Effects on Pregnancy and the Fetus

It’s easy to imagine what germs and germ wasteproducts can do when they get into the body of a pregnant mom.

First, there’s a direct attack on the fetus through the placenta.  A direct effect of both the germs and their toxins.

Secondarily, the whole immune system is turned upside down and starts generating all sorts of hormones that can trigger many problems.  In fact, the hormones that get generated when germs and their wastes get into the bloodstream are almost identical to what doctors give women to induce labor.

Pre-term and low Birthweight

Most commonly, we see pre-term births.  And when a baby is born prematurely, they’re always at risk for many more diseases, lung problems and difficulties of brain development.  And some of these issues can be with them for life.

Pre-term, low birthweight babies are FORTY TIMES  MORE LIKELY TO DIE RIGHT AFTER BIRTH.

And bad gums are the strongest predictor for these problems–stronger than smoking or even a previous pre-term birth, incidentally.

Women with deeper gum disease (“periodontitis”) have a four to eight times chance of a pre-term, low birthweight baby.

Women who had no treatment for their deep gum disease during their pregnancy had FIVE TIMES the chance of a pre-term, low birthweight baby than those who did have treatment.

“There is only a 1 in 7 chance that a pregnant woman with gum disease will have a regular healthy child that will grow to normal size” —Dr. Oz


The Bottom Line:

*Women of childbearing age should have regular, thorough dental and gum examinations.

*They should establish and maintain their gum health even before becoming preganant, and especially throughout the pregnancy.

*Don’t be surprised if your physician requests you have a dental examination at the earliest stages of pregnancy or even pre-pregnancy.

*It is probably better NOT getting a referral to go directly to a periodontal specialist.  Let your general dentist decide if that is necessary.

*If you don’t have a general dentist, call your local American Dental Association (ADA) dental society.

  Gestational Diabetes 

Germs and germ waste getting into the bloodstream can throw off many parts of the whole body.  Researchers from New York University have shown that women with deep gum disease are more likely to have high blood sugar.  This can make for babies over ten pounds (!) at birth.  Fortunately, blood sugar eventually will most likely return to normal, but it sometimes takes a long time and can have some damaging effects on the mother.

Dental Care Can Reduce Risk of Preterm Birth By Nearly 50 Percent

WEBWIRE – Friday, October 03, 2008

Columbia University College of Dental Medicine and Aetna presented findings at international Dental Research Institute conference

According to a study conducted by Aetna (NYSE: AET) and Columbia University College of Dental Medicine, women who received dental care before or during their pregnancy had a lower risk of giving birth to a preterm or low birth weight baby than pregnant women who didn’t seek dental care at all. The study, conducted between January 1, 2003 and September 30, 2006, reviewed medical and dental insurance data for 29,000 pregnant women who each had medical and dental coverage with Aetna to determine if there was an association between dental treatment and the likelihood of experiencing either birth outcome.

“Further studies need to be done but our findings show that dental treatment had a protective effect on adverse birth outcomes in women who sought dental treatment” said David A. Albert, DDS, MPH, Director, Division of Community Health, College of Dental Medicine, Columbia University.

When comparing the group who did not receive any dental treatment to the groups that received gum treatment and dental cleaning, the study found:

* The preterm birth rate was 11.0 percent for those not receiving dental treatment, and 6.4 percent for those receiving treatment
* The low birth weight rate was 5.4 percent for those not receiving dental treatment and 3.6 percent or lower among the groups receiving treatment

The Institute of Medicine of the National Academies determined that premature births, meaning babies born at less than 37 weeks of pregnancy, cost at least $26 billion a year and represented 12.5 percent of births in the U.S. in 2005.

“The results of this study send a strong message about the importance of dental care for women who want to start a family” said Dr. Mary Lee Conicella, DMD, FAGD, National Director of Clinical Operations, Aetna Dental. “We are seeing evidence that supports the role of routine preventive dental care in helping to protect the health of the newborn and the mother and contributing to lower associated medical costs.”

