Effect of oral diseases on mothers giving birth to preterm infants

Maternal microbial factors that affect the fetus and subsequent offspring

The maternal microbiome has emerged as an important area of investigation. While birth is a critical timepoint for initial colonization of the newborn, the fetus resides in the womb surrounded by multiple unique colonized niches. The maternal microbiome has recently been shown to be associated with several morbidities in offspring. Understanding the multiple bacterial niches within the pregnant woman and how they interact with the fetus in-utero can lead to novel therapies to improve the health of offspring. In this review, we provide an overview of the available literature on normal bacterial colonization within the individual niches of the pregnant woman and the known associations with outcomes in offspring, including a discussion of the controversy of in-utero colonization.

Keyword Trends for Mother-Child Oral Health in Korea Based on Social Media Big Data from Naver

Objectives

The present study examined trends in search keywords related to the oral health of infants and pregnant women using “social media cafés” on the Korean portal site, Naver.

Methods

We obtained data from January 2015 to December 2017, collected by searching for common terms related to oral health, such as “dental caries”, “oral health”, “scaling”, “tooth brushing”, and “oral examination”. Search results for these terms were organized by frequency and visualized by increase in the font size with increasing frequency.

Results

The ranking of keywords on Naver cafés for pregnant women and women with infants was as follows (in descending order): “oral examination”, “tooth filling”, and “tooth brushing”. The “oral health” network was linked to “dental caries”, “oral health education”, and “tooth brushing”. In addition, the analysis of trends of keyword frequencies according to time periods showed that “dental caries” and “oral examination” were of highest interest to the café users.

Conclusions

We found a high interest in keywords related to preventive measures for the oral health of infants and children, but there was a lack of awareness regarding the oral health of pregnant women. These findings suggest that prevention in infants and pregnant women is necessary, and that public awareness regarding education about oral healthcare needs to be raised.

Association between dental caries and adverse pregnancy outcomes

Poor oral health is not only associated with diabetes and cardiovascular disease but adverse pregnancy outcomes. However the influence of dental caries on pregnancy is unknown. The aim of this study was to evaluate the association between dental caries and adverse pregnancy outcomes and the effect of treatment for dental caries on adverse pregnancy outcomes. Primiparas who delivered a singleton between January 1, 2010 and December 31, 2014 and underwent both general health examination and oral health examination during a National Korea Health Screening Examination within 1 year of pregnancy were eligible. The data of the women who met the inclusion criteria were linked to the data of their offspring contained within the National Korea Health Screening Program for Infants and Children database. Among 120,622 women who delivered during the study period, 28,623 (23.7%) women had dental caries. Among them, 4,741 (16.6%) women were treated for dental caries after diagnosis. In a multivariable analysis, women with dental caries had an increased risk of delivering large-for-gestational-age infants (odds ratio, 1.15; 95% confidence interval, 1.07, 1.23) compared to those without dental caries. When women with dental caries were divided on the basis of the treatment of dental caries, women with dental caries but no treatment had an increased risk of delivering large-for-gestational-age infants (odds ratio, 1.15; 95% confidence interval, 1.06, 1.24); conversely, there was no increased risk in women with dental caries and treatment compared with those without. Dental caries and its treatment were not associated with preterm birth and preeclampsia. Untreated dental caries was not associated with preterm birth or preeclampsia but with the risk of delivering large-for-gestational-age infants. These whole observation may be attributed to the various characteristics of mothers who develop dental caries are not treated.

Exploring Self-Care Needs of Pregnant Women with Gingivitis: A Qualitative Study in Iran

BACKGROUND

Oral self-care behaviors are not satisfactory among pregnant women; incidence of gingivitis is high in them and training programs have slightly improved their gingivitis. This study was aimed to explore self-care needs of pregnant women suffering from gingival inflammation.

MATERIALS AND METHODS

This study was carried out in Sanandaj, west of Iran, in 2017. Twenty pregnant women with gingivitis were included in the study. Data were collected via semi-structured individual and group interviews and note-taking, and were analyzed by conventional content analysis. To confirm the accuracy and strength of the data, credibility, confirmability, and transferability components were taken into account.

RESULTS

The results of data analysis yielded six major categories, including "organizational support," "dentist's professional competence," "increasing perceived threat," "increasing self-efficacy," "increasing perceived benefits," and "culture-making." Increased self-efficacy was the most important concern of pregnant women.

