected studies included a total of 10 215 women. RESULTS Twenty articles contributed to the meta-analysis; 16 used a case-control design, and 4 were prospective cohort studies. The study heterogeneity was low (Q = 24.2464; P = 0.1869; I2 = 21.63%). A positive association between maternal periodontitis and preterm birth was found in 60% of the studies. Under the random-effects model, meta-analysis gave an odds ratio (OR) of 2.01 (95% CI 1.71, 2.36), representing a significant positive association between the explanatory and outcome variables. CONCLUSION Pregnant mothers with periodontitis double the risk of preterm birth. There is a lack of international consensus for diagnosing maternal periodontitis.
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Affiliation(s)
- Edwar J Manrique-Corredor
- Escuela de Medicina, Universidad Pedagógica y Tecnológica de Colombia, Tunja, Boyacá, Colombia.,Chair of Family Medicine, Miguel Hernandez University, San Juan de Alicante, Spain
| | | | - Adriana Lopez-Pineda
- Chair of Family Medicine, Miguel Hernandez University, San Juan de Alicante, Spain
| | - Jose A Quesada
- Chair of Family Medicine, Miguel Hernandez University, San Juan de Alicante, Spain
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31
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The global epidemiology of preterm birth. Best Pract Res Clin Obstet Gynaecol 2018; 52:3-12. [DOI: 10.1016/j.bpobgyn.2018.04.003] [Citation(s) in RCA: 313] [Impact Index Per Article: 52.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 04/23/2018] [Indexed: 02/07/2023]
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Gesase N, Miranda-Rius J, Brunet-Llobet L, Lahor-Soler E, Mahande MJ, Masenga G. The association between periodontal disease and adverse pregnancy outcomes in Northern Tanzania: a cross-sectional study. Afr Health Sci 2018; 18:601-611. [PMID: 30602993 PMCID: PMC6307003 DOI: 10.4314/ahs.v18i3.18] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background For the past two decades, studies have investigated the relationship between periodontal disease and adverse pregnancy outcomes such as pre-eclampsia, preterm birth, low birth weight and preterm premature rupture of membranes. Objectives To determine the prevalence of periodontal disease and associated adverse pregnancy outcomes among women delivering at the Kilimanjaro Christian Medical Centre (KCMC). Methods This cross-sectional study was based on the use of patients' files, clinical examinations and oral interviews with mothers who delivered at the KCMC. Pregnant women with singleton babies (N=1117) who delivered at the KCMC were recruited for the study. Intra-oral examination was performed within five days of birth. The Community Periodontal Index was used to assess periodontal disease Results The prevalence of periodontal disease was 14.2%. Periodontal disease was significantly associated with higher odds of pre-eclampsia [adjusted Odds Ratio 95% Confidence Interval (aOR=4.12;95%CI:2.20–7.90)], low birth weight (aOR=2.41;95%-CI:1.34–4.33) and preterm birth (aOR=2.32;95%CI:1.33–4.27). There was no significant association between periodontal disease and preterm premature rupture of membranes (aORs 1.83;95%CI:0.75–4.21) and eclampsia (3.71;95%CI:0.80–17.13). Conclusion Maternal periodontal disease is a potential independent risk indicator for pre-eclampsia, low birth weight, and preterm birth. Periodontal assessment and therapy should form part of the preventive antenatal care provided to women in developing countries.
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Affiliation(s)
- Nyobasi Gesase
- Department of Obstetrics and Gynaecology, Kilimanjaro Christian Medical Centre (KCMC)/Kilimanjaro Christian Medical University College (KCMU College), Moshi, Tanzania
| | - Jaume Miranda-Rius
- Department of Odontostomatology. Faculty of Medicine and Health Sciences. Universitat de Barcelona, Barcelona, Spain
- Hospital Dentistry & Periodontal Medicine Research Group, Institut de Recerca Sant Joan de Déu (IRSJD), Fundació Sant Joan de Déu, Barcelona, Spain
| | - Lluís Brunet-Llobet
- Hospital Dentistry & Periodontal Medicine Research Group, Institut de Recerca Sant Joan de Déu (IRSJD), Fundació Sant Joan de Déu, Barcelona, Spain
- Division of Pediatric Dentistry. Hospital Universitari Sant Joan de Déu. Universitat de Barcelona, Barcelona, Spain
| | - Eduard Lahor-Soler
- Department of Odontostomatology. Faculty of Medicine and Health Sciences. Universitat de Barcelona, Barcelona, Spain
- Hospital Dentistry & Periodontal Medicine Research Group, Institut de Recerca Sant Joan de Déu (IRSJD), Fundació Sant Joan de Déu, Barcelona, Spain
| | - Michael J Mahande
- Department of Epidemiology and Biostatistics. Institute of Public Health. Kilimanjaro Christian Medical University College (KCMU College), Moshi, Tanzania
| | - Gileard Masenga
- Department of Obstetrics and Gynaecology, Kilimanjaro Christian Medical Centre (KCMC)/Kilimanjaro Christian Medical University College (KCMU College), Moshi, Tanzania
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Komine-Aizawa S, Aizawa S, Hayakawa S. Periodontal diseases and adverse pregnancy outcomes. J Obstet Gynaecol Res 2018; 45:5-12. [PMID: 30094895 DOI: 10.1111/jog.13782] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Accepted: 07/13/2018] [Indexed: 12/14/2022]
Abstract
From last decade of the 20th century, numerous epidemiological studies and intervention trials have attempted to prove the relationships between maternal periodontal diseases and adverse pregnancy outcomes (APO). Periodontal diseases are considered a risk factor for APO, including preterm birth, fetal growth restriction, low birthweight, pre-eclampsia and gestational diabetes. However, the efficacy of periodontal treatment during pregnancy is controversial. Two pathogenic mechanisms might explain the potential effect of periodontal diseases on pregnancy outcomes. First, periodontal bacteria originating in the gingival biofilm directly affect the feto-placental unit subsequent to bacteremia. Second, inflammatory mediators secreted by the subgingival inflammatory site are carried to the feto-placental unit, where they then cause an inflammatory response. To elucidate these mechanisms, many researchers have been investigating the use of experimental animal models and in vitro models. In the present review, we summarize the current literature on the relationship between periodontal diseases and APO from epidemiological studies, animal models studies and in vitro studies, and speculate on the possible mechanism of periodontal diseases affecting pregnancy outcomes.
