Every day, dentists across the country decide whether or not to provide dental care to a patient who is pregnant. On the one hand, they realize the patient needs to maintain her good oral health, especially if she has periodontal disease. On the other hand, dentists traditionally have lacked the scientific evidence to make informed decisions about the possible effects of dental care, if any, to the developing child. The lack of data has caused many dentists to err strongly on the side of caution, especially during the second trimester when the child's development accelerates and, in theory, exposure to infectious oral bacteria or dental products could have adverse effects. However, the fundamental questions remain: Should dentists provide dental care to pregnant women through the second trimester? If so, which types of treatment are safe to provide?
During the last 5 years, newer scientific evidence has provided answers to these important questions. The data so far indicate that mothers who receive dental care through the second trimester—both general and periodontal treatment—do not appear to increase their risk of adverse events during pregnancy. Some of the most scientifically rigorous data come from the National Institute of Dental and Craniofacial Research (NIDCR)-supported Obstetrics and Periodontal Therapy Trial (OPT). In 2006, the OPT reported in the New England Journal of Medicine that pregnant women, most with early to moderate periodontitis, benefitted from general and periodontal care without an increase in preterm births or other negative pregnancy outcomes.
As published online in the journal Pediatrics on April 11, the investigators report findings from a follow-up study of the OPT patients and their children born during the original trial. The researchers evaluated the neurodevelopment of 411 children, including 32 preterm infants, 2 years after the study. The scientists found no difference in the neurodevelopment of children from mothers previously assigned to the treatment or control group. They also report slight associations between improvements in a mother's periodontal attachment loss during the original study and higher cognitive and motor skills in their children. But both the associations are so weak, the scientists considered them "to be of little or no clinical significance."
(Source: NIDCR, Science News in Brief, April 19, 2011)