Periodontal Disease and Pregnancy Outcome

Abstract

Periodontal diseases are silent infections that often go undiagnosed until irreparable damage occurs to the teeth and oral structures. These chronic oral infections are characterized by the presence of a biofilm matrix that adheres to the periodontal structures and serves as a reservoir for bacteria (plaque). Response of the body toward the bacterial challenge of dental plaque can lead to bone loss and the migration of the junctional epithelium, resulting in periodontal pocketing and periodontal disease. This bacterial insult can result in destruction of the periodontal tissues that precipitates a systemic inflammatory and immune response leading to the release of several cytokines and immunomodulatory agents, which may affect systemic conditions and diseases. The influence of periodontal infection on systemic disease and conditions documented include coronary heart disease (CHD) and CHD-related events such as angina, infarction, atherosclerosis, and other vascular conditions; stroke; diabetes mellitus; preterm labor, low birth weight delivery, and preeclampsia; and respiratory conditions such as chronic obstructive pulmonary disease. Adverse pregnancy outcomes, including preeclampsia, preterm delivery, and intrauterine growth restriction, and fetal demise affect a significant number of pregnancies and are a major source of both maternal and neonatal morbidity and mortality. This chapter highlights the two-way relationship between periodontitis and adverse pregnancy outcome.