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Affiliation(s)
- Shihoko Komine-Aizawa
- Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan
| | - Sohichi Aizawa
- Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan.,Department of Oral Surgery, JCHO Yokohama Chuo Hospital, Kanagawa, Japan
| | - Satoshi Hayakawa
- Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan
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Interdisciplinary Community-Based Oral Health Program for Women and Children at WIC. Matern Child Health J 2018; 22:1617-1623. [PMID: 29936657 DOI: 10.1007/s10995-018-2557-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Objectives To evaluate the women, infants, and children (WIC) Oral Health Program in a county in Florida. Methods The non-traditional interdisciplinary program of the current study was designed to reach at-risk populations with untreated dental diseases and limited access to care; it provides oral health education, dental screenings, preventive dental services, and referrals for women, children, and families at WIC offices. We evaluated the health status of patients enrolled in the program and the services provided. Results From 2013 to 2016, the program provided dental screenings for 576 children and 180 women. Caries prevalence for 3-5 year olds was 46.0%. Only 6.6% (12/114) of pregnant women were eligible for comprehensive dental care under Medicaid (< 21 years). Further, 71.2% (47/66) of all pregnant women had unmet dental care needs. Conclusions for Practice Our results suggested that many children and women had untreated dental diseases and need preventive services and dental care. Also, many pregnant women were not covered by Medicaid. This program demonstrates that collaboration with the WIC program can improve access to oral health services for underserved populations.
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Liang S, Ren H, Guo H, Xing W, Liu C, Ji Y, Jiang H, Zhang P, Du M. Periodontal infection with Porphyromonas gingivalis induces preterm birth and lower birth weight in rats. Mol Oral Microbiol 2018; 33:312-321. [PMID: 29754448 DOI: 10.1111/omi.12227] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2018] [Indexed: 12/29/2022]
Abstract
Preterm birth (PTB), accompanied by low birth weight (LBW) or not, is a syndrome with tremendous risk factors and long-term health consequences for children. In recent decades, overwhelming studies have shown that periodontitis contributes to prematurity and LBW. This study was conducted to determine the link between maternal periodontitis and the pathogenesis of PTB and/or LBW through a rat infection model induced by Porphyromonas gingivalis, an important periodontopathic bacterium. The murine model was established by surgically ligating the left mandibular first molars and inoculating with P. gingivalis, and then all female rats initiated mating 6 weeks post infection. The gestational day and birth weight were recorded, and blood, amniotic fluid, and placental specimens were collected. Rats with a PTB and LBW newborns were observed in the P. gingivalis-infected group. Additionally, P. gingivalis infection significantly increased the maternal serum levels of interferon-γ and interleukin-1β, whereas no significant difference in the cytokine response was observed in the amniotic fluid. Moreover, with the translocation of P. gingivalis to placentas, remarkable changes in gestational tissues were found, followed by significantly enhanced expression of Toll-like receptor 2 (TLR2) as well as Fas and Fas ligand (FasL). These results support the concept that severe cases of periodontitis caused by P. gingivalis infection may be indicative of rats being more susceptible to PTB/LBW, probably through the activation of the TLR2 and Fas/FasL pathways within the placental tissues. This study gave us new insight into how maternal periodontopathogens might be linked to placental damage and premature pathogenesis.
