Monday, February 1, 2010

Periodontal Disease and Pregnancy, a New Risk

A researcher from Department of Periodontics at Case Western Reserve University School of Dental Medicine, reported the first documented link between a mother with pregnancy-associated gum disease to the death of her fetus.
The link was discovered when a friend of the mother of the stillborn baby introduced her to the researcher, Yiping Han. Han was studying the bacteria, Fusobacterium nucleatum, and it’s relationship to pre-term labor and stillbirths.

This study caught my eye because F Nucleatum is one of the known periodontal pathogens that we test for using DNA-PCR, when we find menacing bacteria from the gums when we look under the microscope.

The mother gave a history of bleeding gums during the pregnancy. Bleeding gums during pregnancy are not uncommon, indeed around 75% of pregnant women experience bleeding gums.

Postmortem microbial studies of the baby found the presence of F. nucleatum in the lungs and stomach. The baby had died from a septic infection and inflammation caused by bacteria. The bacteria was also found in the mother’s mouth.
It is now well understood that oral bacteria can make their way into the bloodstream through the bleeding gums. We are just now beginning to realize the extent of the potential for problems in other organs systems. And too many people still accept bleeding gums as normal. Bleeding gums are dangerous.

WIth the numbers of people with gum disease, 50% over age 30, and the delaying of childbirth by so many women, we need to be more diligent in our explanations of the need for good oral health to pregnant or potentially pregnant women.

And as I continue to remind all involved, the old paradigm of mechanical debridement, is just not enough to cure an existing bacterial infection. Brushing and flossing helps, but once you are infected, it is just not enough.

There is a happy ending to the story. The mother has had periodontal therapy and has now given birth to a healthy baby

The findings are discussed in the February issue of Obstetrics & Gynecology.

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