Aetna provides educational information about the importance of good oral health to women who are planning to become pregnant, as identified in responses to its Health Risk Assessment tool. Aetna also provides a dental/medical integration (DMI) program to pregnant women and at-risk members with diabetes and cardiovascular diseases who have both Aetna dental and medical coverage. The program is comprised of enhanced benefits, including an extra cleaning, full coverage for certain periodontal services and a variety of outreach methods to at-risk members who are not currently seeking dental care. As a result of various outreach methods during a two-year pilot with 500,000 Aetna members, 63 percent of those at-risk members who had not been to the dentist in 12 months sought dental care.  “The findings from this latest study we conducted continue to show that members with certain conditions who are engaged in seeking preventive care, such as regular dental visits, can improve their overall health and quality of life” said Alan Hirschberg, head of Aetna Dental.  

Aetna Dental launched its DMI program last fall following a published research analysis it conducted with Columbia University College of Dental Medicine which found that high-risk individuals that sought earlier dental care lowered the risk or severity of their condition and subsequently, lowered their overall medical costs.


Dental Visits May Help Your Baby Arrive on Schedule

Periodontal therapy may reduce the risk of delivering a preterm low birth weight baby

CHICAGO–May 1, 2007– There is good news today for pregnant women: a study in this month’s issue of the Journal of Periodontology (JOP) showed that periodontal therapy may significantly reduce the risk of delivering a preterm low birth weight baby for women with periodontal disease. Study Abstract *

The study looked at 328 pregnant women with periodontal disease and 122 periodontally healthy women. Periodontal treatment was performed during the second trimester of pregnancy on 266 of the women with periodontal disease. Sixty-two women dropped out of treatment. Postpartum follow up on all 450 subjects showed that 79% of the women with untreated periodontal disease had delivered a preterm low birth weight baby compared to only 7.5% of the periodontally treated women and 4.1% of the healthy women.

“Our study showed that performing periodontal therapy on pregnant women who have periodontal disease may reduce the risk of preterm delivery to equal that of periodontally healthy women,” explained study author Catia M. Gazolla, DDS. “These are important findings that we hope all pregnant women will take to their dental professionals when discussing their periodontal health.”

“These findings are interesting, as they come on the heels of another study appearing in the May issue of the JOP that showed the effects of high levels of periodontal bacteria during pregnancy on increased risk for preterm delivery,” said Preston D. Miller, DDS and AAP president. “These studies and others continue to strengthen the idea that women should consider a periodontal evaluation as part of their prenatal care.”

To asses your oral health, take the AAP’s online test to assess your gum disease risk.    [from http://www.perio.org:80/consumer/pregnancy-therapy07.htm?rss]

Amniotic fluid infections linked to premature births

Researchers find a greater number and variety of bacteria and fungi in a notable portion of women with pre-term deliveries. The more severe the infection, the earlier they were likely to give birth. By Mary Engel, Los Angeles Times Staff Writer

August 30, 2008 Microbes in the wrong place at the wrong time — a woman’s amniotic fluid during pregnancy — may play a role in causing premature births, according to a study published in the online journal PLoS ONE.

Using sensitive molecular techniques, researchers found a greater quantity and variety of bacteria and fungi in a significant portion of women who gave birth prematurely. The more severe the infection, the earlier the women were likely to give birth.

The amniotic sac, which surrounds a fetus, has long been considered a protected, almost inviolable, site.

“Certain kinds of organisms have been known to get in and not necessarily cause any harm,” said Dr. David Relman, an infectious disease specialist at Stanford University School of Medicine and the study’s senior author. “But in general, bugs don’t belong there.”

One in eight American infants is born before full term, which is defined as 37 completed weeks.

The high rate is attributed in part to assisted reproduction, which often results in twins or triplets. But the cause of about half of all spontaneous premature births is a mystery.

Babies born too early can have learning disabilities, neurological problems, lung diseases and cerebral palsy. Prematurity is the leading cause of infant mortality in the United States, accounting for more than a third of all infant deaths, according to the national Centers for Disease Control and Prevention.

Dr. Dan DiGiulio, a research associate in Relman’s laboratory, used two techniques of molecular biology — polymerase chain reaction and DNA sequencing — to look for microbes in amniotic fluid samples from 166 women in preterm labor. Of these women, 113 went on to deliver prematurely and 53 carried their babies to full term.

DiGiulio found evidence of infection in 15% of the samples, all from women who gave birth early. The microbes found represented one fungal and 17 bacterial species, including one that had never been identified, according to the report published Monday.

One of the most common was Leptotrichia, which can be found in the mouth and the vagina. Both gum disease and bacterial vaginosis have been linked with a higher risk of premature delivery.

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*major impacts on health

*major impacts on quality of life

*much of the results are in your hands