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Affiliation(s)
- S Liang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - H Ren
- Xiangyang Hospital of Stomatology, Xiangyang, China
| | - H Guo
- The State Key Laboratory Breeding Base of Basic Science of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - W Xing
- The State Key Laboratory Breeding Base of Basic Science of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - C Liu
- The State Key Laboratory Breeding Base of Basic Science of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Y Ji
- The State Key Laboratory Breeding Base of Basic Science of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - H Jiang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - P Zhang
- School of Dentistry, University of Alabama at Birmingham, Birmingham, AL, USA
| | - M Du
- The State Key Laboratory Breeding Base of Basic Science of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
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Uwitonze AM, Uwambaye P, Isyagi M, Mumena CH, Hudder A, Haq A, Nessa K, Razzaque MS. Periodontal diseases and adverse pregnancy outcomes: Is there a role for vitamin D? J Steroid Biochem Mol Biol 2018; 180:65-72. [PMID: 29341890 DOI: 10.1016/j.jsbmb.2018.01.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 12/06/2017] [Accepted: 01/12/2018] [Indexed: 01/22/2023]
Abstract
Studies have shown a relationship between maternal periodontal diseases (PDs) and premature delivery. PDs are commonly encountered oral diseases which cause progressive damage to the periodontal ligament and alveolar bones, leading to loss of teeth and oral disabilities. PDs also adversely affect general health by worsening of cardiovascular and metabolic diseases. Moreover, maternal PDs are thought to be related to increasing the frequency of preterm-birth with low birth weight (PBLBW) in new-borns. Prematurity and immaturity are the leading causes of prenatal and infant mortality and is a major public health problem around the world. Inflamed periodontal tissues generate significantly high levels of proinflammatory cytokines that may have systemic effects on the host mother and the fetus. In addition, the bacteria that cause PDs produce endotoxins which can harm the fetus. Furthermore, studies have shown that microorganisms causing PDs can get access to the bloodstream, invading uterine tissues, to induce PBLBW. Another likely mechanism that connects PDs with adverse pregnancy outcome is maternal vitamin D status. A role of inadequate vitamin D status in the genesis of PDs has been reported. Administration of vitamin D supplementation during pregnancy could reduce the risk of maternal infections and adverse pregnancy outcomes. As maternal PDs are significant risk factors for adverse pregnancy outcome, preventive antenatal care for pregnant women in collaboration with the obstetric and dental professions are required.
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Affiliation(s)
- Anne Marie Uwitonze
- Department of Preventive & Community Dentistry, University of Rwanda College of Medicine & Health Sciences, School of Dentistry, Kigali, Rwanda
| | - Peace Uwambaye
- Department of Preventive & Community Dentistry, University of Rwanda College of Medicine & Health Sciences, School of Dentistry, Kigali, Rwanda
| | - Moses Isyagi
- Department of Preventive & Community Dentistry, University of Rwanda College of Medicine & Health Sciences, School of Dentistry, Kigali, Rwanda
| | - Chrispinus H Mumena
- Department of Preventive & Community Dentistry, University of Rwanda College of Medicine & Health Sciences, School of Dentistry, Kigali, Rwanda
| | - Alice Hudder
- Department of Biochemistry, Lake Erie College of Osteopathic Medicine, Erie, PA, USA
| | - Afrozul Haq
- Department of Food Technology, School of Interdisciplinary Sciences & Technology, Jamia Hamdard, New Delhi, India
| | - Kamrun Nessa
- Department of Obstetrics & Gynaecology, Chittagong Medical College Hospital, Chittagong, Bangladesh
| | - Mohammed S Razzaque
- Department of Preventive & Community Dentistry, University of Rwanda College of Medicine & Health Sciences, School of Dentistry, Kigali, Rwanda; Department of Applied Oral Sciences, Forsyth Institute, Harvard School of Dental Medicine Affiliate, Cambridge, MA, USA; Department of Pathology, Lake Erie College of Osteopathic Medicine, Erie, PA, USA.
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Krüger MSDM, Casarin RP, Pinto GDS, Pappen FG, Camargo MBJ, Correa FOB, Romano AR. Maternal periodontal disease and adverse perinatal outcomes: is there an association? A hospital-based case-control study. J Matern Fetal Neonatal Med 2018; 32:3401-3407. [PMID: 29642740 DOI: 10.1080/14767058.2018.1464554] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Objectives: The association between maternal periodontal disease and adverse perinatal outcomes although extensively studied remains unclear. The aim of this study was to evaluate, by a case-control study, conducted in three hospitals the association between preterm birth and/or low birth weight (PTB/LBW) and clinical parameters of maternal periodontal disease. Material and methods: Postpartum women who gave birth to a newborn PTB/LBW (case group), and postpartum women who had babies at full term with normal weight (control group) were included, in 1:2 ratio. Data were collected through medical records, interview, and periodontal clinical parameters. Bivariate analysis was performed to assess the PTB/LBW proportion relative to independent variables and multiple logistic regression analysis to assess the association between adverse perinatal outcomes and independent variables. Results: The sample consisted of 148 cases and 296 controls. By the 148 postpartum women with PTB/LBW in case group, 126 (87.5%) had preterm birth, and 75 (50.7%) had PTB and LBW. The periodontal status and generalized periodontitis presence were not associated with any adverse pregnancy outcomes. Having made four or more prenatal visits was a protective factor for all outcomes. The history of previous PTB/LBW was a risk factor for new cases of PTB and PTB and/or LBW. The presence of systemic disease was associated with preterm and low birth weight (PTLBW). Preeclampsia and cesarean delivery were associated with all outcomes. Conclusions: The clinical parameters of maternal periodontitis were not considered as a risk factor for the studied adverse perinatal outcomes. Clinical relevance: The present study demonstrated no association between maternal periodontitis and PTB/LBW.
