Int J Stomatol

Inter J Stomatol ›› 2018, Vol. 45 ›› Issue (5): 501-508.doi: 10.7518/gjkq.2018.05.002

• Young Experts’ Views • Previous Articles     Next Articles

The treatment strategy of periodontal disease during pregnancy

Changchang Ye1(),Lei Zhao1,Dongqing Wang2,Xiaoli Wang3,Haiyan Wang4,Meng You5,Ping Huang1,Yafei Wu1   

  1. 1. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Periodontology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
    2. Dept. of Periodontology, Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China
    3. Dept. of Gynaecology and Obstetrics, West China Women’s and Children’s Hospital, Sichuan University, Chengdu 610041, China
    4. Dept. of Oral Medicine, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200011, China
    5. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Radiology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2018-01-22 Revised:2018-06-07 Online:2018-09-01 Published:2018-09-20
  • Contact: Changchang Ye E-mail:yechang111@163.com
  • Supported by:
    This study was supported by National Natural and Science Foundation of China(81600875);Chengdu Science and Technology Bureau(2015-HM01-00088-SF);National key clinical specialist construction programs of China (2010)

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Abstract:

Periodontal disease was a risk factor for adverse pregnancy outcomes. Periodontal treatment during pregnancy will benefit for controlling local and systemic inflammation, even prevent the incidence of adverse pregnancy outcomes. This article reviews the causes, treatment principles and precautions of periodontal disease during pregnancy, hoping to provide some new clinical ideas for the diagnosis and treatment of periodontal diseases during pregnancy.

Key words: periodontal disease, adverse pregnancy outcomes, drugs in pregnancy, periodontal treatment

CLC Number: 

  • R781.4

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Fig 1

The possible mechanism of how periodontal disease affect pregnancy outcomes"

Fig 2

Treatment of a gingivitis during pregnancy"

Fig 3

An epulis during pregnancy resected by using Nd-YAG Laser"

Tab 1

Drugs and their U.S. FDA classification of oral treatment"

药物 分级 使用提示
维生素类、枸橼酸类 A：动物实验和临床观察未见对胎儿有损害,是最安全的一类。 可安全使用
青霉素类、部分头孢类、对乙酰氨基酚、甲硝唑、利多卡因 B：动物实验中显示对胎仔有危害,但临床研究未能证实,或动物实验未发现有致畸作用,但无临床验证资料。 有明确指征时慎用
氧氟沙星、阿司匹林、阿替卡因 C：仅在动物研究中证实对胎仔有致畸作用或者杀胚胎作用,但人类研究缺乏资料证实。 在确有应用指征时,充分权衡利弊后决定是否选用
米诺环素、卡马西平、碘制剂 D：临床有一定资料表明对胎儿有危害的迹象,但治疗孕妇疾病的疗效肯定,又无代替之药物,其效益明显超过其危害时,再考虑使用。 避免使用,但在确有应用指征,且患者受益大于风险时选用
利巴韦林 X：动物或人的研究中已证实对胎儿有危害,为妊娠期禁用的药物。 禁用

Fig 4

The ideal strategy for pregnant patients visit dental clinic"

