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Preterm Births and Periodontitis Does Periodontal Therapy Work?

Preterm Births and Periodontitis Does Periodontal Therapy Work?. Marjorie Jeffcoat DMD Dean University of Pennsylvania School of Dental Medicine. Periodontitis and Pregnancy. Why is preterm delivery important. Major cause of neonatal death

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Preterm Births and Periodontitis Does Periodontal Therapy Work?

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  1. Preterm Births and PeriodontitisDoes Periodontal Therapy Work? Marjorie Jeffcoat DMD DeanUniversity of Pennsylvania School of Dental Medicine

  2. Periodontitis and Pregnancy

  3. Why is preterm delivery important • Major cause of neonatal death • Causes nearly half of long-term neurologic morbidity

  4. Pre term delivery and low birth weight

  5. What defines a preterm low birth weight baby • A baby born during or before the 36th week of gestation (one week before full term) and weighing less than 2,500 grams (5 pounds, 8ounces)

  6. How does low birth weight affect a baby • Low birth weight babies may face serious health problems such as: • Respiratory distress syndrome (RDS) • Anemia • Jaundice • Mental retardation • Cerebral palsy • Impaired lung function, sight and hearing • Intracranial hemorrhage • Malnutrition • Congestive heart failure

  7. What causes low birth weight • Some of the known causes include: • Prior preterm births • Cigarette smoking • Alcohol • Multi fetal pregnancies • Mother’s medical problems • An abnormal placenta, uterus or cervix

  8. Prospective Studies: Periodontitis and PTB • Jeffcoat et al >3000 patients examined • 22 weeks • Periodontal exams • O.B. exams • Determine preterm or not preterm after delivery

  9. Other studies • Literature since 1996 • Must be case control or longitudinal • Must have appropriate outcomes • Periodontal exams prepartum • Range of periodontal disease and PTB • Appropriate statistics

  10. Other studies - results • 11 studies • 10 studies show an association • These studies involve 5686 subjects • 101 subjects in the negative study

  11. NO Do case-control and prospective studies provide convincing evidence that treatment of periodontitis will reduce the risk of preterm birth

  12. Intervention Studies • Can demonstrate that treating periodontitis reduces the risk of preterm birth

  13. Intervention studies <37 weeks

  14. Intervention studies <35 weeks

  15. GA by treatment group

  16. GA by treatment groupp<0.05

  17. Length of stay vs Gestational Age

  18. Fewer neonatal days with treatment

  19. Why the differences? • Very different prevalence of more severe periodontal disease • Very different proportions of African American women in different studies • These issues are important because effect is greatest at smaller GA which happen with a lower prevalence • Sample size

  20. Length of stay vs Gestational Age

  21. Costs of prematurity • Hospital Costs • 15 times the cost of a full term baby • Full Costs include • Hospital Costs • Physicians • Drugs • Loss of productivity

  22. Cost vs Prematurity

  23. Calculating the effect of Periodontal RX on Cost • Take into account • GA • Scaling and root planing • Costs for six months for loss of productivity • Hospitalization for baby and mother • Physican and other charges • Drugs

  24. The results • In these studies nearly $15 million dollars were saved

  25. Watch for more results and think about the results

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