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Affiliation(s)
| | | | | | | | | | | | - Ana Regina Romano
- a Graduate Program in Dentistry , Federal University of Pelotas , Pelotas , Brazil
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Vivares-Builes AM, Rangel-Rincón LJ, Botero JE, Agudelo-Suárez AA. Gaps in Knowledge About the Association Between Maternal Periodontitis and Adverse Obstetric Outcomes: An Umbrella Review. J Evid Based Dent Pract 2018; 18:1-27. [DOI: 10.1016/j.jebdp.2017.07.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 07/04/2017] [Accepted: 07/10/2017] [Indexed: 01/01/2023]
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Gupta S, Shrestha B, Gupta N, Tuladhar A, KC S, Dhami B. Periodontal Health Status and Pregnancy Outcomes: A Survey in Medical Doctors. JNMA J Nepal Med Assoc 2018; 56:565-571. [PMID: 30375998 PMCID: PMC8997300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Periodontal disease and caries are the most common causes of tooth loss worldwide. Studies have demonstrated strong association between periodontitis and adverse pregnancy outcomes. Medical doctors, who are the primary healthcare providers, seldom advise women to seek dental care during pregnancy. This study was undertaken to explore the knowledge, attitudes and behaviours of medical doctors towards oral health and to identify the barriers of prenatal periodontal healthcare in their practices and its possible implications on pregnancy outcomes. METHODS Total 377 doctors filled the questionnaire. The data collected through personal contacts, social networking, emails, online forms and networking at conferences were analysed using Statistical Package for the Social Sciences 20 software program and presented in tables, charts and diagrams. RESULTS Out of 263 (69.8%) male and 114 (30.2%) female doctors enrolled in the study, only 52 (13.8%) had received education or training on oral care during pregnancy. Among them 299 (79.3%) agreed that there is possible link between health of teeth-gums and pregnancy. Approximately 105 (27.9%) encountered patients with oral/periodontal problem every week but only 108 (28.6%) "always" advised their patient for regular dental check-ups. Similarly, 358 (95%) agreed that there is need for universal guidelines however, 133 (35.3%) thought there was insufficient time to advise patients on oral health during check-ups. CONCLUSIONS There is need for training on 'oral healthcare during pregnancy' for medical doctors. Developing universal guidelines for oral healthcare in pregnant women for all health professionals would be another important step. An adequate referral system to oral healthcare providers and biannual check-ups is recommended for both general patient as well as pregnant women for preventing adverse situations related to oral and specifically periodontal diseases.
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Affiliation(s)
- Sujaya Gupta
- Department of Periodontics, Kantipur Dental College, Basundhara, Kathmandu, Nepal,Correspondence: Dr. Sujaya Gupta, Department of Periodontics, Kantipur Dental College, Basundhara, Kathmandu, Nepal. , Phone: +977-9803588959
| | | | - Neha Gupta
- Department of Dental Surgery, Nobel Medical College, Biratnagar, Nepal
| | - Anik Tuladhar
- School of Oral Health, Kathmandu Model Hospital, Kathmandu, Nepal
| | - Sushil KC
- Department of Dental Surgery, Shree Birendra Army Hospital, Chhauni, Kathmandu, Nepal
| | - Bhageshwar Dhami
- Department of Periodontics, Kantipur Dental College, Basundhara, Kathmandu, Nepal
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Johnson CD, Jones S, Paranjothy S. Reducing low birth weight: prioritizing action to address modifiable risk factors. J Public Health (Oxf) 2017; 39:122-131. [PMID: 26888979 PMCID: PMC5409066 DOI: 10.1093/pubmed/fdv212] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background Low birth weight (LBW) affects 6.9% of all UK births and has remained largely unchanged for many years. The United Nations and the World Health Assembly have set targets to substantially reduce global incidence. Understanding the contribution of modifiable risk factors to the burden of LBW is required to ensure appropriate interventions are in place to achieve this reduction. Methods Data from published studies on the risks from key modifiable factors were used alongside prevalence data from the Welsh population to calculate the population attributable risk for each factor individually and in combination. Results Fourteen risk factors accounted for nearly half of LBW births, and 60% of those to younger mothers (<25 years). Tobacco smoke exposure was the largest contributor. We estimated that smoking in pregnancy was a factor in one in eight LBW births, increasing to one in five for women aged under 25. Conclusions Risk factors are interrelated and inequitably distributed within the population. Exposure to one factor increases the likelihood of exposure to a constellation of factors further increasing risk. Action to address LBW must consider groups where the risk factors are most prevalent and address these risk factors together using multi-component interventions.