[1] 国家卫生和计划生育委员会办公厅. 早产儿保健工作规范[J]. 中华围产医学杂志, 2017(6):401-406.
doi: 10.3760/cma.j.issn.1007-9408.2017.06.001
General office of the national health and family planning commission. Health care standards for premature infants[J]. Chin J Perinat Med, 2017(6):401-406.
doi: 10.3760/cma.j.issn.1007-9408.2017.06.001
[2] Offenbacher S, Katz V, Fertik G , et al. Periodontal infection as a possible risk factor for preterm low birth weight[J]. J Periodontol, 1996,67(10):1103-1113.
doi: 10.1902/jop.1996.67.10s.1103
[3] Hasegawa K, Furuichi Y, Shimotsu A , et al. Associa-tions between systemic status, periodontal status, serum cytokine levels, and delivery outcomes in pregnant women with a diagnosis of threatened premature labor[J]. J Periodontol, 2003,74(12):1764-1770.
doi: 10.1902/jop.2003.74.12.1764
[4] Ye C, Katagiri S, Miyasaka N , et al. The anti-phos-pholipid antibody-dependent and independent effects of periodontopathic bacteria on threatened preterm labor and preterm birth[J]. Arch Gynecol Obstet, 2013,288(1):65-72
doi: 10.1007/s00404-013-2741-z
[5] Sugita N, Kobayashi T, Kikuchi A , et al. Immuno-regulatory gene polymorphisms in Japanese women with preterm births and periodontitis[J]. J Reprod Immunol, 2012,93(2):94-101.
doi: 10.1016/j.jri.2012.01.005 pmid: 22382006
[6] Lohsoonthorn V, Qiu CF, Williams MA , Maternal se-rum C-reactive protein concentrations in early preg- nancy and subsequent risk of preterm delivery[J]. Clin Biochem, 2007,40(5/6):330-335.
doi: 10.1016/j.clinbiochem.2006.11.017
[7] Stadelmann P, Alessandri R, Eick S , et al. The poten-tial association between gingival crevicular fluid infla-mmatory mediators and adverse pregnancy outcomes: a systematic review[J]. Clin Oral Investig, 2013,17(6):1453-1463.
doi: 10.1007/s00784-013-0952-0
[8] Swati P, Thomas B, Vahab SA , et al. Simultaneous detection of periodontal pathogens in subgingival plaque and placenta of women with hypertension in pregnancy[J]. Arch Gynecol Obstet, 2011,285(3):613-619.
[9] León R, Silva N, Ovalle A , et al. Detection of Por-phyromonas gingivalis in the amniotic fluid in preg-nant women with a diagnosis of threatened premature labor[J]. J Periodontol, 2007,78(7):1249-1255.
doi: 10.1902/jop.2007.060368
[10] Han YW, Redline RW, Li M , et al. Fusobacterium nucleatum induces premature and term stillbirths in pregnant mice: implication of oral bacteria in preterm birth[J]. Infect Immun, 2004,72(4):2272-2279.
doi: 10.1128/IAI.72.4.2272-2279.2004
[11] Ercan E, Eratalay K, Deren O , et al. Evaluation of periodontal pathogens in amniotic fluid and the role of periodontal disease in pre-term birth and low birth weight[J]. Acta Odontol Scand, 2012,71(3/4):553-559.
[12] Figuero E , Carrillo-de-Albornoz A, Herrera D, et al. Gingival changes during pregnancy: Ⅰ. Influence of hormonal variations on clinical and immunological parameters[J]. J Clin Periodontol, 2010,37(3):220-229.
doi: 10.1111/cpe.2010.37.issue-3
[13] Jensen J, Liljemark W, Bloomquist C , The effect of female sex hormones on subgingival plaque[J]. J Periodontol, 1981,52(10):599-602.
doi: 10.1902/jop.1981.52.10.599 pmid: 6946202
[14] Gürsoy M, Haraldsson G, Hyvönen M , et al. Does the frequency of Prevotella intermedia increase during pregnancy[J]. Oral Microbiol Immunol, 2009,24(4):299-303.
doi: 10.1111/j.1399-302X.2009.00509.x pmid: 19572891
[15] Yokoyama M, Hinode D, Yoshioka M , et al. Relation- ship between Campylobacter rectus and periodontal status during pregnancy[J]. Oral Microbiol Immunol, 2007,23(1):55-59.
doi: 10.1111/j.1399-302X.2007.00391.x pmid: 18173799
[16] Jain K, Kaur H , Prevalence of oral lesions and mea-surement of salivary pH in the different trimesters of pregnancy[J]. Singapore Med J, 2015,56(1):53-57.
doi: 10.11622/smedj.2015010
[17] 吴亚菲 . 女性牙周炎患者的临床诊疗[J]. 中华口腔医学杂志, 2017,52(2):75-76.
doi: 10.3760/cma.j.issn.1002-0098.2017.02.004
Wu YF . Interpretation of consensuses on treatment of female patients with periodontal disease[J]. Chin J Stomatol, 2017,52(2):75-76.
doi: 10.3760/cma.j.issn.1002-0098.2017.02.004
[18] 孟焕新 . 牙周病学[M]. 4版. 北京: 人民卫生出版社, 2012: 154-156.
