Table 3 Oral microbial differences responding to prenatal dental treatment.
From: Oral microflora and pregnancy: a systematic review and meta-analysis
Author (year) | Country, study design | Groups (no. of subjects) | Sample source | Measurement interval | Microorganisms evaluated | Microbial detection methods | Study findings | Quality assessment |
|---|---|---|---|---|---|---|---|---|
Brambillia et al. (1998) | Italy, RCT | Treatment group (33) Dietary counseling + Dental Prophy + systematic fluoride (1 mg per day from the last week of 6th month GA) + daily fluoride and CHX mouth rinse Control group (32) Dietary counseling + Dental Prophy + systematic fluoride (1 mg per day from the last week of 6th month GA) | Unstimulated saliva | T1: 3rd month GA T2: 6th month GA T3: 9th month GA T4: 6 months postpartum T5-T7: 12, 18, 24 months postpartum, respectively | S. mutans | Culturing | A reduction in salivary S. mutans levels in treatment group became significant (p < 0.01) six months after the study began (at T3); S. mutans reduction remained significant (p < 0.001) at the end of the study Children of mothers in treatment group had significantly lower salivary S. mutans levels than those of control-group mothers at 18 months old (p < 0.05) and 24 months old (p < 0.01) | See Fig. 2 |
Mitchell-Lewis et al. (2001)59 | USA, prospective cohort | Treatment group (74) Prenatal Periodontal intervention (Hygiene instruction + full mouth debridement) Control group (90) Postpartum periodontal intervention | Subgingival plaque | Treatment group T1: During pregnancy Control group T1: After delivery | P. gingivalis, P. intermedia, P. nigrescens, B. forsythus, A. actinomycetemcomitans, F. nucleatum, T. denticola, P. micros, C. rectus, E. corrodens, E. nodatum, S. intermedius | DNA-DNA hybridization checkerboard method | Mothers who had pre‐term low birth weight had significantly higher levels of B. forsythus and C. rectus, and elevated counts for the other species examined | Fair |
Offenbacher et al. (2006)60 | USA, RCT | Treatment group (40) SRP + polishing + OHI + sonic power toothbrush during 2nd trimester Control group (34) (Supragingival debridement + manual toothbrush during pregnancy) + (SRP 6 weeks postpartum) | Gingival cervical fluid, subgingival plaque | T1: < 22 weeks GA T2: Postpartum | Red cluster P. gingivalis, T. forsythensis, T. denticola Orange cluster F. nucleatum, P. intermedia, P. nigrescens, C. rectus, A. actinomycetemcomitans | DNA-DNA hybridization checkerboard method | No significant changes from baseline to postpartum in the levels of any single bacterial species or cluster among control mothers P. intermedia and P. nigrescens reduction detected in the treatment group (p < 0.05) A composite score of orange-cluster organisms decreased in treatment group (p = 0.03) | See Fig. 2 |
Novak et al. (2008)61 | USA, RCT | Treatment group (413): SRP before 21 weeks GA Control group (410): SRP after delivery | Subgingival plaque | T1: 13–16 weeks GA T2: 29–32 weeks GA | P. gingivalis, T. denticola, T. forsythia, P. intermedia, C. rectus, F. nucleatum, A. actinomycetemcomitans | Realtime PCR | Women in treatment group had significantly greater reductions (p < 0.01) in counts of P. gingivalis, T. denticola, T. forsythia, P. intermedia, and C. rectus than untreated women | See Fig. 2 |
Volpato et al. (2011)27 | Brazil, prospective cohort | Treatment group (30) Oral Environment Stabilization (atraumatic caries excavation and fillings + extraction of retained roots) | Saliva | T1: Before treatment (70% in 2nd trimester) T2: 1 week after treatment | S. mutans | Culturing | A statistically significant decrease (p < 0.0001) in S. mutans counts between saliva samples before and after oral environment stabilization | Fair |
Jaramillo et al. (2012)29 | Colombia RCT | Pregnant women with preeclampsia (57) Treatment group (26): SRP Control group (31): Supragingival prophy | Subgingival fluid | T1: Before treatment T2: Postpartum | P. gingivalis, P. intermedia, P. nigrescens, T. forsythia, C. rectus, E. Corrodens, D. pneumosintes, A. actinomycetemcomitans | PCR | The detection of assessed microorganisms did not decrease following periodontal treatment in control group and intervention group | See Fig. 2 |
Asad et al. (2018)28 | Pakistan, RCT | Pregnant women with a minimal of 3 decayed teeth Treatment group (32): atraumatic restorative treatment Control group (32): no treatment | Stimulated saliva | T1: Before treatment T2: 1 week after treatment | S. mutans | Realtime PCR | Salivary S. mutans was reduced after the atraumatic restorative treatment (p < 0.001) Salivary S. mutans remained the same level between the two study time point in the control group (p = 0.29) | See Fig. 2 |
Escalante-Medina et al. (2019)62 | Peru, RCT | Treatment group (23): toothpaste with 10% xylitol Control group (22): toothpaste without xylitol | Saliva | T1: Before the use of xylitol toothpaste T2: 14 days after the use of the toothpaste | S. mutans | Culturing | No difference in S. mutans among the pregnant women who used xylitol toothpaste compared to those who used toothpaste without xylitol (p = 0.062) Both toothpastes, with and without xylitol, were effective to decrease the count of S. mutans in the saliva of pregnant women (p = 0.001 and p = 0.005, respectively) | See Fig. 2 |
