Pathogens & Pregnancy

By: Dr. Evelyn Chan

December 1, 2017

The Challenge:

Our goal was to treat the periodontal disease and reduce bacterial levels to lessen the impact of her periodontal disease to her potential pregnancy.

The Background:

  • Age: 31
  • Sex: Female
  • Medical History: Patient revealed her family was ready to start to try to become pregnant
  • Last Dental Exam: 6 months ago
  • Chief Complaint: “My gums are swollen and painful.”
  • Periodontal Assessment: Radiographic evidence of horizontal bone loss, heavy generalized subgingival calculus present. Tissue: red and erythematous. Periodontal pockets depths ranged between 5-9 mm. Diagnosed chronic severe periodontal disease

The Solution:

  • Date of MyPerioPath®: 3/22/2017
  • Periodontal therapy: 4 quads of scaling & root planing, irrigation with chlorhexidine and laser decontamination
  • SABX used per MyPerioPath® recommendation
  • Perform MyPerioProgress® (post-therapy test): 6/27/2017

Additional comments: The MyPerioPath® revealed significant levels Fusobacterium nucleatum. This particular bacteria is associated with low birth weights and stillborn babies. (1,2)

The Result:

The patient returned 3 months later for her first periodontal maintenance visit after scaling and root planing. Results from the initial saliva test showed 9 bacterial pathogens present with 7 pathogens above threshold level, including Fn bacteria associated with low birth weight and still born babies.(1, 2) After therapy and antibacterial services, a follow up MyPerioPath®(MyPerioProgress®) was performed to reveal the above threshold pathogens decreased from 7 to 0. The importance of this case and our protocol is that we were able to tell the patient with confidence that her periodontal disease was controlled, and her current bacterial pathogens would not affect her pregnancy. This is an important test to do for any patient planning to become pregnant.

About the Author:

Dr. Chan was born and raised in San Diego and enjoys reading, swimming, yoga, and exploring new places to eat in Denver. She also loves to hike around Rocky Mountain National Park.

References:

  1. Han YW, Houcken W, Loos BG, Schenkein HA, Tezal M. Periodontal disease, atherosclerosis, adverse pregnancy outcomes, and head-and-neck cancer. Adv DentRes 2014;26:47-55.
  2. Andonova I, Iliev V, Zivkovic N, Susic E, Bego I, Kotevska V. Can oral anaerobic bacteria cause adverse pregnancy outcomes? Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2015;36:137-43.