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Ren H, Du M. Role of Maternal Periodontitis in Preterm Birth. Front Immunol 2017; 8:139. [PMID: 28243243 PMCID: PMC5303728 DOI: 10.3389/fimmu.2017.00139] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Accepted: 01/26/2017] [Indexed: 01/22/2023] Open
Abstract
In the last two decades, many studies have focused on whether periodontitis is a risk factor for preterm birth (PTB). However, both epidemiological investigation and intervention trials have reached contradictory results from different studies. What explains the different findings, and how should future studies be conducted to better assess this risk factor? This article reviews recent epidemiological, animal, and in vitro studies as well as intervention trials that evaluate the link between periodontitis and PTB. Periodontitis may act as a distant reservoir of microbes and inflammatory mediators and contribute to the induction of PTB. Animal studies revealed that maternal infections with periodontal pathogens increase levels of circulating IL-1β, IL-6, IL-8, IL-17, and TNF-α and induce PTB. In vitro models showed that periodontal pathogens/byproducts induce COX-2, IL-8, IFN-γ, and TNF-α secretion and/or apoptosis in placental tissues/cells. The effectiveness of periodontal treatment to prevent PTB is influenced by the diagnostic criteria of periodontitis, microbial community composition, severity of periodontitis, treatment strategy, treatment efficiency, and the period of treatment during pregnancy. Although intervention trials reported contradictory results, oral health maintenance is an important part of preventive care that is both effective and safe throughout pregnancy and should be supported before and during pregnancy. As contradictory epidemiological and intervention studies continue to be published, two new ideas are proposed here: (1) severe and/or generalized periodontitis promotes PTB and (2) periodontitis only promotes PTB for pregnant women who are young or HIV-infected or have preeclampsia, pre-pregnancy obesity, or susceptible genotypes.
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Affiliation(s)
- Hongyu Ren
- MOST KLOS and KLOBM, School and Hospital of Stomatology, Wuhan University , Wuhan , China
| | - Minquan Du
- MOST KLOS and KLOBM, School and Hospital of Stomatology, Wuhan University , Wuhan , China
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Maisonneuve E. Mode de vie et règles hygiénodiététiques pour la prévention de la prématurité spontanée chez la femme enceinte asymptomatique. ACTA ACUST UNITED AC 2016; 45:1231-1246. [DOI: 10.1016/j.jgyn.2016.09.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 09/16/2016] [Indexed: 12/27/2022]
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Pinto G, Silva MD, Peddey M, Sillankorva S, Azeredo J. The role of bacteriophages in periodontal health and disease. Future Microbiol 2016; 11:1359-1369. [PMID: 27633580 DOI: 10.2217/fmb-2016-0081] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The human periodontium health is commonly compromised by chronic inflammatory conditions and has become a major public health concern. Dental plaque, the precursor of periodontal disease, is a complex biofilm consisting mainly of bacteria, but also archaea, protozoa, fungi and viruses. Viruses that specifically infect bacteria - bacteriophages - are most common in the oral cavity. Despite this, their role in the progression of periodontal disease remains poorly explored. This review aims to summarize how bacteriophages interact with the oral microbiota, their ability to increase bacterial virulence and mediate the transfer of resistance genes and suggests how bacteriophages can be used as an alternative to the current periodontal disease therapies.
