Public Health Implications of Chronic Periodontal Infections in Adults

Potential Public Health Implications of Associations Between Periodontitis and Reproductive Outcomes
Susan Reed, DDS, MPH, DrPH, Assistant Professor and Director Dental Public Health and Oral Epidemiology Section, Department of Stomatology and the Department of Biometry, Bioinformatics, & Epidemiology, Medical University of South Carolina, Charleston, South Carolina

Preterm birth is a major public health problem under investigation. Medical care costs total an estimated $5 billion annually for approximately 467,000 preterm births in the United States. That is an average of $10,706 per preterm birth. In 2000, 11.6% of infants were born preterm in the United States. That rate translates into nearly 1,300 preterm deliveries each day for the 4,058,808 babies born in the United States in 2000. Between 1991 and 2000, the percentage of all U.S. babies born preterm increased more than 7%. Major risk factors for preterm birth include multiple births, history of preterm delivery, stress, infection, bleeding, smoking, illicit drugs, and maternal age extremes.

The role of infection, specifically periodontal infection, in reproductive outcomes is explored in today’s presentations. As described in the Institute of Medicine report, public health efforts include a description of the problem, regular data collection and dissemination, promotion of scientific knowledge in decision making on policy matters, and assurance that services necessary to achieve the goals are available. Thus, studies are needed to better describe the inflammatory and host responses and also the role of periodontitis microbes in preterm births. Periodontal infections are preventable and treatable. Periodontitis can be viewed as a modifiable risk factor, and pilot intervention studies provide evidence that does not indicate an increase in the rate of adverse obstetric events associated with dental treatment during pregnancy. Evidence from some studies supports periodontal treatment as a means to reduce preterm births. The implication for dental care professionals is to learn or unlearn old practices, and then relearn how to best care for pregnant women.

The American Academy of Periodontology recommends that a periodontal evaluation be included as part of prenatal care. Implications for the pregnant woman suggest that preventing periodontal disease is the better option; however, she can safely receive periodontal treatment. The Healthy People 2010 objectives include reducing low birth-weight from 7.6% to 5.0% of births and reducing preterm births from 11.6% to 7.6%. The association of periodontitis and preterm births suggest the potential merit of conducting additional studies of infection, host response, and preterm births as well as additional intervention studies.

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Page last reviewed: February 2, 2005
Content source: Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion