Third Molars and Progression of Periodontal Pathology During Pregnancy
Purpose
This study was conducted to evaluate the association between third molar periodontal pathology at enrollment and periodontal disease progression during pregnancy.
Patients and Methods
The data were derived from patients in an institutional review board–approved prospective study known as the Oral Conditions and Pregnancy (OCAP) study. Demographic, health behavior, and medical history data were obtained from medical records. Full-mouth periodontal examinations of 6 periodontal probing sites for each visible tooth, including third molars, were conducted at less than 26 weeks of pregnancy and within 72 hours postpartum. The primary outcome variable was periodontal progression (4 or more probing sites with at least a 2 mm increase in probing depth (PD), all at least 4 mm deep), between the enrollment and postpartum examinations. The primary predictor variables at enrollment were at least 1 PD ≥4 mm around the third molars, and the upper tertile of the number of third molar probing sites recorded as bleeding on probing (BOP). Bivariate analyses were performed for baseline characteristics. The χ2 test was used to determine statistical significance (P = .05). Significant variables were included in unconditional logistic multivariable models to derive relative risk ratios (RRs) and 95% confidence intervals (CIs).
Results
Data from enrollment and term were available for 360 subjects with visible third molars (mean age, 27.3 years; standard deviation, 5.5 years). At the postpartum examination, 122 subjects (34%) demonstrated periodontal progression. These subjects included 74 of the 176 subjects (42%) in whom a third molar PD ≥4 mm was detected at baseline and 48 of the 184 (26%) without third molar PD ≥4 mm (P = .001). Periodontal progression was found in 40 of the 77 subjects (52%) who were in the upper tertile of the number of third molar probing sites exhibiting BOP at enrollment versus 82 of the 203 (29%) in the lower tertiles (P = .0002). In multivariable models, either third molar PD ≥4 mm at enrollment (RR = 1.4; 95% CI = 1.1 to 2.0) or third molar bleeding on probing (RR = 1.7; 95% CI = 1.3 to 2.3) was associated with periodontal disease progression.
Conclusion
Third molar periodontal pathology appears to be a significant risk indicator for periodontal disease progression during pregnancy.
⁎Research Applications Specialist, Department of Dental Ecology, School of Dentistry, University of North Carolina, Chapel Hill, North Carolina.
†Senior Resident, Department of Oral and Maxillofacial Surgery, School of Dentistry, University of North Carolina, Chapel Hill, North Carolina.
‡OraPharma Distinguished Professor, Department of Periodontology, School of Dentistry, University of North Carolina, Chapel Hill, North Carolina.
§Distinguished Kenan Professor, Department of Dental Ecology, School of Dentistry, University of North Carolina, Chapel Hill, North Carolina.
∥Associate Professor, Department of Dental Ecology, School of Dentistry, University of North Carolina, Chapel Hill, North Carolina.
¶Dalton L. McMichael Distinguished Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, University of North Carolina, Chapel Hill, North Carolina.
Address correspondence and reprint requests to Dr White: School of Dentistry, Department of Oral and Maxillofacial Surgery, University of North Carolina, CB 7450, Chapel Hill, NC 27599-7450
This study was supported by the National Institutes of Health (grants RO-1-DE-12453 and RR-00046), the American Association of Oral and Maxillofacial Surgery, the Oral and Maxillofacial Surgery Foundation, and the Dental Foundation of North Carolina.
ABSTRACT