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Affiliation(s)
- Graça Pinto
- CEB - Centre of Biological Engineering, LIBRO - Laboratório de Investigação em Biofilmes Rosário Oliveira, University of Minho, 4710-057 Braga, Portugal
| | - Maria Daniela Silva
- CEB - Centre of Biological Engineering, LIBRO - Laboratório de Investigação em Biofilmes Rosário Oliveira, University of Minho, 4710-057 Braga, Portugal
| | - Mark Peddey
- Mark Peddey Pty Ltd, 65 Glenhuntly Road, Elwood, VIC, Australia
| | - Sanna Sillankorva
- CEB - Centre of Biological Engineering, LIBRO - Laboratório de Investigação em Biofilmes Rosário Oliveira, University of Minho, 4710-057 Braga, Portugal
| | - Joana Azeredo
- CEB - Centre of Biological Engineering, LIBRO - Laboratório de Investigação em Biofilmes Rosário Oliveira, University of Minho, 4710-057 Braga, Portugal
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Azofeifa A, Yeung LF, Alverson CJ, Beltrán-Aguilar E. Dental caries and periodontal disease among U.S. pregnant women and nonpregnant women of reproductive age, National Health and Nutrition Examination Survey, 1999-2004. J Public Health Dent 2016; 76:320-329. [PMID: 27154283 PMCID: PMC5097890 DOI: 10.1111/jphd.12159] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Accepted: 02/29/2016] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This study assessed and compared the prevalence and severity of dental caries and the prevalence of periodontal disease among pregnant and nonpregnant women of reproductive age (15-44 years) using data from the National Health and Nutrition Examination Survey, NHANES (1999-2004). METHODS Estimates were derived from a sample of 897 pregnant women and 3,971 nonpregnant women. Chi-square and two-sample t-tests were used to assess differences between groups stratified by age, race/ethnicity, education, and poverty. Bonferroni method was applied to adjust for multiple comparisons. RESULTS In general, there were no statistically significant differences in the prevalence estimates of dental caries and periodontal disease between pregnant women and nonpregnant women. However, results showed significant differences when stratified by sociodemographic characteristics. For example, the prevalence of untreated dental caries among women aged 15-24 years was significantly higher in pregnant women than in nonpregnant women (41 percent versus 24 percent, P = 0.001). Regardless of their pregnancy status, racial/ethnic minorities or women with less education or lower family income had higher prevalence of untreated dental caries, severity of dental caries, and periodontal disease compared to the respective reference groups of non-Hispanic whites or women with more education or higher family income. CONCLUSION Results of this study show few clinical differences in dental caries and periodontal disease between pregnant and nonpregnant women but persistent disparities by sociodemographic characteristics. In order to reduce oral health disparities in the United States, it is important to improve access to oral health care particularly among vulnerable groups. Integrating oral health into the overall health care could benefit and improve women's oral health outcomes.
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Affiliation(s)
- Alejandro Azofeifa
- Division of Evaluation, Analysis and Quality, Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, MD
- Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Lorraine F. Yeung
- Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - C. J. Alverson
- Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
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Ide M, Papapanou PN. Epidemiology of association between maternal periodontal disease and adverse pregnancy outcomes--systematic review. J Periodontol 2016; 84:S181-94. [PMID: 23631578 DOI: 10.1902/jop.2013.134009] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND AND OBJECTIVES There is still debate regarding potential relationships between maternal periodontitis during pregnancy and adverse pregnancy outcomes. The aim of this systematic review was to synthesize the available epidemiological evidence on this association. DATA SOURCES Combined electronic and hand search of MEDLINE, EMBASE, WEB OF SCIENCE and Cochrane Central Register databases. STUDY ELIGIBILITY CRITERIA Original publications reporting data from cross-sectional, case-control or prospective cohort epidemiological studies on the association between periodontal status and preterm birth, low birthweight (LBW) or preeclampsia. The search was not limited to publications in English. All selected studies provided data based on professional assessments of periodontal status, and outcome variables, including preterm birth (<37 weeks gestation), LBW (<2500 g), gestational age, small for gestational age, birthweight, pregnancy loss or miscarriage, or pre-eclampsia. PARTICIPANTS Pregnant women with or without periodontal disease, and with or without adverse pregnancy outcomes, assessed either during pregnancy or postpartum. No intervention studies were included. Study appraisal and synthesis methods - Publications were assessed based on predefined screening criteria including type of periodontal assessment, consistency in the timing of the periodontal assessment with respect to gestational age, examiner masking and consideration of additional exposures and confounders. RESULTS Maternal periodontitis is modestly but significantly associated with LBW and preterm birth, but the use of a categorical or a continuous exposure definition of periodontitis appears to impact the findings: Although significant associations emerge from case-control and cross-sectional studies using periodontitis "case definitions," these were substantially attenuated in studies assessing periodontitis as a continuous variable. Data from prospective studies followed a similar pattern, but associations were generally weaker. Maternal periodontitis was significantly associated with pre-eclampsia. LIMITATIONS There is a high degree of variability in study populations, recruitment and assessment, as well as differences in how data are recorded and handled. As a result, studies included in meta-analyses show a high degree of heterogeneity. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS Maternal periodontitis is modestly but independently associated with adverse pregnancy outcomes, but the findings are impacted by periodontitis case definitions. It is suggested that future studies employ both continuous and categorical assessments of periodontal status. Further use of the composite outcome preterm LBW is not encouraged.
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Affiliation(s)
- Mark Ide
- Periodontology, King's College London Dental Institute, London, UK.
