Periodontal Disease & Pregnancy

The Challenge:

The patient is expressing oral inflammation and is pregnant. The clinical signs of periodontal disease due to pathogenic bacteria look identical to the clinical signs produced by pregnancy hormones.

The Background:

• Age: 34
• Sex: Female
• Medical History: 21 weeks pregnant, no history of tobacco use
• Home Care: Brushing 2 x day and occasional flossing
• Clinical Assessment: Moderate bleeding on probing
• Periodontal Assessment: Generalized 3-4 mm probe depths with marginal inflammation

Additional Comments: Increase recall during pregnancy

The Solution:

• Date of Pre MyPerioPath^®: 6/14/2018
• Periodontal Therapy: Sub & supra debridement, irrigation with chlorhexidine & periodontal laser (SiroLaser) on 6/14/2018
• Systemic Antibiotic Use: Metronidazole 500 mg bid for 8-10 days was prescribed on 6/19/2018 due to evidence that Fn can complicate pregnancies. However, the patient never started or completed the course.
• Home Care Instruction: Increase brushing & flossing instruction
• Date of MyPerioProgress^® (post-therapy test): 10/31/2018

The Result:

The patient, still pregnant, returned on 9/26/2018 for adult prophylaxis. The clinical improvements included generalized knife-edge margins with localized light bleeding on scaling. The patient reported that she had started to floss daily and brush 2 x day. When asked about taking the systemic antibiotic, the patient stated that she did not take the Metronidazole as she was apprehensive due to pregnancy.

A post MyPerioPath^®, aka MyPerioProgress^®, was collected post-partum 10/31/2018. The results revealed a dramatic reduction of pathogen load by 43% with Td below the limit of quantification, Tf reduced by 1 log, and Fn reduced by 2 logs. It was decided to wait and secure the specimen post-partum because I wanted to see the change in pathogen load after delivery.

About the Author:

Carmeliza dela Paz received her undergraduate degree with a Bachelor of Science from Regis College in 1991 and completed her doctorate in dental sciences at University of Colorado Health Science Center in 1998. In her spare time, she enjoys reading especially international and domestic news tinkering around, and playing fantasy football. Her favorite football team is the Denver Broncos. Dr. dela Paz will help you understand the Mouth-Body Connection and how to bring you to a healthier and happier smile.