Periodontal disease in pregnancy and adverse pregnancy outcomes: Progress in related mechanisms and management strategies

Abstract

Periodontal disease is an inflammatory and destructive disease of tissues supporting the tooth. A large number of studies have confirmed that periodontal pathogens and their metabolites can lead to adverse pregnancy outcomes in direct or indirect ways. Adverse pregnancy outcomes, such as preterm birth, low birth weight, and pre-eclampsia, have a serious impact on human reproductive health. In recent years, although the level of global medical technology has gradually improved, the incidence of adverse pregnancy outcomes has not declined and is still a global public health problem. The purpose of this review is to summarize the current data on periodontal disease in pregnancy and adverse pregnancy outcomes, including the association between periodontal disease and adverse pregnancy outcomes, the pathogenic mechanism related to this association, the efficacy of different nutrition supplements for both periodontal disease and adverse pregnancy outcomes and the effect of providing periodontal treatment on the occurrence of adverse pregnancy outcomes, to provide guidance for the prevention and treatment of adverse pregnancy outcomes in clinical practice.

Keywords: adverse pregnancy outcomes; antiphospholipid syndrome; genetic susceptibility; nutrition; periodontal disease; periodontal therapy.

FIGURE 1

The left side of the picture shows the mechanisms related to periodontal disease leading to adverse pregnancy outcomes, including periodontal pathogen infection, the changes in the level of inflammatory mediators, host immune response, gene polymorphism, and APS with elevated anticardiolipin antibodies. The right side of the picture shows the effect of periodontal treatment on adverse pregnancy outcomes, the intervention methods include plaque control, application of drugs, supragingival scaling, subgingival scaling and root planning. Reasonable intervention of periodontal diseases during pregnancy is beneficial to the physical and mental health of patients and can reduce the mother-to-child transmission of periodontal pathogens. The ideal time for periodontal treatment is the second trimester (14–27 weeks), if intervention for infection is absolutely necessary, emergency treatment can be performed throughout pregnancy. Created with https://biorender.com/.