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Periodontal Disease and Adverse Pregnancy Outcomes: A Prospective Study in a Low-Risk Population. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2016; 38:346-50. [PMID: 27208603 DOI: 10.1016/j.jogc.2016.02.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 12/22/2015] [Indexed: 02/08/2023]
Abstract
BACKGROUND Periodontal disease has been associated with systemic inflammation and adverse pregnancy outcomes, including preeclampsia and preterm birth. OBJECTIVE To examine the relationship between periodontal disease in early pregnancy and the risk of amniotic inflammation, preterm birth, and preeclampsia. METHODS We performed a prospective cohort study of women undergoing amniocentesis for fetal karyotype between 15 and 24 weeks' gestation. Participants underwent periodontal examination by a certified dentist, and a sample of amniotic fluid was collected. Periodontal disease was defined as the presence of one or more sites with probing depths ≥ 4 mm and ≥ 10% bleeding on probing. Matrix metalloproteinase-8 and interleukin-6 concentrations in the amniotic fluid were measured. Medical charts were reviewed for perinatal outcomes. Univariate and multivariate logistic regression analyses were used to assess the association between periodontal disease and adverse pregnancy outcomes. RESULTS We recruited 273 women at a median gestational age of 16 weeks (range 15 to 24), and 258 (95%) agreed to undergo periodontal examination. Periodontal disease was observed in 117 of the participants (45%). We observed no significant association between periodontal disease and preterm birth (relative risk [RR] 2.27; 95% CI 0.74 to 6.96) or spontaneous preterm birth (RR 0.90; 95% CI 0.20 to 4.11). However, women with periodontal disease were more likely to develop preeclampsia, and this association remained significant after adjustment for potential confounders (adjusted RR 5.89; 95% CI 1.24 to 28.05). Periodontal disease was not associated with significant differences in the intra-amniotic concentration of matrix metalloproteinase-8 (13.0 ± 46.6 vs 5.7 ± 10.4 ng/mL, P = 0.098) or interleukin-6 (3.3 ± 20.3 vs 1.0 ± 1.6 ng/mL, P = 0.23), although a non-significant trend was observed. CONCLUSION Periodontal disease is associated with preeclampsia but not with spontaneous preterm birth. The current study cannot exclude an association between periodontal disease and intra-amniotic inflammation.
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Vinturache AE, Gyamfi-Bannerman C, Hwang J, Mysorekar IU, Jacobsson B. Maternal microbiome - A pathway to preterm birth. Semin Fetal Neonatal Med 2016; 21:94-9. [PMID: 26936188 DOI: 10.1016/j.siny.2016.02.004] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Despite great medical advances in preventing maternal and infant mortality in the past century, one issue remains unresolved: why do so many women give birth prematurely? A major new field of human microbiome studies has begun to shed light on the impact of microbes (of both the commensal and pathogen varieties) on pregnancy outcomes. Recent advances in next-generation sequencing and metagenomic analysis have revealed that maternal microbiomes at a variety of niches including the oral, vaginal, gut, cervical, and even the placenta itself govern pregnancy outcomes. In this review, we describe how alterations in the microbial biomasses impact preterm birth and we discuss the major research questions concerning the cause and/or interdependent relationships between microbiome, infection, and preterm delivery.
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Affiliation(s)
- Angela E Vinturache
- Department of Paediatrics, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
| | - Cynthia Gyamfi-Bannerman
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Columbia University Medical Center, New York, NY, USA
| | - Joseph Hwang
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA
| | - Indira U Mysorekar
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, MO, USA; Pathology and Immunology, Washington University School of Medicine, St Louis, USA
| | - Bo Jacobsson
- Department of Obstetrics and Gynecology, Institute for the Health of Women and Children, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Genes and Environment, Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
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Tada A, Nakayama-Imaohji H, Yamasaki H, Hasibul K, Yoneda S, Uchida K, Nariya H, Suzuki M, Miyake M, Kuwahara T. Cleansing effect of acidic L-arginine on human oral biofilm. BMC Oral Health 2016; 16:40. [PMID: 27001253 PMCID: PMC4802732 DOI: 10.1186/s12903-016-0194-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 03/10/2016] [Indexed: 11/26/2022] Open
Abstract
Background Dental plaque formed on tooth surfaces is a complex ecosystem composed of diverse oral bacteria and salivary components. Accumulation of dental plaque is a risk factor for dental caries and periodontal diseases. L-arginine has been reported to decrease the risk for dental caries by elevating plaque pH through the activity of arginine deiminase in oral bacteria. Here we evaluated the potential of L-arginine to remove established oral biofilms. Methods Biofilms were formed using human saliva mixed with Brain Heart Infusion broth supplemented with 1 % sucrose in multi-well plates or on plastic discs. After washing the biofilms with saline, citrate (10 mM, pH3.5), or L-arginine (0.5 M, pH3.5), the retained biofilms were analyzed by crystal violet staining, scanning electron microscopy, and Illumina-based 16S rDNA sequencing. Results Washing with acidic L-arginine detached oral biofilms more efficiently than saline and significantly reduced biofilm mass retained in multi-well plates or on plastic discs. Illumina-based microbiota analysis showed that citrate (pH3.5) preferentially washed out Streptococcus from mature oral biofilm, whereas acidic L-arginine prepared with 10 mM citrate buffer (pH3.5) non-specifically removed microbial components of the oral biofilm. Conclusions Acidic L-arginine prepared with citrate buffer (pH3.5) effectively destabilized and removed mature oral biofilms. The acidic L-arginine solution described here could be used as an additive that enhances the efficacy of mouth rinses used in oral hygiene. Electronic supplementary material The online version of this article (doi:10.1186/s12903-016-0194-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ayano Tada
