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Oral Health Surveys: Basic Methods

Fusobacterium nucleatum: a commensal-turned pathogen

https://www.astdd.org/docs/Xiong2006periopregnancy.pdf

Periodontal disease and adverse pregnancy outcomes: a systematic review

Objective This review evaluates the effectiveness of quality improvement (QI) strategies in reducing disparities in health and health care. Data sources We identified papers published in English between 1983 and 2011 from the MEDLINE® database, the Cumulative Index of Nursing and Allied Health Literature (CINAHL), Web of Science Social Science Index, and PsycINFO. Review methods All abstracts and full-text articles were dually reviewed. Studies were eligible if they reported data on effectiveness of QI interventions on processes or health outcomes in the United States such that the impact on a health disparity could be measured. The review focused on the following clinical conditions: breast cancer, colorectal cancer, diabetes, heart failure, hypertension, coronary artery disease, asthma, major depressive disorder, cystic fibrosis, pneumonia, pregnancy, and end-stage renal disease. It assessed health disparities associated with race or ethnicity, socioeconomic status, insurance status, sexual orientation, health literacy/numeracy, and language barrier. We evaluated the risk of bias of individual studies and the overall strength of the body of evidence based on risk of bias, consistency, directness, and precision. Results Nineteen papers, representing 14 primary research studies, met criteria for inclusion. All but one of the studies incorporated multiple components into their QI approach. Patient education was part of most interventions (12 of 14), although the specific approach differed substantially across the studies. Ten of the studies incorporated self-management; this would include, for example, teaching individuals with diabetes to check their blood sugar regularly. Most (8 of 14) included some sort of provider education, which may have focused on the clinical issue or on raising awareness about disparities affecting the target population. Studies evaluated the effect of these strategies on disparities in the prevention or treatment of breast or colorectal cancer, cardiovascular disease, depression, or diabetes. Overall, QI interventions were not shown to reduce disparities. Most studies have focused on racial or ethnic disparities, with some targeted interventions demonstrating greater effect in racial minorities--specifically, supporting individuals in tracking their blood pressure at home to reduce blood pressure and collaborative care to improve depression care. In one study, the effect of a language-concordant breast cancer screening intervention was helpful in promoting mammography in Spanish-speaking women. For some depression care outcomes, the collaborative care model was more effective in less-educated individuals than in those with more education and in women than in men. Conclusions The literature on QI interventions generally and their ability to improve health and health care is large. Whether those interventions are effective at reducing disparities remains unclear. This report should not be construed to assess the general effectiveness of QI in the health care setting; rather, QI has not been shown specifically to reduce known disparities in health care or health outcomes. In a few instances, some increased effect is seen in disadvantaged populations; these studies should be replicated and the interventions studied further as having potential to address disparities.

Closing the quality gap: revisiting the state of the science (vol. 3: quality improvement interventions to address health disparities).

Comparison of different tissue-derived stem cell sheets for periodontal regeneration in a canine 1-wall defect model.

According to many studies, generalised periodontitis can be a risk factor for preterm birth (PB). A case-control study was carried out to examine if early localised periodontitis could be a risk factor for adverse pregnancy outcome. Material and Methods: Postpartum women without any systemic disease were included into the study. Similar numbers of patients belonged to the case (41) and to the control (44) groups. A PB case was defined if a patient had a threatening premature labour during pregnancy, preterm premature rupture of membranes, or spontaneous preterm labour, and/or the weight of the newborn was ≤2499 g. Control women had delivery after the 37th gestational week and the newborn's weight was ≥2500 g. Known risk factors like smoking, alcohol, drug consumption, socio-economic status and the periodontal status were recorded. Results: A significant association was found between PB and early localised periodontitis of the patient with the following criterion having bleeding at ≥50% of the examined sites (6 at each tooth) and having at least at one site ≥4 mm probing depth (p = 0.001). The odds ratio was 5.46 at the 95% confidence interval. The average weight of the newborns in the periodontitis group was less than in the control group, the difference is significant (p = 0.047). Conclusion: The results indicate that early localised periodontitis of the patient during pregnancy can be regarded as an important risk factor for PB.

A possible association between preterm birth and early periodontitis. Pilot study

Background: A case–control study was undertaken to detect whether initial chronic localized periodontitis could be a risk factor for preterm birth (PB) and foetal growth restriction. Methods: A PB case was defined if a patient had a threatening premature event during pregnancy pre-term premature rupture of membranes, or spontaneous pre-term delivery, before the 37th week of pregnancy, and/or the weight of the newborn was o2500 g. Into the PB (case) group, 77 women were allocated, while 84 were included in the control group, all of whom had delivery after the 37th gestational week and with a newborn weighing X2500 g. Results: A significant association was found between PB and initial chronic localized periodontitis, the criteria being bleeding at X50% of the examined teeth and having at least at one site at X4 mm probing depth (p 5 0.0001). The adjusted odds ratio for initial chronic localized periodontitis was 3.32, 95% CI: 1.64–6.69. The average weight of newborns of mothers with periodontitis was significantly less than that of the women without periodontitis (p 5 0.002). Conclusions: The results support the hypothesis that initial chronic localized periodontitis of pregnant women could lead to PB, and birth-weight reduction.

Possible association between mother's periodontal status and preterm delivery

There is growing evidence that chronic periodontitis may be a risk factor for pre-term birth. The goal of this intervention study was to determine the effect of periodontal treatment on the pregnancy outcome in women with threatening pre-term birth and initial localized chronic periodontitis. Forty-one women with a singleton pregnancy were enrolled in the study. For this treatment group, oral hygiene instruction and periodontal therapy were provided in the third trimester, while those in the control group (42 persons) did not receive any periodontal treatment. In the treatment group, the mean weight of newborns was 3079.0 g, compared with the control group mean of 2602.4 g. The incidence of pre-term birth and low birthweight in the treatment group was significantly less than in the control group (p = 0.015). Periodontal treatment completed before the 35th week appeared to have a beneficial effect on birth weight and time of delivery.

Benefits of Periodontal Therapy When Preterm Birth Threatens

Distribution of anaerobic bacteria among pregnant periodontitis patients who experience preterm delivery

https://www.hain-diagnostics.com/downloads/mID_studie_cultur_vs_mID_2010.pdf

István Gorzó

Papers

A possible association between preterm birth and early periodontitis. Pilot study

Possible association between mother's periodontal status and preterm delivery

Benefits of Periodontal Therapy When Preterm Birth Threatens

Distribution of anaerobic bacteria among pregnant periodontitis patients who experience preterm delivery

Detection of periodontopathogenic bacteria in pregnant women by traditional anaerobic culture method and by a commercial molecular genetic method.