Clean teeth linked to healthy newborns Study involves 2nd trimester cleaning for expectant moms October 30, 2003 By Lois M. Collins Desert Morning News Research shows pregnant women who have their teeth cleaned in the second trimester appear less likely to have premature, low-birthweight babies — and the Utah Department of Health is enrolling pregnant Medicaid participants to help figure out why. Tara Boice talks with Dr. Ben Leaver before getting her teeth cleaned as part of a study to find out why such a cleaning apparently makes mothers less likely to give birth to premature, low-birthweight babies. Tom Smart, Desert Morning News Gum disease may cause babies to be born too soon and too small, putting them at significant risk of complications and long-term health problems. Margaret Palmer, who's expecting a baby in March, and Tara Boice, due in January, are both on Medicaid and said they welcome the chance to do something to help ensure they have healthy babies. They both had their teeth professionally cleaned Wednesday. It's not easy for pregnant women to sort through all the advice they get, Boice said, and she was initially not sure whether dental work should be put off during pregnancy. "I always felt you were not supposed to go" while you're pregnant, Palmer said. Also, when money is tight, teeth cleaning is something she's gone without. None of her three previous children have been born preterm, but she said the teeth-cleaning issue has her concerned. Dr. Steven Steed from the state health department's Oral Health Program said the advantages of getting dental care outweigh any small risks during pregnancy. Patient and dentist together should decide which X-rays are appropriate and what treatment might be put off until the baby's born. But generally, he said dental offices are very safe. The mechanism of how gum disease affects pregnancy isn't completely understood, said Jana Kettering, health department spokeswoman. But the prevailing theory is the bacteria in gum disease creates a hormone that acts as a jump-start for contractions, triggering early labor. Cleaning teeth in the second trimester seemed to most dramatically reduce preterm births in terms of timing. But it's a good time to get dental care for other reasons as well, Steed said, including patient comfort — the first and third trimesters are generally the most uncomfortable, and women often experience morning sickness during the early stages. "I try to emphasize that oral health is integral to general health, and certainly during pregnancy there's a heightened need to be sure there aren't problems," Steed said. Over the next few months a pilot study will offer dental examinations, treatment of decayed teeth and thorough teeth cleaning (at the Health Department's Family Dental Plan Clinics) to at least 500 pregnant women who live in Salt Lake and Davis Counties. Birth data of the women who participate will then be compared to those who don't participate. The pilot study may later be expanded to include all pregnant Medicaid recipients in the state. Even those who don't qualify for the study can receive a dental examination and treatment, said Andrea Hight, Utah Medicaid Family Dental Plan administrator. Though Utah's Medicaid program generally restricts dental care for adults to emergency care and extractions, pregnant women have access to both preventive and restorative dental care. Because of that, the study won't increase costs in the Medicaid program or force reductions elsewhere. The department will gather information on other factors impacting preterm births including tobacco use, obesity, alcohol consumption, age and whether a mother has had other premature babies.

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