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Dr. Judith Reichman

Q: I'm pregnant and my dentist suggested that I get a deep cleaning. He said it will help prevent premature delivery. Is he right and is it safe?

A: Probably no to the preterm delivery and yes to it’s being safe.

Despite all the research and developments in obstetrics, preterm births ( prior to 37 weeks gestation) are, unfortunately, way too common. They occur in 12.5 percent of births in the U.S. and account for 70 percent of fetal deaths and 50 percent of long-term neurological abnormalities in children.

One of the known risk factors for preterm birth is multiple gestation. (Seen more frequently because of the widespread use of fertility drugs.) In fact, 50 percent of women who are pregnant with twins deliver prematurely. Other risk factors include low socioeconomic status, poor nutritional and low weight status, a history of previous preterm births and infections — in the bladder  kidney,  vagina, appendix, and lungs (pneumonia).  And it was thought that gum infection (periodontal disease) was also at fault.

But in most cases, when a woman delivers prematurely we don't know why. What is known is that infections in any part of the body can cause a system wide or total body state of inflammation. Moreover the infecting organisms in the gums could seed onto the placenta or into the amniotic fluid. In either case the response in the immune system causes the production of factors that “issue forth” to treat the infection. This in turn can affect the integrity of the cervix and the amniotic membranes. The uterine muscle is also more likely to be irritated and contract. So it stands to reason that if we can treat one of the causes of this inflammation (i.e. inflammation of the gums and the base of the teeth) we can eliminate a risk factor for premature delivery.

A study in the November issue of the New England Journal of Medicine looked at the relationship between periodontal infection and pregnancy. It followed 823 pregnant women with periodontal disease who underwent scaling and root planning (cleaning the base of the teeth under the gums). One group of women received this treatment early in their second trimester and the other group had it performed after they delivered (this was the control group — they didn't want to neglect their teeth altogether). The study found that the women who had been having ongoing periodontal disease during pregnancy did not experience a significant increase in births before 37 weeks gestation. Moreover, treating the periodontal disease by the second trimester of pregnancy didn't lower their likelihood of preterm birth.

An editorial on the subject suggested that the treatment might have been too late, and that periodontal disease is “ more strongly associated with late miscarriage, stillbirth and early preterm birth than with preterm birth in general.” If treatment is given, future studies may confirm that it should be given before pregnancy (especially if it effects miscarriage rates).

Finally, the study did find that having these dental treatments in no way disturbed the pregnancy and was safe.

Dr. Reichman’s Bottom Line: If you have periodontal disease that needs to be treated, do so. However, it's probably better to get it done before you're pregnant.

Dr. Judith Reichman, the “Today” show's medical contributor on women's health, has practiced obstetrics and gynecology for more than 20 years. You will find many answers to your questions in her latest book, "Slow Your Clock Down: The Complete Guide to a Healthy, Younger You," which is now available in paperback. It is published by William Morrow, a division of HarperCollins

PLEASE NOTE: The information in this column should not be construed as providing specific medical advice, but rather to offer readers information to better understand their lives and health. It is not intended to provide an alternative to professional treatment or to replace the services of a physician.