Expectant mothers who have gum disease are less likely to deliver their babies prematurely if they use mouthwash throughout their pregnancy, a new study suggests.
Pregnant women with periodontal disease are known to have more preemies than women with healthy gums. But it's unclear whether that link is causal, and so whether better oral hygiene would make a difference.
The new study, although not ironclad proof, found that regularly using an alcohol-free mouth rinse appeared to cut women's risk of early labour by about 75%.
"I think this is extremely encouraging," said Dr Steven Offenbacher, a professor at the University of North Carolina's School of Dentistry, who was not involved in this study.
How the water-only scored in the test
"We haven't known the best way to manage these patients."
The research team, which included staff and funding from Procter and Gamble, the company that markets the mouthwash used in the study, asked 71 pregnant women with gum disease to rinse twice a day for 30 seconds with Crest Pro Health mouthwash. The mouthwash does not contain alcohol.
They compared the number of pre-term births in this group to 155 pregnant women who also had gum disease, but rinsed only with water.
Among the water-only group, 34 mothers or about one in five delivered their babies before 35 weeks of pregnancy.
Mouthwash works better than water-only
In the mouthwash group, just four mothers delivered their babies prematurely, which is about one in 20 births.
The difference between the groups was just incredible, said Dr Marjorie Jeffcoat, the lead author of the study and a professor at the University Of Pennsylvania School Of Dental Medicine.
But she pointed out that the women knew which treatment they were getting – water or mouthwash, which in principle might have influenced the results.
Dr Jeffcoat's team did not identify why the mouthwash was linked to fewer premature babies, but gum disease might play a role.
Inflammation in gum disease sparks early labour
Inflammation in gum disease involves the hormone-like substance prostaglandin E2, Dr Jeffcoat explained. This same chemical is involved in labour.
Her hypothesis is that gum disease leads to inflammation and more prostaglandin E2 circulating through the body, which might then spark an early labour. On the flip side, by treating the gum disease, women can cut their prostaglandin E2 levels and reduce their risk of going into labour early, she believes.
The study, published online in the American Journal of Obstetrics and Gynaecology, found that mouthwash did appear to help the gum disease.
Aggressive cleaning safe for mothers to be
Mothers who didn't use the mouthwash had more inflammation and sites along the gums where the tissue would bleed.
Aggressive teeth-cleaning is also used to fight gum disease during pregnancy, and a study found that the procedure appeared to be safe for expectant mothers. But whether it has an effect on pre-term births is still unclear.
"We are seeing that those types of treatments are usually not adequate to prevent mothers from getting worse during pregnancies," Offenbacher told Reuters Health.
Soft toothbrush for pregnant women
Mouthwash is a less-invasive alternative to teeth cleaning, and it typically costs less than R60 a bottle.
Both dentists agreed it's important for pregnant women to take care of their oral health.
"They need to use a soft toothbrush and floss the right way," wrapping the floss around the tooth, Dr Jeffcoat told Reuters Health earlier this year. "The first goal with almost all dental disease is prevention, prevention, prevention."
(Reuters Health, July 2011)