Meng HX. Periodontology[M]. 4th ed. Beijing: Peo-ple’s Medical Publishing House, 2012: 154-156.
[19] Miyazaki A, Yamaguchi T, Nishikata J , et al. Effects of Nd: YAG and CO2 laser treatment and ultrasonic scaling on periodontal pockets of chronic periodon-titis patients[J]. J Periodontol, 2003,74(2):175-180.
doi: 10.1902/jop.2003.74.2.175
[20] Renvert S, Roos-Jansåker AM, Claffey N , Non-surgi- cal treatment of peri-implant mucositis and peri-implan- titis: a literature review[J]. J Clin Periodontol, 2008,35(8 Suppl):305-315.
[21] FDA/CDER SBIA Chronicles. Drugs in pregnancy and lactation: improved benefit-risk information[EB/OL]. ,[ 2015-07-22].
[22] Chacko M, Bhide SV , Carcinogenicity, perinatal car- cinogenicity and teratogenicity of low dose metroni-dazole (MNZ) in Swiss mice[J]. J Cancer Res Clin Oncol, 1986,112(2):135-140.
doi: 10.1007/BF00404396
[23] Schwebke JR , Metronidazole: utilization in the obs-tetric and gynecologic patient[J]. Sex Transm Dis, 1995,22(6):370-376.
doi: 10.1097/00007435-199511000-00009
[24] Czeizel AE, Rockenbauer M , A population based case-control teratologic study of oral metronidazole treatment during pregnancy[J]. Br J Obstet Gynaecol, 1998,105(3):322-327.
doi: 10.1111/bjo.1998.105.issue-3
[25] Bonthius DJ, West JR , Aspirin augments alcohol in restricting brain growth in the neonatal rat[J]. Neuro-toxicol Teratol, 1989,11(2):135-143.
doi: 10.1016/0892-0362(89)90052-4 pmid: 2733652
[26] Xu TT, Zhou F, Deng CY , et al. Low-dose Aspirin for preventing preeclampsia and its complications: a Meta-analysis[J]. J Clin Hypertens (Greenwich), 2015,17(7):567-573.
doi: 10.1111/jch.12541 pmid: 25833349
[27] Mazaud-Guittot S, Nicolaz CN, Desdoits-Lethimonier C , et al. Paracetamol, aspirin, and indomethacin induce endocrine disturbances in the human fetal testis capa- ble of interfering with testicular descent[J]. J Clin Endocrinol Metab, 2013,98(11):E1757-E1767.
doi: 10.1210/jc.2013-2531
[28] Penfold JL, Pearson CC, Savage JP , et al. Iodide in- duced goitre and hypothyroidism in infancy and child- hood[J]. Aust Paediatr J, 1978,14(2):69-73.
[29] Senior B, Chernoff HL , Iodide goiter in the newborn[J]. Pediatrics, 1971,47(3):510-515.
pmid: 4251257
[30] Herbst AL, Selenkow HA , Hyperthyroidism during pregnancy[J]. N Engl J Med, 1965,273(12):627-633.
doi: 10.1056/NEJM196509162731203
[31] U.S. Food and Drug Administration. Potassium io-dide as a thyroid blocking agent in radiation emer-gencies[EB/OL]. ,[ 2017-09-10].
[32] Sinclair SM, Jones JK, Miller RK , et al. The ribavirin pregnancy registry: an interim analysis of potential teratogenicity at the mid-point of enrollment[J]. Drug Saf, 2017,40(12):1205-1218.
doi: 10.1007/s40264-017-0566-6
[33] U.S. National Library of Medicine. The Ribavirin pregnancy registry (RPR)[EB/OL]., [2018-03-16]
[34] 藤井彰, 秋本芳明 . 新妊娠授乳妇的齿科治疗和药物疗法[M]. 2版. 东京: 砂书房, 2010: 34-45.
Fujii A, Akimoto Y . New dental treatment and drug therapy for pregnancy and lactation[M]. 2nd ed. Tokyo: Shashobo, 2010: 34-45.
[35] Lee JM, Shin TJ , Use of local anesthetics for dental treatment during pregnancy; safety for parturient[J]. J Dent Anesth Pain Med, 2017,17(2):81-90.
doi: 10.17245/jdapm.2017.17.2.81 pmid: 28879335
[36] United Nations Scientific Committee on the Effects of Atomic Radiation. Sources and effects of ionizing radiation[EB/OL]. ,[ 2008-05-12].
[37] Charles M , United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) Effe-cts of Ionizing Radiation. UNSCEAR 2006 Report to the General Assembly, with scientific annexes United Nations: New York[J]. Rad Prot Dosimet, 2010,138(2):187-189.
doi: 10.1093/rpd/ncp262
[38] Gibbs SJ , Effective dose equivalent and effective dose: Comparison for common projections in oral and maxillofacial radiology[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2000,90(4):538-545.
doi: 10.1067/moe.2000.109189
[39] European commission. European guidelines on ra-diation protection in dental radiology.The safe use of radiographs dental practice[EB/OL]. , [2016-11-26].
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