- Department of Microbiology, Faculty of Medicine, Kagawa University, 1750-1, Miki, Kagawa, 761-0793, Japan.,Department of Dental Oral Surgery, Faculty of Medicine, Kagawa University, 1750-1, Miki, Kagawa, 761-0793, Japan
| | - Haruyuki Nakayama-Imaohji
- Department of Microbiology, Faculty of Medicine, Kagawa University, 1750-1, Miki, Kagawa, 761-0793, Japan
| | - Hisashi Yamasaki
- Department of Cellular and Molecular Medicine, Wakayama Medical University Graduate School of Medicine, Wakayama, 641-8509, Japan
| | - Khaleque Hasibul
- Department of Dental Oral Surgery, Faculty of Medicine, Kagawa University, 1750-1, Miki, Kagawa, 761-0793, Japan
| | - Saori Yoneda
- Department of Microbiology, Faculty of Medicine, Kagawa University, 1750-1, Miki, Kagawa, 761-0793, Japan
| | - Keiko Uchida
- Department of Microbiology, Faculty of Medicine, Kagawa University, 1750-1, Miki, Kagawa, 761-0793, Japan
| | - Hirofumi Nariya
- Department of Microbiology, Faculty of Medicine, Kagawa University, 1750-1, Miki, Kagawa, 761-0793, Japan
| | - Motoo Suzuki
- Department of Microbiology, Faculty of Medicine, Kagawa University, 1750-1, Miki, Kagawa, 761-0793, Japan
| | - Minoru Miyake
- Department of Dental Oral Surgery, Faculty of Medicine, Kagawa University, 1750-1, Miki, Kagawa, 761-0793, Japan
| | - Tomomi Kuwahara
- Department of Microbiology, Faculty of Medicine, Kagawa University, 1750-1, Miki, Kagawa, 761-0793, Japan.
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Periodontal disease and carotid atherosclerosis: A meta-analysis of 17,330 participants. Int J Cardiol 2016; 203:1044-51. [DOI: 10.1016/j.ijcard.2015.11.092] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 11/11/2015] [Accepted: 11/16/2015] [Indexed: 12/18/2022]
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Jiang H, Xiong X, Buekens P, Su Y, Qian X. Use of mouth rinse during pregnancy to improve birth and neonatal outcomes: a randomized controlled trial. BMC Pregnancy Childbirth 2015; 15:311. [PMID: 26608342 PMCID: PMC4660817 DOI: 10.1186/s12884-015-0761-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 11/23/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Poor oral health, such as periodontal (gum) disease, has been found to be associated with an increased risk of adverse pregnancy outcomes including preterm birth, low birth weight, and neonatal and infant mortality, especially in low-and middle-income countries. However, there is little or no access to preventive dental care in most low-and middle-income countries. We propose to develop and test a "Mouth Rinse Intervention" among pregnant women to prevent the progression of periodontal disease during pregnancy and reduce adverse birth and neonatal outcomes in a rural county of China. METHODS/DESIGN This is a randomized controlled clinical trial. A sample of 468 (234 in each arm of the study) women in early pregnancy with periodontal disease will be recruited for the study. Periodontal disease will be diagnosed through the methods of Periodontal Screening and Recording. All women diagnosed with periodontal disease will be randomly allocated into the intervention or control group. Women assigned in the intervention group will be provided with non-alcohol antimicrobial mouth rinse containing cetylpyridinium chloride throughout the pregnancy and oral health education. Women in the control group will receive a package of tooth brush and paste, plus oral hygiene education. Women will be followed-up to childbirth until the 42nd day postpartum. The main outcomes include mean birthweight (gram) and mean gestational age (week). DISCUSSION Compared with conventional mechanical 'scaling and root planning' periodontal treatment during pregnancy, our proposed mouth rinse intervention could be a simple, cost-effective, and sustainable solution to improve both mother's oral health and neonate outcomes. If the mouth rinse is confirmed to be effective, it would demonstrate great potential for the application in other low- or middle-income countries to prevent adverse birth outcomes such as preterm birth and low birth weight and to reduce neonatal and infant mortality. TRIAL REGISTRATION This trial was registered with Chinese Clinical Trial Registry (ChiCTR): ( #ChiCTR-TRC-13003768 ) on November 06, 2013.
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Affiliation(s)
- Hong Jiang
- School of Public Health; Global Health Institute, Fudan University, Mailbox 175, No. 138 Yixueyuan Road, Shanghai, 200032, China. .,Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China.
| | - Xu Xiong
- School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, Suite 2022, New Orleans, LA, 70112, USA.
| | - Pierre Buekens
- School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, Suite 2022, New Orleans, LA, 70112, USA.
| | - Yi Su
- Eye & ENT Hospital of Fudan University, Shanghai, China.
| | - Xu Qian
- School of Public Health; Global Health Institute, Fudan University, Mailbox 175, No. 138 Yixueyuan Road, Shanghai, 200032, China. .,Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China.
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