Periodontal Disease
Periodontal disease has the potential to cause systemic effects, including preterm delivery and low birth weight; therefore, dental professionals must be aware of these risks in order to properly treat and educate pregnant women. This editorial will review the risks that the inflammation process imposes on a fetus. A healthy pregnancy is important not only for the mother’s health, but also for the baby’s health. As healthcare providers, dental hygienists have a responsibility to educate pregnant women about the effects of an unhealthy oral cavity on a pregnancy. In the United States annually, more than six million women become pregnant and 40% of the six million have never been pregnant before.1 Periodontal disease is also prevalent
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Preterm delivery is “defined as delivery at a gestational age of less than 37 weeks,” and low birth weight is identified as less than five pounds eight ounces.2,4 Pregnancy causes physiological hormonal changes, which include elevated levels of estrogen and progesterone.5 These hormones cause an increase in vascular permeability, which allow bacterial products to travel more freely in the gingival tissue.5 Furthermore, these bacterial products eventually may reach the placenta, where fetal IgM antibodies may already be present.2 Forty percent of pregnancies involve fetal IgM antibodies, but through isotype switching, the IgM antibodies can convert to IgG antibodies, which can pass through the placenta.2,5 The fetus is not immunocompetent and can only respond to IgM antibodies.5 Such compromise may result in premature birth or miscarriage. In addition to these antibodies, cytokines attempting to combat the infection cause tissue damage in the placenta.2 This destruction also compromises the exchange of vital nutrients between the mother and the fetus—resulting in possible low birth weight.2 If preventable, result of a low birth weight baby should be avoided because this condition increases the risk of other health disorders, such as neurodevelopmental problems (cerebral palsy, blindness, deafness), respiratory problems (asthma, lower respiratory infections, bronchopulmonary dysplasia, chronic lung disease), behavioral problems (attention deficit hyperactivity disorder), learning problems, cardiovascular disease, and metabolic abnormalities (obesity, type 2 diabetes mellitus).2 These health concerns can effect an individual’s quality of life; therefore, maintaining a healthy oral cavity is important for expecting
Preterm delivery is “defined as delivery at a gestational age of less than 37 weeks,” and low birth weight is identified as less than five pounds eight ounces.2,4 Pregnancy causes physiological hormonal changes, which include elevated levels of estrogen and progesterone.5 These hormones cause an increase in vascular permeability, which allow bacterial products to travel more freely in the gingival tissue.5 Furthermore, these bacterial products eventually may reach the placenta, where fetal IgM antibodies may already be present.2 Forty percent of pregnancies involve fetal IgM antibodies, but through isotype switching, the IgM antibodies can convert to IgG antibodies, which can pass through the placenta.2,5 The fetus is not immunocompetent and can only respond to IgM antibodies.5 Such compromise may result in premature birth or miscarriage. In addition to these antibodies, cytokines attempting to combat the infection cause tissue damage in the placenta.2 This destruction also compromises the exchange of vital nutrients between the mother and the fetus—resulting in possible low birth weight.2 If preventable, result of a low birth weight baby should be avoided because this condition increases the risk of other health disorders, such as neurodevelopmental problems (cerebral palsy, blindness, deafness), respiratory problems (asthma, lower respiratory infections, bronchopulmonary dysplasia, chronic lung disease), behavioral problems (attention deficit hyperactivity disorder), learning problems, cardiovascular disease, and metabolic abnormalities (obesity, type 2 diabetes mellitus).2 These health concerns can effect an individual’s quality of life; therefore, maintaining a healthy oral cavity is important for expecting