CONCLUSIONS

The findings showed that self-care behaviors to prevent gingivitis in pregnant women are influenced by various factors. It is essential to consider the cooperation of the media and organizations, support of society, and attention of families and authorities to oral health education and disease prevention among women.

Oral, systemic and socioeconomic factors associated with preterm birth

BACKGROUND

The rates of preterm births have been increasing worldwide. Complications related to preterm births are associated with increased costs of care, and have a direct impact on the health system of the countries. Therefore, it is important to address factors associated with preterm birth in order to provide prevention strategies.

OBJECTIVE

This case-control study investigated oral, systemic, and socioeconomic factors associated with preterm birth in postpartum women. Participants were 279 postpartum women that gave birth to a singleton live-born infant. Cases were women giving birth before 37 completed weeks of gestation (preterm birth). Controls were women giving birth at term (≥37weeks). Data were collected through questionnaires, medical records and intra-oral clinical examinations, which included dental caries registration according to World Health Organization criteria and oral biofilm evaluation through visible plaque index.

RESULTS

Ninety-one women had preterm birth (cases) and 188 women had birth at term (controls), ratio 1:2. Caries lesions were present in 62.3% of the cases and in 62.5% of the controls. The univariate analysis showed no association between dental caries and preterm birth (Odds Ratio=1.08, p=0.90). The multivariate analysis showed that maternal educational level (Odds Ratio=2.56, p=0.01) and arterial hypertension (Odds Ratio=2.32, p=0.01) were associated with prematurity.

CONCLUSION

This study demonstrated that dental caries is frequent in postpartum women, but it does not appear to be associated with preterm birth. Meanwhile, maternal education level and arterial hypertension were associated with prematurity in this population.

Dental caries and preterm birth: a systematic review and meta-analysis

OBJECTIVES

The primary objective of this systematic review was to evaluate the association between dental caries and preterm birth (PTB). The secondary objective was ascertaining the difference between women with dental caries who experienced PTB and those who did not with regard to decayed, missing and filled teeth (DMFT), and decayed, missing and filled surfaces (DMFS) indices.

METHODS

MEDLINE, Embase, CINAHL and Cochrane databases were searched initially in November 2015 and repeated in December 2016. We included observational cohort and case-control studies. Only studies reporting the risk of PTB in women affected compared with those not affected by dental caries in pregnancy were included. Random-effect meta-analyses were used to compute the summary OR of PTB among women with caries versus women without caries, and the mean difference in either DMFT or DMFS indices between women experiencing PTB and those without PTB.

RESULTS

Nine observational studies (4826 pregnancies) were included. Women affected by dental caries during pregnancy did not show a significantly higher risk of PTB (OR: 1.16, 95% CI 0.90 to 1.49, P=0.25, I2=35%). Also, the women with PTB did not show significantly higher DMFT or DMFS indices (summary mean differences: 1.56, P=0.10; I2=92% and -0.15, P=0.9, I2=89%, respectively).

CONCLUSION

Dental caries does not appear to be a substantial risk factor for PTB.

TRIAL REGISTRATION NUMBER

NCT01675180; Pre-results.

Dental caries in Arab League countries: a systematic review and meta-analysis

OBJECTIVE

The aim of this review was to determine prevalence of dental caries in primary and permanent teeth in the 2-20-year-old population of the Arab league.

METHODS

A literature search was performed on Pubmed, Summon and Google Scholar using the key words 'Dental caries', 'dmft' and 'DMFT'. A total of 293 articles were found, of which 35 passed our inclusion criteria and were included in analysis. Tables were made separately for primary and permanent teeth; the age group for primary teeth was 2-12 years and for permanent teeth 6-20 years.

RESULTS

A meta-analysis was run by using data extracted from the studies included. Heterogeneity was tested by forest plot and chi-square test, and considerable heterogeneity was found. Mean decayed, missing and filled teeth (dmft) was 4.341 (95% CI 3.714, 4.969) and in permanent teeth (DMFT) was 2.469 (95% CI 2.019, 2.919) from a random effect model. Publication bias diagnostics suggested missing of four studies of primary teeth caries data and eight studies of permanent teeth caries data to obtain symmetry in the funnel plot.

CONCLUSION

The incidence of caries in primary teeth was found to be high compared with caries in permanent teeth in the Arab League. This study does not provide a comprehensive picture of caries prevalence in the Arab League because in many of these countries only a few studies were performed. Therefore, these data cannot provide a complete picture of the prevalence of caries in those countries. Additional studies are needed to better evaluate the prevalence of caries in children and young adults in Arab League countries.