You might think that, as a dentist here in Roseville, the last thing I would be writing about are the potential complications of pregnancy. However, you might be surprised to learn that there are several scientific studies that have linked periodontal disease with premature onset of labor and delivery or delivery of a low birth weight baby. Before going into a discussion of this topic, let’s first define what we mean by “premature birth” and “low birth weight.”
A “premature” birth is any birth that occurs before the 37th week of pregnancy, assuming that the expected date of delivery has been reliably determined earlier in the pregnancy. Women who have gone into premature labor and given birth to a premature baby are more likely to develop premature labor in later pregnancies. As I’m sure you know, the earlier a baby is born the more likely it is that the baby will have problems breathing due to immature lungs. Other problems, some of which can be serious health issues, may be present as well.
Low birth weight is defined as a baby whose birth weight is less than 5 pounds 8 ounces (2.5 kg). A low birth weight baby may be born at full term or may be born prematurely. In either case, low birth weight babies are subject to many of the health problems seen in premature infants.
Although the relationship between periodontal disease and premature labor / low birth weight is clearly established (women with periodontal disease are up to seven times more likely to develop premature labor and an estimated 18% of low birth weight babies are born to mothers who have periodontal disease), the actual process that causes such events remains unclear. However, the most popular explanation for these phenomena holds that the bacteria that are responsible for periodontal disease will sometimes break free of their typical location and enter the bloodstream. Once they are free these bacteria begin to multiply rapidly and, in the process of reproduction, release chemicals called toxins into the mother’s bloodstream. The mother’s immune system reacts to the presence of the bacteria and their toxins by unleashing a torrent of chemicals called cytokines, whose purpose is to destroy the bacteria while neutralizing any toxins. Occasionally, the cytokines are too successful at their job and cause the release of other chemicals that can cause contractions of the muscles of the uterus and precipitate premature labor.
Cytokines are also implicated in low birth weight babies, although in those cases the cytokines seem to reduce blood flow to the placenta and thus disrupt the flow of nutrients to the unborn baby. Unfortunately, this reduced blood flow is often not suspected until the onset of labor.
Knowing the association of periodontal disease with prematurity / low birth weight it is important that any dentist, from Roseville to San Francisco and all points close by, educate their female patients to the risks of periodontal disease during pregnancy and urge these women to receive regular dental care, including cleanings, throughout their pregnancies. In my practice here in Roseville, both myself and my staff are deeply concerned about this issue and will work with our expectant mothers to insure that they receive the best dental care possible.
As you dentist, I’ll always keep myself aware of health issues that may be caused or influenced by your dental health. That’s the way I would want it to be if you were to be my dentist.