Of course your dentist tells you to keep your mouth scrupulously clean, but now your obstetrician will too. Obstetrics journals contain articles describing the latest relationship between preterm labor and—of all things—periodontal disease (gingivitis, chronic inflammation of the gums). All of the official causes of preterm labor lumped together aren't as frequent as the unknown causes, but it's possible that at least part of the unknown group may have an explainable cause: bad gums.
Researchers have found that periodontal treatment significantly reduced the risk of having a preterm birth or low birth weight infant, according to a 2005 study published in the Journal of Periodontology. Visiting a dentist before and during pregnancy reduced preterm birth and low birth weight infant rates by an impressive 68 percent in women with pregnancy-associated gingivitis.
What does this mean to you? The current thinking is that the effect of chronic inflammation around the gums may spill over into the rest of the body as a chronic inflammatory state, decreasing the threshold necessary to trigger uterine irritability.
Most obstetricians scoffed upon first hearing this, thinking that people with gum disease were more frequently indigent persons who were less likely to have good nutrition or seek adequate prenatal care—making them high risk, and therefore more susceptible to complications of pregnancy, including preterm labor. But the latest studies have corrected for social strata and variations in prenatal care, meaning that bad gums themselves are indeed the culprits.
So how much more likely are you to experience preterm labor with gum disease? The number is a staggering five to seven times as likely, according to a five-year study conducted at the University of North Carolina.
Suddenly, the risk of preterm delivery makes going to the dentist during pregnancy a very good idea. It also seems prudent to have a good dental exam before conception, just as it seems prudent to have a good OB-GYN exam. Will your obstetrician be giving away toothbrushes like the dentist? Not likely. But soon you can expect questions about your dental hygiene to be asked at the initial OB interview.
Women who have had oral surgery involving prosthetics (implants, etc.) should consider themselves at the same risk, since foreign bodies tend to establish a chronic inflammatory state.