A Randomized Controlled Clinical Trial of Prenatal Oral Hygiene Education in Pregnancy-Associated Gingivitis |
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| Authors: | Nicolaas C. Geurs DDS MS Marjorie K. Jeffcoat DMD Nipul Tanna DMD Maria L. Geisinger DDS MS Samuel Parry MD Joseph R. Biggio MD MS Matthew J. Doyle PhD Julie M. Grender PhD Robert W. Gerlach DDS MPH Michael S. Reddy DMD DMSc |
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| Affiliation: | 1. Department of Periodontology, University of Alabama at Birmingham, Birmingham, Alabama;2. Department of Periodontics, University of Pennsylvania, Philadelphia, Pennsylvania;3. Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania;4. Department of Obstetrics and Gynecology, Ochsner Baptist, New Orleans, Louisiana Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA;5. Research & Development, The Procter & Gamble Company, Cincinnati, Ohio;6. School of Dentistry, University of California San Francisco, San Francisco, California |
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| Abstract: | Introduction Research shows there is a significant increase in gingival inflammation during pregnancy. This study was conducted to determine if an oral health intervention (OHI), including oral hygiene education delivered by nurse-led staff and an advanced over-the-counter (OTC) oral home care regimen, improved gingival inflammation in pregnant women with moderate-to-severe gingivitis compared with a standard oral hygiene control group. Methods This was a multicenter, randomized, controlled, single-masked, parallel group clinical trial conducted in obstetrics clinics of 2 medical centers. A total of 750 pregnant women between 8 and 24 weeks of pregnancy with at least 20 natural teeth and moderate-to-severe gingivitis (>30 intraoral bleeding sites) were enrolled. Participants were randomized to either the OHI group, which included oral hygiene instructions supplemented with an educational video and advanced OTC antibacterial/mechanical oral hygiene products, or the control group receiving oral hygiene instructions and standard products. Both groups received oral hygiene instructions from nurse-led staff. Experienced, masked examiners measured whole mouth gingival index (GI) and periodontal probing depths (PDs) at baseline and months 1, 2, and 3. Results Participants enrolled in this study presented with moderate-to-severe gingivitis at baseline. Both the OHI and control groups exhibited significant reductions in GI (P < .001) and PD (P < .03) from baseline that persisted throughout the study period. The OHI group exhibited modest, yet statistically greater, reductions in GI (P ≤ .044) compared with the control at all time points. The reduction in PD directionally favored the OHI group, but between-group differences were small (<0.03 mm) and not statistically significant (P > .18). Discussion Significant gingivitis was prevalent among participants in this study and identifies an opportunity to improve gingival health during pregnancy by providing oral health education during the course of prenatal care when coupled with an advanced OTC oral hygiene regimen. |
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| Keywords: | pregnancy oral health gingivitis inflammation education prenatal care |
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