Periodontitis can trigger complications of pregnancy

If a woman is planning a pregnancy, she should get her periodontal status checked and have it monitored closely during pregnancy as a preventive measure. Because periodontitis-associated bacteria can play a role in the development of complications of pregnancy.

Preemie in incubator

Clinical and epidemiological studies show that women with periodontal disease may be at higher risk of having a

  • Low-birth-weight ( below 2.5 kg),
  • or preterm delivery, miscarriage or stillbirth and of
  • preeclampsia.

These correlations are attributed to periodontopathogenic bacteria, their toxins and the state of chronic, systemic inflammation that they induce.

Oral bacteria get into the uterus

In the presence of untreated periodontitis, the bacteria and their metabolites spread through the bloodstream to the uterus. Here they are able to penetrate the fetoplacental unit. On the one hand, this infection can, through the activity of bacterial collagenases, lead to premature rupture of the amniotic sac. On the other hand, the bacteria trigger a systemic and local immune response that leads to increased formation of interleukin-1B, TNF-α and prostaglandin E2. These mediators not only have an inflammatory function, but they also play a part in the maintenance of pregnancy, the onset of labor and the birth process. The inflammatory mediators circulating freely in the blood in the presence of full-blown periodontitis are themselves able to trigger contractions of the uterine muscles and thus cause premature delivery.

Periodontal therapy reduces the risk of premature birth

As a result of hormonal changes, pregnant women are affected more than average by periodontal problems. This is associated with an increased risk to the fetus. According to scientific studies, successful periodontal treatment can reduce the risk of premature birth by a factor of 3.8. Periodontal therapy is therefore doubly important for pregnant women: Treatment both prevents tooth loss and reduces the risk of complications of pregnancy. Ideally, women should undergo periodontal treatment even if they are just planning to become pregnant, in order to prevent disease. During pregnancy, the recommended time for periodontal therapy is the second trimester, although x-ray diagnostic procedures should be used only in isolated cases.